Depression is a common and treatable mood disorder that affects how you feel, think, behave and relate to others. At Ocnos Psychology Clinic, in the Campo de Gibraltar area, we have created this guide to provide clear, reliable information. Most importantly, we want to remind you that seeking help is a strong and effective step.
Table of Contents for this article
Quick summary (30 seconds)
- Depression is not “just feeling sad”: it has clear clinical criteria and can significantly affect daily functioning.
- For many people, it appears as low mood, irritability or emotional numbness, alongside fatigue, sleep or appetite changes and persistent negative thoughts.
- If symptoms last for more than two weeks and interfere with your life, a professional psychological assessment is recommended.
- Effective treatments exist, especially evidence-based psychotherapy and, in some cases, medication prescribed by a doctor.
Important notice
If you are experiencing thoughts of self-harm or suicide, please seek immediate help through emergency services or local crisis lines.
What is depression?
Depression (depressive disorder) is characterised by a persistently low mood and/or a marked loss of interest or pleasure (anhedonia), together with emotional, cognitive and physical symptoms that interfere with everyday life. Therefore, it is not a matter of willpower or personal weakness, but a mental health condition that can be treated.
What happens to a person with depression?
When someone experiences depression, the way they feel, think and behave is significantly affected. However, it does not always look the same. In some cases, sadness is very visible; in others, irritability, exhaustion or physical complaints are more prominent.
Emotional changes
- Persistent sadness, emptiness or hopelessness for most of the day.
- Irritability and low tolerance to frustration (particularly common in adolescents).
- Loss of interest or pleasure in activities that used to feel meaningful.
Changes in thinking
- Negative views about oneself, the world and the future (the depressive cognitive triad).
- Rumination: repetitive thoughts that are difficult to stop.
- Thoughts about death or suicide, sometimes with planning. If this occurs, immediate support is essential.
Physical changes and energy levels
- Intense fatigue and lack of energy, even for small tasks.
- Sleep disturbances: insomnia or sleeping excessively.
- Changes in appetite or weight without intention.
- Recurrent physical pain (headaches, back pain, digestive discomfort) that worsens with low mood.
Behavioural and relational changes
- Social withdrawal and cancelling plans.
- Reduced work or academic performance, increased mistakes or absenteeism.
- Neglect of self-care and increased reliance on unhealthy coping strategies (for example, alcohol).
In short, depression can present in many ways. For this reason, a psychological assessment is the most reliable way to understand what is happening and what type of support is needed.
What causes depression?
From a clinical psychology and psychiatry perspective, depression is understood as a multifactorial condition. In other words, there is no single cause; rather, it develops through the interaction of vulnerabilities and life experiences.
Biological factors
- Genetics: having close relatives with depression increases risk, although it does not determine it.
- Neurobiology: changes in systems involved in mood regulation (such as serotonin, noradrenaline and dopamine) and emotional regulation circuits.
- Physical illness: chronic pain, diabetes, cardiovascular disease and other health conditions can increase vulnerability.
Psychological factors
- Highly self-critical, perfectionistic or rigid thinking styles.
- Early adverse experiences (abuse, neglect, significant losses).
- Limited coping strategies, such as avoidance, rumination or difficulty asking for help.
Social and environmental factors
- Bereavement, relationship breakdowns, unemployment, financial stress or caregiving overload.
- Loneliness, social isolation, discrimination, bullying or violence.
- Prolonged stressful contexts that overwhelm personal resources.
Overall, depression often emerges when these factors exceed a person’s capacity to cope at a particular moment in their life.
How can I tell if I may be depressed?
It is common to wonder whether what you are experiencing is stress, sadness or depression. However, it is advisable to seek a professional opinion if you identify with several of the following:
- Low mood, irritability or emotional numbness almost every day for more than two weeks.
- Difficulty carrying out basic tasks such as working, studying, maintaining routines or self-care.
- A general loss of interest or ability to enjoy things.
- Persistent exhaustion that rest does not relieve.
- Strongly negative thoughts about yourself, the world or the future.
- Thoughts about death or suicide, even if you do not intend to act on them.
A clear answer requires a comprehensive psychological assessment. If you are already considering support, you may wish to explore our approach to depression treatment.
Stages of depression
Although depression does not follow exactly the same course for everyone, clinicians often describe several common phases.
1. Early phase or warning signs
- Increased tiredness.
- Reduced motivation and enjoyment.
- Heightened irritability or emotional sensitivity.
- Mild concentration or memory difficulties.
2. Acute depressive episode
- Clear emotional, cognitive and physical symptoms.
- Noticeable impairment in work, study, social or family life.
3. Response to treatment and remission
- Gradual reduction in symptom intensity and frequency.
- Recovery of routines, relationships and enjoyable activities.
4. Relapse and recurrence
- Relapse: symptoms return before full recovery is consolidated.
- Recurrence: a new episode appears after a longer period of recovery.
What is “silent” or masked depression?
Silent (or masked) depression refers to cases where a person appears to function normally on the outside, while significant distress is experienced internally. This may show up as extreme tiredness, physical complaints, over-activity, rigid self-demands or emotional withdrawal. Early identification can greatly reduce suffering.
Evidence-based treatment for depression
Treatment depends on symptom severity, duration, context and risk level. In most cases, the most effective approaches involve psychotherapy, sometimes combined with medication.
Psychotherapy
- Cognitive Behavioural Therapy (CBT): focuses on thoughts, emotions and behaviours, including behavioural activation.
- Interpersonal Therapy (IPT): addresses relationship difficulties, grief and role transitions.
If you would like to know how we work in practice, you can find more information about our depression treatment service.
Medication
For moderate to severe depression, antidepressant medication may be recommended. This is always prescribed and monitored by a medical professional (psychiatrist or GP).
A message from Héctor Lozano
Héctor Lozano — General Health Psychologist · Professional registration: AN 11777 (Andalusia).
“In therapy, many people ask me whether they are ‘really’ depressed or simply being weak. One of the first things we work on is challenging that belief. Depression is not a character flaw; it is a health condition shaped by biology, life experiences and context.
When self-blame decreases and curiosity and compassion increase, the therapeutic process changes. From there, we can use practical tools: psychoeducation, cognitive-behavioural strategies, activity planning adapted to real energy levels, and when necessary, collaboration with medical professionals.
If there is one message I would like you to take from this article, it is that you do not have to wait until you reach breaking point. If your experience resembles what you have read here, it may be time to ask for help.”
Note: This article is for informational purposes and does not replace an individual clinical assessment. In case of emergency or immediate risk, please contact emergency services.