When everything feels heavy, seeking help is also a way forward
Psychological assessment and treatment to understand low mood, regain activity, rebuild support and move forward with realistic goals.
Not all sadness is depression, but persistent suffering should not be minimised
Duration, intensity, change from usual functioning and impact on work, studies, relationships, sleep, eating, self-care and capacity for enjoyment are considered.
Sadness, emptiness or irritability
Persistent distress, disconnection, crying or irritability that is difficult to regulate.
Loss of interest or pleasure
Activities, relationships or projects that used to matter no longer bring motivation or enjoyment.
Tiredness and slowing down
Low energy, difficulty starting tasks, abandoning routines or feeling that everything takes too much effort.
Sleep and appetite
Sleeping too much or too little, waking at night, appetite changes or loss of self-care routines.
Guilt and self-criticism
Feeling worthless, burdensome, guilty for not improving or trapped in past mistakes and failures.
Withdrawal and disconnection
Withdrawing from others, stopping asking for help or feeling that nobody can understand what is happening.
Low energy leads to doing less, and doing less reduces opportunities for relief
Withdrawal is understandable when everything feels difficult. However, reducing activities, relationships and rewarding experiences may maintain low mood.
Start with a first step →Loss, stress, exhaustion or other factors increase distress.
It becomes difficult to start tasks, care for yourself, socialise or maintain routines.
Support, achievement, enjoyment and a sense of capability decrease.
The situation appears to confirm that nothing will change or that trying is not worthwhile.
Before treating, we need to understand what is happening
Similar symptoms may appear in grief, burnout, anxiety, trauma, medical conditions, substance or medication effects, or mood disorders requiring a different approach.
When it began, what changed and how it has developed.
Sleep, eating, work, relationships, self-care and concentration.
Hopelessness, thoughts of death, self-harm, support network and available resources.
Want to put a number on what you feel?
This is the PHQ-9, a brief questionnaire widely used in clinical settings to gauge depressive symptoms. It does not replace a professional assessment, but it can help you decide whether to book an appointment.
Work with activity, thoughts, emotions and environment
The plan is adapted to severity, causes, current functioning, personal resources, support network and therapeutic goals.
Recover routines and meaningful experiences
Plan small steps that increase self-care, connection, achievement and contact with meaningful activities.
Review hopelessness, guilt and self-criticism
Identify rigid interpretations and build more accurate and compassionate ways of responding.
Process loss and rebuild support
Make space for difficult emotions, improve communication and reduce isolation.
Psychotherapy, medical assessment and everyday support may form part of the same plan
In some cases coordination with medical practitioners, psychiatry or other professionals is appropriate. Medication can only be prescribed and supervised by medical professionals.
Suicidal thoughts or immediate risk require action
The clinic is not an emergency service. In immediate danger, call 112 or go to emergency services. In Spain, Line 024 operates 24 hours a day and is free, accessible, immediate and confidential for people with suicidal behaviour, family members and close contacts.