All Conditions

Major Depressive Disorder.

A persistently low mood that drains energy, joy and motivation.

Major depressive disorder (or clinical depression) is one of the most common psychological conditions, with a lifetime prevalence rate of 5 to 17%. This disorder is characterized by a persistently low mood that lasts at least two weeks, and a loss of interest in activities that were previously enjoyed. This can often start a cycle that becomes very difficult to break out of, since the depressed person finds it very hard to perform the very activities that could previously help improve their mood. Loss of energy and motivation can make it further complicated to seek help and break out of this cycle. Clinical depression can slowly take over every aspect of a person’s life, causing changes in their sleep, appetite, self-care, work and socialising habits etc. A person suffering from this condition may have thoughts of harming themselves or attempting suicide to escape the emotional pain they are in. While it may be tough to point to a singular cause that can make a person depressed, often an interplay of genetics, environmental factors and difficult life circumstances can trigger this condition.

When to seek help

While it is normal to experience low moods every once in a while, it becomes imperative to seek help when a depressed mood lasts longer than two weeks and does not seem to go away even when you are partaking in activities you used to enjoy. Clinical depression can cause a person to feel worthless and take on guilt for their own suffering, which makes it harder to seek professional help. If you suspect that you may be struggling with major depressive disorder, it is important to know that this condition is not your fault, and that it may be managed with a combination of medication and therapy.

How we can help

Self-assessment scales

These are the same validated scales clinicians use. Your answers stay on your device and take a few minutes.

Common questions

How do I know if what I'm feeling is depression or just a rough patch?
Sadness in response to loss, stress, or disappointment is normal, and it usually shifts as the situation does. Major depressive disorder is more pervasive and more persistent. The threshold is low mood and loss of interest most of the day, nearly every day, for at least two weeks, together with other features such as sleep changes, appetite changes, fatigue, or thoughts of self-harm. If you cannot engage with things that used to matter to you, even when nothing in particular is wrong, it is reasonable to talk to a clinician about it.
Will I have to be on antidepressants forever?
After a first episode, the standard recommendation is to stay on antidepressants for at least six to nine months after symptoms remit, in order to reduce the risk of early relapse [1]. After a second or third episode, longer-term or indefinite treatment is often considered because the relapse risk climbs with each episode. Many people taper off successfully when the time is right, while others find that life works better with ongoing medication. The decision about how long to stay on treatment is best made with your prescriber over time, based on how you respond and how stable you remain.
How do antidepressants and therapy compare?
For mild to moderate depression, therapy alone (especially CBT or interpersonal therapy) tends to work about as well as medication. For moderate to severe depression, the combination usually outperforms either approach on its own. Antidepressants typically begin to work in two to four weeks, with full effect by eight to twelve. Therapy is slower to take hold but tends to leave behind skills and insights that reduce the risk of relapse after treatment ends. Many people benefit most from sequencing both at different points in their care.
I'm having thoughts of suicide. Does that mean I need hospitalization?
Not always. The clinical question is whether you have intent and a plan, and whether you can stay safe at home with outpatient treatment, family support, and access to a crisis line. Many people experience suicidal thoughts (sometimes called passive ideation) without acting on them. If you have a specific plan, access to the means to act on it, or you feel you cannot keep yourself safe, that is the threshold for emergency care. If you are uncertain, tell a clinician. They are trained for this conversation and will not react with shock.

References

  1. Practice Guideline for the Treatment of Patients with Major Depressive Disorder, Third Edition — American Psychiatric Association
  2. Depression — National Institute of Mental Health

Written by

Marium Nasir · MS Clinical Psychology (NUST), C-DBT certified

Clinically reviewed

Dr. Zuhaib Ali · MBBS, FCPS (Psych)

Last reviewed 29 April 2026