Everybody has days, sometimes stretches of days, when things feel flat. The motivation is low, the pleasure is quiet, the energy does not quite arrive. That is part of being human.

But there is a point at which low mood becomes something more persistent, more pervasive and more interfering than that. And a great many people who have crossed that point are still telling themselves they are just having a hard time.

This is about the difference between the two, what the signs of depression actually look like, and why they are so often missed, including by the person living with them.

If anything here lands close to home, there is a section at the end on where to find support, and there is no threshold you have to reach first.

What is low mood?

Low mood is a normal emotional response to life. A disappointment, a loss, a difficult week, a grey January. Any of these can bring a period of feeling flat, sad or unmotivated. The world loses some of its colour, socialising stops appealing, and getting out of bed takes more effort than usual.

That is not a disorder. It is emotional weather. Variable, sometimes difficult, but moving. Given time, rest, connection or a change in circumstances, it tends to lift and you feel like yourself again.

The defining feature of ordinary low mood is that it is responsive. It makes sense in context, it shifts when circumstances shift, and even in the middle of it there are usually moments, a good meal, a conversation, a piece of music, when the feeling lifts for a while.

What is depression, and how is it different?

Depression is not an intensified version of low mood. It is a different thing. Clinically it is a persistent low mood or loss of interest that lasts for most of the day, nearly every day, for at least two weeks, and that affects how you function in everyday life.

Two symptoms sit at the centre of it:

• Persistent low mood. A heaviness or sadness that does not lift, even when circumstances are objectively fine.
• Anhedonia. The loss of pleasure or interest in things that used to matter. Not simply not feeling like it. The pleasure itself has gone.

That second one is often the clearest signal. Someone who used to love cooking cannot find a reason to make dinner. Music that used to move them sounds like noise. They are in a conversation with someone they love and feel nothing in particular. That is not laziness or ingratitude. It is a symptom.

Low mood shifts with circumstances. Depression persists through them, including the good ones.

What are the signs of depression?

Depression does not always look the way we expect. It is not always tearfulness or obvious withdrawal. Sometimes it looks like irritability. Sometimes it looks like getting everything done and feeling nothing while doing it. Sometimes, from the outside, it looks like somebody who is fine.

• Persistent low mood that does not lift, most of the day, nearly every day
• Loss of interest or pleasure in things that used to matter: hobbies, relationships, food, sex
• Fatigue that does not improve with rest, a heaviness in the body as well as the mind
• Difficulty concentrating. Brain fog, indecision, forgetting things that would normally be easy
• Changes in sleep. Sleeping far more than usual, or unable to sleep despite exhaustion
• Changes in appetite or weight, eating noticeably more or less than usual
• Feelings of worthlessness or heavy guilt, a persistent critical inner voice
• Slowed movement or speech, often noticed by other people before the person notices it themselves
• Withdrawal. Cancelling plans, going quiet, not answering messages
• Irritability or agitation, particularly common in men and in anyone who does not show sadness outwardly
• Thoughts that life is not worth living. This one is serious and warrants support straight away. There are numbers at the end of this article.

Nobody has all of these. Two people can both be depressed and look nothing like each other. What matters is the persistence, the pervasiveness, and the effect on daily life.

Low mood or depression? A simple comparison

Low mood	Depression
Usually has a clear trigger	May arrive without an obvious cause
Lifts when circumstances improve	Persists even when things are going well
Some moments of relief or pleasure	Pleasure largely absent
Lasts days, or a week or two	Most of the day, nearly every day, for two weeks or more
Functioning reduced but mostly maintained	Functioning noticeably affected: work, relationships, self-care
Often resolves with rest, connection and time	Usually needs support to lift

Why do so many people not realise they are depressed?

Depression is widely underdiagnosed, and a large part of that is that people do not recognise it in themselves. They do not describe themselves as depressed. They assume what they are experiencing is stress, tiredness, getting older, or simply a difficult stretch.

The things people say to themselves tend to be the same:

• “I am just tired.”
• “Everyone feels like this sometimes.”
• “I just need to be stronger.”
• “I have nothing to be depressed about.”
• “Depression is something other people have, not me.”

Without a framework for what is happening, people tend to blame themselves instead. They get frustrated at their own lack of motivation and conclude they should try harder, which is the one thing that reliably makes it worse.

The picture of depression is too narrow

Most people carry an image of depression as somebody who cannot get out of bed and cries every day. That does happen. But depression also hides behind work, responsibilities, humour and competence. Plenty of people go to work, care for their family and manage the household while privately carrying emptiness or emotional exhaustion.

What we were taught about feelings

How somebody understands mental health is shaped by their upbringing, their culture and the messages they received growing up. If you were taught that emotions should be managed privately, that asking for help is weakness, or that difficulty is something to be quietly absorbed, you are considerably less likely to look at your own experience and name it.

It arrives slowly

Depression rarely announces itself. It often develops over months or years. You gradually stop doing things you enjoyed. You see fewer people. Confidence erodes. Tiredness becomes normal. Because each change is small, the overall shift goes unnoticed, including by the people closest to you.

The signs that get missed

High functioning depression

Some people with depression meet every external obligation. They work, they parent, they reply to messages. From the outside they look fine. Inside they are running on empty, performing the motions of a life without feeling any of it. This is particularly common in people who learned early to manage their feelings quietly and not bring difficulty to anybody else.

Depression as irritability

In men especially, though not only in men, depression often presents as irritability, a short fuse, or restlessness rather than sadness. The person does not feel low so much as flat, frustrated, and unable to tolerate small things. It gets missed because it does not match the cultural picture.

Depression in the body

In many communities, including East Asian, South Asian, African, Middle Eastern and Eastern European backgrounds, depression is expressed physically rather than emotionally. Persistent headaches, stomach problems, fatigue and pain with no clear medical cause can all be depression carried in the body. That is not dismissive. It is the body holding what the mind has not yet found words for, and in some languages there is no straightforward word to find.

Depression does not always look like crying. Sometimes it looks like somebody who is fine, and exhausted by being fine.

What does it do to the rest of life?

Relationships. Social contact starts to feel expensive, so people withdraw. They become less communicative, more easily hurt, more distant. Those around them often read this as not caring, when the truth is the opposite and entirely invisible from the outside.

Work. Concentration, decision making, motivation and energy all take a hit. Tasks that used to be routine take longer. Performance slips. Each day feels like something to be pushed through. Over time that feeds burnout, falling confidence and a growing sense of failure, which then feeds the depression.

Depression and anxiety usually travel together

Around half of people with depression also experience significant anxiety, and the reverse is just as true. They reinforce each other. The exhaustion of depression heightens worry, and the relentless activation of anxiety eventually depletes the energy needed to feel anything at all, which arrives looking like shutdown.

If you have been reading about both and recognising both, that is worth knowing rather than worrying about. Our piece on anxiety, what it is and how it differs from stress covers the other half of this.

When should I speak to somebody?

If you have had low mood, loss of pleasure, or several of the signs above for more than two weeks, and particularly if they are affecting your work, your relationships or your ability to look after yourself, it is worth talking to someone.

You do not need to have reached a crisis point. Depression responds better the earlier it is addressed, and waiting until things are at the bottom simply means there is more to recover from.

It is also worth saying plainly: you do not have to understand it before you ask for help. Most people who come to us about this do not arrive with the word depression. They arrive saying some version of “I do not know what is wrong with me”, “I do not feel like myself any more”, or “I have everything I should be grateful for and I am still unhappy”. Those are perfectly good starting points. Therapy does not require a diagnosis or an explanation at the door.

What helps?

Therapy works on depression in a few directions at once. Understanding what is actually happening rather than treating it as a personal failing. Noticing the patterns of thinking that keep it in place. Looking at the life experiences, relationships and pressures underneath it. And slowly rebuilding contact with the things that used to mean something, which tends to come back before the feeling does rather than after.

If your symptoms are severe, or if you are having thoughts of not wanting to be here, please speak to your GP as well. Therapy and medical support are not alternatives to each other and many people use both.

How to start

Everyone begins with a one hour assessment at £50, online, with a senior member of the team. It is not a therapy session. It is how we understand what you are bringing and match you to the right counsellor.

Weekly sessions of fifty minutes follow with the counsellor you have been matched to. £125 with a qualified counsellor, or £50 with a trainee counsellor supervised weekly by our clinical lead. Every fee is on our fees page. No waiting list and no GP referral needed.

Several of our therapists work in their first language, including Vietnamese, Mandarin, French, Arabic, Tagalog, Yoruba, Hausa, Japanese and Turkish. If naming this is easier in a language other than English, see multilingual therapy.

Call 07960 333256, email bookings@talkingcounselling.co.uk, or use our contact page. Every enquiry is read by a person and answered within one working day.

NHS Talking Therapies also accepts self-referral for depression without a GP referral, though waiting times vary by area.

If you need to talk to someone today

If things feel unmanageable right now, or you are having thoughts of ending your life, please contact one of these. Any of them, today.

• Samaritans, free on 116 123, any time of day or night
• Shout, text the word SHOUT to 85258
• NHS 111 for urgent mental health help
• 999 if you are in immediate danger

Our immediate support page has more.

Anh Doan
BACP registered Psychotherapist and Clinical Supervisor
Founder, Talking Counselling

This article is for information and is not a substitute for individual assessment or therapy. If anything here speaks to your experience, you are warmly invited to get in touch.