Patient support
Low mood and depression
Sadness about serious illness is normal. Depression is different — it flattens everything, including the things that used to help — and it is treatable.
Sadness or depression?
Grief and sadness come in waves; between the waves you can still be moved, amused, comforted. Depression is flatter and more constant — the waves stop, and so does pleasure.
In physical illness the picture is muddier, because fatigue, poor appetite and disturbed sleep can come from treatment as well as from mood. That is exactly why the emotional questions matter: loss of interest, hopelessness, worthlessness and guilt point to depression more reliably than tiredness does.
Signs worth acting on
- Two weeks or more of low mood or loss of interest in nearly everything.
- Believing you are a burden, or that your family would be better off without you.
- Withdrawing from people who matter to you.
- Stopping treatment, or not caring whether treatment works.
- Any thought of ending your life — this needs same-day help, not a wait-and-see.
What actually helps
Depression tells you to wait until you feel like doing something. That order is backwards: in depression, action comes first and motivation follows. This is called behavioural activation and it is one of the best-evidenced treatments there is.
Start absurdly small and schedule it: sit outside for five minutes at 10am; phone one person on Tuesday; wash and dress before noon. Rate mood before and after. You are gathering evidence against the belief that nothing helps.
Treatment options to ask about
- Talking therapy — CBT, ACT, or counselling adapted for physical illness.
- Antidepressant medication, checked against your current drugs for interactions.
- Treating the physical drivers: pain, anaemia, thyroid problems, poor sleep, low vitamin D.
- Palliative or supportive care teams, who are experts in symptom and mood management at any stage — not only at the end of life.
Try this
One small thing
About 10 minutes
- 1Choose one activity that used to give you pleasure or a sense of achievement.
- 2Shrink it until it is almost too easy — five minutes, not an afternoon.
- 3Put it in the day at a specific time.
- 4Rate your mood 1–5 before and after. Write both numbers down.
- 5Repeat daily for a week before you judge whether it works.
Where to go next
Afya Companion offers education and self-help support. It does not diagnose, treat or replace care from your doctor, nurse, psychologist or dietitian. If something in your health changes, speak to your care team.