A health condition, not a character trait
Roughly one person in five experiences a depressive episode in their lifetime, and anxiety disorders are more common still. These are neither weaknesses of character nor phases to be pushed through by willpower: they are diagnosable, treatable conditions with high remission rates when addressed early.
Recognising more than a bad patch
Low mood after bad news is normal. The signs that warrant attention are those present most days for more than two weeks:
- Persistent sadness, or often persistent irritability.
- Loss of interest or pleasure in things you used to enjoy: the most telling sign.
- Disturbed sleep or appetite, in either direction.
- Heavy fatigue, slowing, difficulty concentrating.
- Guilt, worthlessness, harsh self-criticism.
- Dark thoughts or thoughts of death.
Two questions capture most of it: over the past two weeks, have you felt down or hopeless? Have you had markedly less interest or pleasure in doing things? Two yeses justify an appointment.
For anxiety: intrusive worry that is hard to control, constant tension, disturbed sleep, physical symptoms such as palpitations, chest tightness and digestive problems, and avoidance. Panic attacks are frightening but not dangerous in themselves; they do tend to recur, which is why treatment helps.
Burnout
Occupational burnout combines deep emotional exhaustion, cynical detachment from work and a sense of ineffectiveness. It is classified as an occupational phenomenon rather than a medical condition, and it does not resolve with a holiday: it requires changing what produced it. It frequently coexists with depression, which is treatable.
What helps, and in what order
For milder presentations, several levers have measurable effects:
- Physical activity: in trials, comparable to a mild antidepressant.
- Sleep: sleep loss worsens almost every psychological difficulty.
- Social contact: withdrawal feels right in the moment and reliably makes things worse.
- Structure: fixed times for getting up, eating, and one task completed.
- Less alcohol: the short relief is paid for the next day in worse sleep and higher anxiety.
Beyond that, two treatments have solid evidence: psychotherapy, particularly structured, time-limited approaches, and medication. Antidepressants take two to four weeks to work, are not addictive, and should be stopped gradually and with a doctor. For moderate to severe depression, the combination outperforms either alone.
In a crisis
Suicidal thoughts do not mean an attempt is imminent, but they do mean speaking to someone the same day. Crisis lines exist everywhere, are free and confidential, and answer to worried relatives as well. Asking someone who is struggling whether they are thinking of suicide does not plant the idea: the opposite is true, and the question brings relief.
If you are supporting someone: stay present, listen without minimising or dramatising, offer to go with them to an appointment, and put distance between them and dangerous means. Do not promise secrecy where safety is at stake.
The law country by country
The legal framework, the procedure, the time limits and the costs differ from one country to another. Each country below has a detailed page: governing texts, key facts, the actual procedure, costs, where to go and the traps to avoid.
Select a country to open its detailed page.