Symptoms of Depression and Defining Level of Depression





Key Symptoms of Depression

  • Persistent sadness or low mood
  • Loss of interests or pleasure
  • Fatigue or low energy

At least one of these, most days, most of the time for at least 2 weeks.



Associated Symptoms

  • Disturbed Sleep
  • Poor concentration or indecisiveness
  • Low self-confidence
  • Poor or increased appetite
  • Suicidal thoughts or acts
  • Agitation or slowing of movements
  • Guilt or self blame






Mild Depression

Has 4 symptoms in total including at least 1 key symptom


Moderate Depression

Has 5-6 symptoms in total including at least 1 key symptom


Severe Depression

Has 7 or more symptoms in total, including at least 1 key symptom









STEP 2: If a patient has persistent mild depression

· Consider patient choice and information

· Consider treatment availability

· Consider referral to IAPT (Improving Access to Psychological Therapies)  

- IAPT information for referrers

- IAPT information for people who use services

·  Arrange follow up to monitor progress. Note: Telephone follow up is shown to be effective

Use clinical judgement and patient choice to decide number of Step 2 options to try before considering a move to Step 3.  


STEP 3: moderate or severe depression


This includes patients with:


· Persistent mild depression with or without chronic physical health problem


· A history of moderate or severe depression




Treatment includes psychological and/or pharmacological therapy 



STEP 4: Severe Depression or


IF step 3 is ineffective


Refer to specialist mental services
































Possible Treatment Options:




Step 4