Depression
Also called: clinical depression, major depressive disorder, depressive disorder, low mood illness
Depression is a common, treatable mental health condition. It causes low mood or loss of interest in things for at least two weeks, with poor sleep, low energy and hopeless thoughts. Talking therapies, and for some people antidepressants, help most people get better.
General health information for Pakistan. It does not give doses or brand advice. If you are worried, or symptoms are severe, see a doctor. When to see a doctor
Overview
Depression is more than feeling sad for a day or two. It is a common health condition in which low mood, or loss of interest and pleasure in daily life, lasts most of the day, nearly every day, for at least two weeks. It can change how a person thinks, sleeps, eats and copes with work, study and family life. Depression is not a weakness or a personal failing, and it is nobody's fault.
The World Health Organization estimates that about 5 in every 100 adults in the world have depression, and it is more common in women than in men. It can affect anyone, at any age, whatever their income, culture or education. Doctors describe an episode as mild, moderate or severe. Some people have one episode, while others have it again later (recurrent depression).
There is rarely a single cause. Life stresses such as losing a loved one, losing a job or living through trauma, together with family history and changes in brain chemistry and brain pathways, can all play a part. The good news is that effective treatment exists for every level of depression. Talking therapies are usually tried first, and antidepressant medicines are added for some people with moderate or severe depression. With the right help and support, many people recover fully.
In Pakistan
A 2021 review of 26 studies found that about 4 in 10 university students in Pakistan reported depressive symptoms on screening questionnaires, although study quality varied and the authors called for better surveys and campus mental health services.
Symptoms
- Low, sad or empty mood most of the day, nearly every day
- Loss of interest or pleasure in things you used to enjoy
- Feeling tired or having very little energy
- Sleeping badly, or sleeping much more than usual
- Eating less or more than usual, with weight loss or weight gain
- Trouble concentrating or making decisions
- Feeling guilty, worthless or a burden to others
- Feeling hopeless about the future
- Thoughts of death or of ending your life
- In children and teenagers, irritability or anger may show more than sadness
Causes and risk factors
Causes
- Difficult life events such as bereavement (death of a loved one), unemployment or trauma
- Stress in childhood or harmful early experiences, which can affect the brain and stress hormones
- Genes passed down in families, which can make some people more likely to get depression
- Changes in brain chemicals and in the brain pathways that control mood
- Physical health problems and some medicines or substances, which can cause or worsen low mood
What makes it more likely
- Being female (depression is about twice as common in women)
- A family history of depression
- A past episode of depression
- Few close relationships, or being divorced, separated or widowed
- Long-term physical illness such as diabetes or heart disease
- Harmful use of alcohol or use of drugs
- Having an anxiety disorder or another mental health condition
Complications
Without treatment, depression can last for months and make it hard to work, study, look after a family or keep up friendships. It is one of the leading causes of disability in the world. Depression can lead to thoughts of suicide, which is why getting help early matters so much. It is also linked with physical health: it can make conditions such as diabetes, high blood pressure, lung disease and heart disease harder to manage. Some people turn to alcohol or drugs to cope, which usually makes things worse. Depression can come back after recovery, so ongoing support helps.
When to see a doctor
- Thoughts of harming yourself or ending your life need urgent help now: contact emergency services or a doctor straight away, and do not stay alone
- Making plans to end your life, or saying goodbye to people: get emergency help immediately
- Hearing voices, or having strange beliefs that others do not share
- Not eating or drinking, or being unable to look after yourself
- Severe depression during pregnancy
- Feeling much more agitated, restless or low soon after starting or changing an antidepressant, especially in young adults
- Periods of unusually high mood, very little need for sleep and racing thoughts, which may be a sign of bipolar disorder
Diagnosis
There is no blood test or scan that shows depression. A doctor makes the diagnosis by talking with you about your mood, sleep, appetite, energy and thoughts, how long these have lasted and how they affect daily life. With your permission, they may also speak to a family member. Short questionnaires such as the PHQ-9 (a list of nine questions about mood) help to measure how severe it is and to follow progress. The doctor will also gently ask about thoughts of self-harm or suicide, because this helps keep you safe.
A physical examination and some blood tests, such as a blood count and thyroid tests, are often done to rule out physical causes that can look like depression. The doctor will also check for other conditions, such as bipolar disorder, anxiety, grief or the effects of alcohol, drugs or medicines, because these change the treatment.
Treatment
- See a doctor or health worker to talk about how you feel, check how severe the depression is and make sure you are safe
- For mild depression, start with a psychological treatment such as guided self-help, cognitive behavioural therapy (CBT, a talking therapy that changes unhelpful thinking), behavioural activation (planning helpful activities) or group exercise; antidepressants are not usually needed
- For moderate or severe depression, a talking therapy combined with an antidepressant is often offered; an SSRI antidepressant is usually the first medicine choice, and your doctor decides the medicine and the dose
- Have a check-up soon after starting an antidepressant (within about a week for young adults aged 18 to 25) and again within a few weeks to see if it is helping and to review side effects
- If there is little improvement, the doctor checks the diagnosis and other causes, then may change the medicine, add another treatment or refer you to a psychiatrist
- After you feel well again, keep taking the antidepressant for as long as your doctor advises (usually at least six months) to stop the depression coming back
- Never stop an antidepressant suddenly; when it is time to stop, your doctor lowers it slowly in steps over weeks or months to avoid withdrawal symptoms
Medicines in Pakistan
Medicines a doctor may use, by group. Each link opens our page for that medicine, with every brand and its official DRAP price. Your doctor decides which medicine and dose are right for you.
| Group | Role | Medicines |
|---|---|---|
| SSRI antidepressants (selective serotonin reuptake inhibitors) | usual first choice of antidepressant for moderate or severe depression; need a doctor's prescription and must not be stopped suddenly | Sertraline (14 brands), Fluoxetine (87 brands), Citalopram (7 brands), Escitalopram (47 brands), Paroxetine (21 brands), Fluvoxamine maleate (3 brands) |
| SNRI antidepressants (serotonin and noradrenaline reuptake inhibitors) | an option when an SSRI has not helped, or when there is also long-term pain | Duloxetine (4 brands) |
| Other (atypical) antidepressants | used alone or added to another antidepressant, for example when SSRIs cause side effects | Bupropion (44 brands) |
| Tricyclic antidepressants | older medicines used less often today because of more side effects and safety concerns; only on a doctor's advice | Amitriptyline (6 brands), Clomipramine (9 brands) |
| Mood stabilisers (add-on) | added to an antidepressant by a specialist when depression has not improved with other treatment; needs regular blood tests | Lithium carbonate (8 brands) |
Also used (not yet in our price list): Mirtazapine, Venlafaxine, Vortioxetine, Second-generation antipsychotics (added by a specialist for hard-to-treat or psychotic depression)
Self-care and prevention
Self-care
- Keep doing activities you used to enjoy, even in small amounts
- Stay in touch with family and friends, and talk to someone you trust about how you feel
- Be physically active regularly, even a short walk helps
- Keep regular times for sleeping and eating
- Avoid or cut down alcohol and do not use drugs, as they make depression worse
- Take medicines exactly as prescribed and talk to your doctor before making any change
- Remind yourself that depression is treatable and that many people recover
Prevention
- Build coping and problem-solving skills, for example through school-based programmes for children and teenagers
- Support parents, especially those caring for children with behaviour problems
- Encourage regular exercise, including for older adults
- Limit alcohol and avoid drugs
- After an episode, keep taking treatment as advised and attend follow-up to lower the chance of it returning
Common questions
Is depression just feeling sad?
No. Everyone feels sad sometimes, but depression lasts at least two weeks and affects sleep, energy, appetite, concentration and the way you think about yourself. It is a real health condition, not a weakness, and it can be treated.
Do I need antidepressants?
Not always. Mild depression usually gets better with talking therapies, guided self-help, exercise and support. For moderate or severe depression, a doctor may offer an antidepressant, often together with a talking therapy. Antidepressants need a doctor's prescription and regular follow-up.
Can I stop my antidepressant once I feel better?
Do not stop suddenly. Doctors usually advise continuing for at least six months after you feel well, to stop the depression returning. When it is time to stop, your doctor will lower the medicine slowly over weeks or months, because stopping quickly can cause withdrawal symptoms.
Are antidepressants safe for children and teenagers?
The World Health Organization advises that antidepressants should not be used to treat depression in children, and in teenagers they are not the first choice and need extra care. Talking therapies and family support come first. Young people should always be treated by a doctor experienced in mental health.
What should I do if someone tells me they want to end their life?
Take it seriously, stay with them and listen without judging. If they are in immediate danger, contact emergency services straight away. Otherwise, help them see a doctor or mental health worker urgently.
Sources
- World Health Organization. Depressive disorder (depression) (2026).
- NICE. Depression in adults: treatment and management (NG222) (2022).
- StatPearls (NCBI Bookshelf). Major Depressive Disorder - StatPearls - NCBI Bookshelf (2023).
- NIMH. Depression - National Institute of Mental Health (NIMH) (2024).
- Frontiers in Public Health. Prevalence of Depressive Symptoms Among University Students in Pakistan: A Systematic Review and Meta-Analysis (2021).
Prepared from the sources listed below by the MedInfoBase team. Last reviewed 16 October 2026. This page is general health information, not medical advice. It gives no doses and does not replace a doctor: talk to your doctor or pharmacist before starting, stopping or changing any medicine. How we write and check our pages.
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