Understanding depression

It's one topic at a time. You can read it or click Listen: the phrase that sounds is color-coded.

What depression is

Depression is a common disorder. It's not being sad for a few days. It consists of a low mood or a loss of interest and pleasure in things. It happens most of the day, almost every day, for at least two weeks. It's different from normal mood swings. It affects about 5.7% of the world's adults. It is more common in women. It has effective treatment, whether mild, moderate or severe.

Sources: 1 (see Sources tab)

How it shows

Sadness, emptiness or irritability. What I used to like, I don't like anymore. It's hard to concentrate. Excessive guilt and low self-esteem appear. The future looks hopeless. Sleep changes: you have trouble sleeping or you sleep too much. They change appetite or weight. There's a lot of fatigue and little energy. Thoughts about death may appear. Sometimes it's expressed mostly in the body: pain, fatigue, weakness.

Sources: 1 (see Sources tab)

Mild, moderate or severe

It depends on how many symptoms you have, how severe they are, and how much they affect your life. It can be a single episode or repeat. When depressive episodes alternate with periods of euphoria or high energy, it's called bipolar disorder, which is treated in another way. Assessing this is a job for a professional.

Sources: 1 (see Sources tab)

Why it happens

There is no single cause. Social, psychological and biological factors are combined. Losses, unemployment, and other difficult experiences increase the risk. Physical health and depression influence each other. It's not laziness or lack of will.

Sources: 1 (see Sources tab)

The inactivity cycle

When you're down, you do fewer things. By doing less, you have fewer pleasant moments and less sense of accomplishment. That lowers your mood even more. And then you do even less. Behavioral activation breaks this cycle from behavior: act first, even if you don't feel like it. Studies show it's an effective treatment for depression.

Fonts: 2, 3 (see the Fonts tab)

Which treatments work

Psychological treatments are the first line of treatment for depression. In moderate and severe depression they can be combined with antidepressants. In mild depression, there is no need for antidepressants. The most widely supported therapies are behavioral activation, cognitive-behavioral, and interpersonal. The medication is prescribed and followed by a doctor. Don't leave her alone. Physical exercise reduces the symptoms of depression. Keep doing activities and keep in touch with your helpers.

Fonts: 1, 2, 3, 4 (see the Fonts tab)

If you're thinking about death

Thoughts about death can be a symptom of depression. It doesn't mean you're weak or that there's no way out. Tell someone you trust or a professional today. In Spain, the 024 line supports people with suicidal thoughts and their families, 24 hours a day. If there is immediate danger, call 112.

Sources: 1 (see Sources tab)

Common myths

It's a matter of cheering up. No. It's a disorder and it needs treatment. If I have reasons to be okay, it can't be depression. It can appear without an obvious cause. Asking for help is weak. It's the shortest step to depression. Antidepressants are forever. The doctor decides with each person how long. It's not curable. There are effective treatments.

Sources: 1 (see Sources tab)

Tips for each difficulty

Choose the area that weighs the most on you today. Mark the pattern you're going to practice and it'll be kept in My plan.

Getting active step by step

With depression, the urges don't come before the action. Don't wait to get better to move. Move to get better.

Write down how you spend your day. For a few days, write down what you do and your mood from 0 to 10. You'll see what feels better.Two lists. Things you used to like and things that make you feel accomplished.One a day, with a set time. Put it on the schedule as a medical appointment.Keep it small. Ten minutes of walking counts. One phone call doesn't count.Do it even if you don't feel like it. The goal is to make it, not enjoy it. The enjoyment comes back little by little.Write down the before and the after. It's good for the mood before and after. It usually goes up a little.

Sources: 2, 3. Guidelines are common techniques in cognitive behavioral therapy.

Routine and body

Depression disrupts sleep, eating, and movement. Putting them in order is part of treatment.

A fixed time to get up. Even if you slept badly. Get out of bed and get dressed.Light and quiet in the morning. Get out at least a few minutes every day.Eat at regular times. Even if you have little appetite, stick to the schedule.Get moving. Walking at a leisurely pace helps. Better little and every day.Avoid alcohol. It's bad for your mood and your sleep.Basic self-care. Showering and changing clothes are accomplishments on a bad day.

Sources: 1, 4. Guidelines are common techniques in cognitive behavioral therapy.

Thoughts and rumination

Depression puts up a dark filter: it's all your fault, nothing's going to change. Going over and over it doesn't solve anything and drags you down further.

Spot rumination. If you've been at it for ten minutes and you haven't decided anything, it's rumination.Ask yourself whether it helps. If it doesn't bring you closer to a solution, change your activity.Move to break the loop. Get up, change rooms or do something with your hands.Question your self-criticism. Would you say that to a friend in your situation?Write down three things. Every night, three things you've done today, no matter how small.

Guidelines are common techniques in cognitive behavioral therapy.

Not isolating yourself

The body wants to be alone. Isolation feeds depression.

One contact a day. A text, a phone call or a quick coffee.Tell someone what's going on. One or two people I trust. You don't have to tell everyone.Accept company without talking. Watching a movie or walking with someone also counts.Say what you need. "Today I just need you to be" is a valid request.Ask someone to go with you. To the office or to take the first walk.

Sources: 1. Guidelines are common techniques of cognitive behavioral therapy.

When everything feels hard

With little energy, tasks pile up and become more overwhelming. Lower the bar and break it down.

Three tasks a day. A necessary one, a caring one and a pleasant one.Ten minutes. Start with the clock in ten minutes. If you can keep going, keep going.Break it down. "Picking up the house" is too much. You can clean the table.Put off big decisions. If you can, don't decide on a job, a partner or money at the worst of times.Ask for practical help. Get someone to help you with paperwork, shopping or dates.

Guidelines are common techniques in cognitive behavioral therapy.

Preventing relapse

Depression can come back. Knowing your signs allows you to act soon.

Your early signs. Notice how it starts in you: worse sleep, withdrawal, irritability.A written plan. What you'll do and who you'll tell if they show up.Keep doing what worked. Activity, routine and contact, even when you're fine.Don't stop the treatment at once. Always talk to your doctor or psychologist.

Guidelines are common techniques in cognitive behavioral therapy.

If you're with someone

You can't get him out of his depression, but your presence helps.

Listen without trying to fix. Avoid cheering up and you have to do your part.Suggest small plans. A short walk, no pressure.Encourage them to ask for help. Offer to get a date and escort.He asks about death thoughts. Asking about them doesn't cause them. If they are there, help them get care today. The 024 line also supports relatives.Look after yourself. Companion fatigue. Seek your own support.

Guidelines are common techniques in cognitive behavioral therapy.

Sources

The information comes from these guides and studies. The numbers of each subject refer to this list.

World Health Organization (2025). Depressive disorder (depression): fact sheet. Open
Ekers et al. (2014). Behavioural activation for depression: meta-analysis of 26 trials. PLoS One. Open
Stein et al. (2021). Effect of behavioural activation on depression, anxiety and activation: meta-analysis. Psychological Medicine. Open
Munro et al. (2026). Effect of exercise on symptoms of depression and anxiety: umbrella review. British Journal of Sports Medicine. Open

This app provides information and general tips. It doesn't diagnose or replace your doctor or psychologist. If you are in crisis or thinking about harming yourself, call 112 or 024.

Would you rather talk it over with a professional? Order your first appointment at the Vivaldi Clinic., in person in Valencia or online.

This guide is produced by Clínica Vivaldi, a psychological health centre in Valencia.: María Teresa Fernández Vicente, Health psychologist and neuropsychologist (CV17304). November 9, 2026. This is the first time I've seen you. The scientific sources are in the Fonts tab. If you need professional help: Psychologist for depression at the Vivaldi Clinic.