Depression
More than a bad week: low mood or loss of interest most of the day, nearly every day, for at least 2 weeks. About 5 in 100 adults worldwide have depression right now. It’s common, it’s not a character flaw, and it’s very treatable.
If you’re thinking about suicide or don’t feel safe, call 000 (Australia) or your local emergency number now. From a mobile, 112 works in most countries. For support any time, call Lifeline on 13 11 14 or Beyond Blue on 1300 22 4636 (both 24/7). Aboriginal and Torres Strait Islander people can call 13YARN on 13 92 76 (24/7). Young people aged 5–25 can call Kids Helpline on 1800 55 1800 (24/7). Outside Australia, find a free helpline at findahelpline.com. Feelings this heavy can and do ease with support. You don’t have to wait until things are worse to reach out.
The depression ladder
Milder depression often lifts with self-care and guided help. For moderate or severe depression, talking therapy, medicine or both work best. Needing more than one rung is normal, not failure.
- Step 1 · Self-careMove, sleep, connectRegular activity (walking, jogging, yoga or strength training), steady sleep and wake times, and a small enjoyable or useful thing planned each day.
- Works
- Exercise lowered depression scores by a moderate amount in a 2024 review of trials, more with harder effort. Walking, jogging, yoga and strength training all helped
- Cost
- Free
- How long
- Most days; benefits build over a few weeks
- Watch for
- Not a substitute for treatment if you’re very unwell. Alcohol deepens low mood, so go easy.
Your brain doesn’t need a marathon. A brisk walk counts.
- Step 2 · Self-careGP visit and online CBTYour GP checks for physical causes (such as thyroid problems or anaemia), asks about safety, and can write a mental health treatment plan. Free online courses such as the MindSpot Wellbeing Course teach practical CBT skills.
- Works
- Guided self-help is a recommended first choice for milder depression in UK guidelines; it works best with someone checking in on you
- Cost
- GP visit often bulk billed or about $40–80 gap; MindSpot is free; THIS WAY UP courses are free with a clinician’s prescription
- How long
- MindSpot Wellbeing Course: 5 lessons over 8 weeks
- Watch for
- Feeling worse or unsafe? Don’t wait for the course to finish: talk to your GP or a crisis line.
CBT in your trackies, with a clinician in your corner.
- Step 3 · Allied healthTalking therapy (CBT, behavioural activation, interpersonal therapy)With a psychologist or other trained therapist. A first choice for most people, alone or alongside medicine.
- Works
- About 4 in 10 respond within about 2 months, vs about 1 in 6 on a waiting list or usual care
- Cost
- About $200–300 a session; Medicare pays back about $100–150 for up to 10 sessions a year with a GP mental health treatment plan. Some services bulk bill
- How long
- Usually weekly for a few months
- Watch for
- If it isn’t clicking after a few sessions, it’s fine to try a different therapist or approach.
Not just venting. It’s skills training for your thoughts.
- Step 4 · PrescriptionAntidepressant medicine (such as sertraline, escitalopram, fluoxetine or mirtazapine)For moderate to severe depression, or when therapy alone isn’t enough. Often combined with therapy.
- Works
- About 50 in 100 improve within 6–8 weeks, vs about 30 in 100 on a dummy tablet. Staying on it for a year or two after recovery cuts relapse from about 50 in 100 to about 23 in 100
- Cost
- Most generics under the $25 PBS co-payment ($7.70 concession)
- How long
- Often 1–2 weeks to notice a change and several weeks for the full effect. Usually continued for at least 6 months after you feel well
- Watch for
- Nausea, sleep changes, sexual side effects. Under 25s: check in often in the first weeks, as thoughts of self-harm can rise early on. Don’t stop suddenly; taper with your GP.
Not a personality transplant. More like turning the volume back up.
- Step 5 · SpecialistPsychiatristFor severe depression, depression that hasn’t lifted after two treatments, possible bipolar disorder, psychosis, or ongoing risk.
- Works
- Not a trial question: reviews the diagnosis, combines or switches medicines and coordinates more intensive care
- Cost
- Private psychiatrist about $300–600 for a first visit, with partial Medicare rebates; public mental health services are free
- How long
- Waits can be weeks to months
- Watch for
- Keep seeing your GP and therapist while you wait.
Join the queue early. You can always cancel if you’re better.
- Step 6 · SpecialistBrain stimulation (rTMS, ECT) and hospital careSpecialist treatments for severe or hard-to-treat depression, arranged by a psychiatrist.
- Works
- Reserved for depression that hasn’t responded to other treatment; your psychiatrist can explain your likely benefit
- Cost
- Free in public services; private costs vary and some are covered by private hospital cover or Medicare when eligible
- How long
- rTMS: daily sessions over several weeks. ECT: usually 2–3 times a week for a few weeks
- Watch for
- ECT can cause short-term memory problems. Ask what to expect before you start.
Old reputations, modern methods. Worth a fair hearing if nothing else has worked.
Save your money
Popular, heavily marketed or often asked about, but the evidence is weak or says no.
- Fish oil (omega-3) capsulesA Cochrane review found a small effect, probably too small to notice, from low-quality studies.
- Vitamin D tablets (if your level is normal)In a 5-year trial of over 18,000 adults, vitamin D didn’t prevent depression or lift mood.
- Medicinal cannabis and CBDA 2026 review of 54 trials found no evidence it helps depression, and the authors warned it may do more harm than good. Pricey, too.
- St John’s wortSome studies suggest it helps milder depression, but strength varies between products and it interacts with many medicines, including the contraceptive pill, blood thinners and antidepressants. UK guidelines advise against it.
What you can do
- Plan one small thing each day that’s enjoyable or gives a sense of achievement, even before you feel like it. Motivation often follows action, not the other way round.
- Keep regular sleep and wake times. If sleep is a battle, see our trouble sleeping page.
- Tell one person you trust how you’re really going.
- Cut back on alcohol and other drugs. They borrow tonight’s relief from next week’s mood.
- Write a simple safety plan with your GP or therapist: warning signs, people to call, and reasons to stay safe.
- Supporting someone? Ask how they’re really going, listen without fixing, and help them book a GP visit.
See your GP if
- Low mood or loss of interest most days for 2 weeks or more
- It’s affecting work, study, relationships or looking after yourself
- You’ve had depression before and notice the early signs coming back
- Low mood during pregnancy or after having a baby
- You’re on an antidepressant and it isn’t helping after 4–6 weeks, or side effects are a problem
Get help the same day if you have thoughts of ending your life, feel unable to keep yourself safe, hear or see things others don’t, or feel unusually high, reckless and sleepless for days. Call your GP, a mental health crisis team, 000 or your local emergency number.
Common questions
What are the symptoms of depression?
Low or empty mood, or losing interest and pleasure in things, most of the day, nearly every day, for at least 2 weeks. Often with poor sleep or sleeping too much, appetite changes, tiredness, poor concentration, guilt or low self-worth, hopelessness, and sometimes thoughts of death.
What causes depression?
Usually a mix of things rather than one cause: genes and family history, stressful or traumatic events, loneliness, long-term illness or pain, alcohol and drugs, some medicines, and big hormonal changes such as after having a baby. It isn’t weakness or something you can just snap out of.
How is depression diagnosed?
By talking with your GP about your symptoms and how long they’ve lasted, often with a short questionnaire. There’s no blood test for depression, but your GP may check for things that mimic it, such as thyroid problems, anaemia or low vitamin B12.
Are antidepressants addictive?
They don’t cause cravings or a need for higher doses the way addictive drugs do. Stopping suddenly can cause dizziness, sleep problems, nausea and restlessness, so reduce the dose slowly with your GP.
Will I need medicine forever?
Most people don’t. It’s usually continued for at least 6 months after you feel well, then reviewed. People who’ve had several episodes may be advised to stay on it longer to prevent relapse.
Helpful resources
- Beyond Blue: Get support24/7 phone (1300 22 4636) and web chat with trained counsellors, plus online peer forums. Free, Australia.
- MindSpot Wellbeing CourseFree 8-week online CBT course for low mood, worry and stress, with optional therapist check-ins. Adults in Australia.
- THIS WAY UPOnline CBT courses for depression, anxiety and more. Free with a prescription from your GP or psychologist, or a small fee to self-enrol. Australia; overseas via your clinician.
- Medicare Mental Health phone serviceFree advice and referral to local mental health services on 1800 595 212 (weekdays). Not a crisis line. Australia.
- Find A HelplineFree, confidential helplines in more than 100 countries, searchable by country and topic.
Evidence and more information
- WHO: Depressive disorder (depression) fact sheet
- NICE: Depression in adults (NG222)
- InformedHealth.org (IQWiG): How effective are antidepressants?
- Cuijpers et al, Acta Psychiatrica Scandinavica 2021: Psychotherapy for depression, response rates
- Noetel et al, BMJ 2024: Exercise for depression
- Cochrane: Omega-3 fatty acids for depression in adults (2021)
- Psychiatric News: VITAL-DEP trial of vitamin D (JAMA 2020)
- University of Sydney: Lancet Psychiatry review of medicinal cannabis (2026)
maladywise.com/depression/