If you feel down, tired and lacking in energy over a sustained period of time, you may be suffering from depression. Everyone feels occasional bouts of depression or sadness from time to time, but a clinical depression doesn’t go away and makes it impossible to enjoy life as normal. If you have prolonged low self-esteem, lose interest in normally enjoyable activities or have low energy and pain without a clear cause, for at least two weeks, you may be suffering from depression.


There is help – cognitive behavioral therapy (CBT) is a very good therapeutic treatment, and things like regular exercise and a good diet can boost mood and ease symptoms. More serious cases however may need treatment with antidepressant drugs. 


APPPOTEK can help you diagnose and treat depression.


Common symptoms of depression include:


  • very low mood, which pervades all aspects of life
  • low energy and fatigue
  • changed appetite or weight
  • problems with concentration 
  • feelings of worthlessness, inappropriate guilt or regret
  • insomnia or oversleeping
  • recurrent thoughts of death or suicide
  • low self-esteem and loss of self-confidence
  • negative and pessimistic thoughts about the future
  • anxiety


Depression is divided into three levels:


  • mild depression – you feel depressed, have lost interest in normally enjoyable activities, have less energy or feel more tired than usual, but can still work and communicate with your friends
  • moderate depression – you feel so bad that it becomes difficult to work and to spend time with family and friends
  • severe depression – the depression affects you so acutely that you find it difficult to walk, eat or drink, and may have thoughts of suicide.


Depression is believed to be caused by a combination of genetic, environmental, and psychological factors. Risk factors include a family history of the condition, major life changes, certain medications, chronic health problems, and substance abuse. Becoming a parent, moving to a new city, changing job or other key life changes can increase stress in everyday life, making you feel tired and powerless. Then behavior patterns can change – you may isolate yourself, postpone tasks or stop exercising. This avoidance of everyday situations may feel helpful in the short term, but in the long term it may make the depression worse.
Heredity is not considered to be a factor in mild depression, but it may increase the risk of severe depression.

Depression in children and adolescents

Depression is unusual in younger children but quite common in adolescents. Symptoms are generally the same as for adults, though children and adolescents respond more often with irritation and anger. Children of younger school age may show aggression or be withdrawn. Many also get stomach aches. In teens, depression can cause problems at school or lead to either insomnia or oversleeping. Sometimes, alcohol abuse also occurs.


Children who have parents or family members who suffer from depression have an increased risk of the disease. There are often factors in the child’s environment that trigger depression and it is important to identify and investigate these.

Prevention and protection

Physical exercise is recommended for management of mild depression and has a positive effect on symptoms. Among other things it increases endorphin levels. (Endorphin is a hormone that makes us feel good.)


There is some evidence that skipping a night’s sleep – or sleep deprivation – may improve depressive symptoms, with the effects usually showing up within a day. However this effect is usually temporary.


It is also important to re engage with life step by step – resuming daily tasks you have avoided during depression, or starting new activities that make you feel better.


Usually depression passes within four to nine months, but it may need treatment with cognitive behavioral therapy or antidepressant drugs.
For mild to moderate depression, psychological treatment is recommended as a first step. Only if this doesn’t help should antidepressants be prescribed.
The most common antidepressants are SSRIs (selective serotonin reuptake inhibitors). They aim to increase the amount of serotonin in the brain and can reduce depressive symptoms.


In severe depression and when no other treatment or medication has helped, electricity treatment (ECT) can sometimes work. This means that short impulses are passed through the brain.


For children: In mild depression in children or adolescents, initial treatment is to reduce stress, make sure they sleep and eat properly and stay physically active. Psychological treatment with cognitive behavioral therapy may also help, sometimes in combination with antidepressants.

When to consult a doctor

If you are experiencing low self-esteem and have lost interest in activities you previously enjoyed for at least two weeks, or if you have prolonged energy loss and fatigue, anxiety and sleeping problems, you may be suffering from depression and should seek care.

How APPOTEK can help

APPOTEK can help you with depression. Our doctor or psychologist can make an individual assessment based on your symptoms during an initial consultation. You may then be prescribed medication or referred for further treatment. We can also offer continuous follow-up and visits to psychologists and doctors.


Valeria Chernikova, Neurologist, M.D.