Depression treatment: what to expect from an initial assessment

Before anything else

This guide is educational and does not diagnose. If you are having thoughts of harming yourself, contact NHS 111 (mental health option), your GP, or 999 in an emergency. Support is also available around the clock from Samaritans on 116 123.

What an initial assessment usually covers

A clinician assessing low mood will typically explore:

• mood, interest and enjoyment, energy and concentration
• sleep, appetite and weight changes
• how long symptoms have lasted and whether there is a pattern
• impact on work, study, relationships and daily functioning
• previous episodes and previous treatment, including what helped
• physical health, medication, alcohol and substance use, as these can contribute
• safety, including thoughts of self-harm or suicide — clinicians ask this routinely and directly

Questionnaires are commonly used alongside the conversation to help track change over time.

Treatment approaches used in the UK

NICE guidance on depression in adults describes a range of options, matched to severity and preference. These include psychological therapies such as cognitive behavioural therapy, behavioural activation and counselling, and antidepressant medication for some people. Guided self-help and structured exercise programmes also feature for less severe presentations. Choice and shared decision-making are central to the guidance.

Preparing for the appointment

• Note when symptoms started and anything that changed at that time
• List current medication, including anything bought over the counter
• Think about what you want to be different in three months
• Bring someone with you if that helps, and ask for adjustments if you need them

Questions to ask the provider

1. What treatments do you offer for depression, and who delivers them?
2. How will we review whether it is working, and how often?
3. If medication is recommended, who prescribes it, who monitors it, and will my GP take it over?
4. What is the plan if things get worse between appointments?
5. Will you write to my GP?

Continuity matters

Depression treatment is rarely a single appointment. Before committing, understand the cost and availability of follow-up, not just the first session. A service that cannot offer regular review may not be the right fit for ongoing care.

Free routes

NHS talking therapies services in England accept self-referral for depression at no cost, and your GP can discuss both therapy and medication options.