Posted in Bipolar Depression, Depression, Major Depressive Disorder (MDD), Mental Health, Mental Health Research, Persistent Depressive Disorder, Postnatal Depression, Psychotic Depression, Seasonal Affective Disorder, Treatment-Resistant Depression, Trowbridge Guru

Depression: Types, Diagnosis, Treatments, and UK Context (with Wiltshire Spotlight)

  Published Date: August 20, 2025
Depression is common, disabling, but treatable. With rising prevalence, especially in younger adults, timely diagnosis and evidence-based treatment are critical. Locally in Wiltshire, thousands of residents are affected — but effective treatments are available, from NHS Talking Therapies to specialist care.

Abstract

Depression is one of the most common mental health conditions worldwide and in the UK. It includes a spectrum of disorders ranging from mild depressive episodes to severe, recurrent forms. This paper outlines the different types of depression, the diagnostic criteria, evidence-based treatments, and current UK prevalence data with a Wiltshire focus. Downloadable graphs and datasets are included.

1) What Is Depression?

Depression is more than low mood. It is a cluster of symptoms affecting thoughts, emotions, and physical health, often lasting for weeks or months. Symptoms include persistent sadness, loss of pleasure, fatigue, poor concentration, sleep changes, appetite disturbances, and feelings of worthlessness or guilt.

For diagnosis, most international guidelines (DSM-5, ICD-11, NICE) require:

  • ≥2 weeks of persistent low mood or loss of interest/pleasure, plus
  • At least four other symptoms (e.g., sleep, appetite, concentration, self-esteem, suicidality).
    Symptoms must cause significant distress or impairment and not be better explained by another condition.

2) Types of Depression

  • Major Depressive Disorder (MDD): One or more major episodes of ≥2 weeks.
  • Persistent Depressive Disorder (Dysthymia): Chronic, less severe but lasting ≥2 years.
  • Bipolar Depression: Occurs within bipolar disorder, alternating with mania/hypomania.
  • Postnatal Depression (PND): After childbirth, often underdiagnosed.
  • Seasonal Affective Disorder (SAD): Depression linked to seasonal light changes.
  • Psychotic Depression: Severe depression with delusions/hallucinations.
  • Treatment-Resistant Depression (TRD): Depression not improved after ≥2 adequate treatment trials.

3) Causes and Risk Factors

  • Biological: Neurotransmitter changes (serotonin, dopamine, noradrenaline), genetics, inflammation.
  • Psychological: Negative cognitive styles, rumination, trauma history.
  • Social: Poverty, unemployment, social isolation, chronic stress.
  • Protective factors: Social support, problem-solving skills, access to care.

4) Prevalence in the UK and Wiltshire

National

  • APMS 2023/24: Around 6.6% of adults experienced a depressive episode in the past week.
  • Any common mental disorder (includes anxiety & depression): 20.2% of adults.
  • Trends: Depressive symptoms rose from ~7% in 1993 to 9.3% in 2023/24.

Regional & Wiltshire

  • South West region: ~19.5% adults with a CMHC (slightly above national average).
  • Wiltshire estimate: ~8% of adults with depression (~30,000 people).

5) Treatments

NICE recommends a stepped-care model:

  1. Mild depression: Active monitoring, self-help, group-based CBT, lifestyle support (sleep, exercise).
  2. Moderate to severe depression:
    • Psychological therapy: CBT, interpersonal therapy (IPT), behavioural activation, mindfulness-based CBT (for relapse prevention).
    • Medication: SSRIs (e.g., sertraline, fluoxetine) are first-line; SNRIs, tricyclics, or mirtazapine as alternatives.
    • Combined therapy is often most effective.
  3. Resistant/severe cases: Specialist referral, augmentation, electroconvulsive therapy (ECT), or newer treatments (e.g., ketamine/esketamine in some centres).

6) Impact

Depression is the leading cause of disability worldwide (WHO). In the UK, it is a major driver of lost productivity and long-term sickness absence. It also increases risk of physical illnesses (cardiovascular disease, diabetes) and suicide.

7) Graphs & Downloadable Data

Conclusion

Depression is common, disabling, but treatable. With rising prevalence, especially in younger adults, timely diagnosis and evidence-based treatment are critical. Locally in Wiltshire, thousands of residents are affected — but effective treatments are available, from NHS Talking Therapies to specialist care.

Author: admin