Depression is frequently missed because it does not look like the picture. Plenty of people who are seriously depressed still get to work, still answer messages, still make other people laugh. What has gone is colour: pleasure, interest, the sense that any of it particularly matters.
It is also physically real. Sleep changes. Appetite changes. Concentration goes. Small tasks acquire a weight that is genuinely out of proportion — and then the failure to do them becomes further evidence against yourself, which is the trap closing.
Therapy works on both ends: interrupting the self-attacking commentary, and rebuilding contact with things that used to matter, in increments small enough to actually be possible.
How the work tends to go
CBT to catch and challenge the commentary, behavioural steps sized so they are genuinely achievable, and — where depression sits on top of unprocessed loss or trauma — work on what is underneath it.
