When to ask for help
The NHS advises seeing a GP if you have had symptoms of depression for most of the day, every day, for more than 2 weeks. You do not have to be certain it is depression. It is enough to say that your mood has been low and it is affecting your life.
The NHS also points out that the sooner you see a doctor, the sooner you can be on the way to recovery. If you are unsure whether your symptoms count, the symptoms page may help.
If you are having thoughts of suicide and feel unsafe, do not wait for a routine appointment. See urgent help for who to contact now.
Booking a GP appointment
When you contact your surgery, you do not have to give the receptionist details. You can simply say it is about your mental health. Many surgeries offer phone, video or face-to-face appointments.
Mind suggests:
- asking for a longer appointment if you have several things to discuss
- asking to see a particular GP you feel comfortable with
- bringing someone you trust, who can come in with you or wait outside
- telling the doctor if you feel nervous, so they can give you time
How to prepare
Appointments can feel short, and it is easy to forget things when you are feeling low. A little preparation helps. Mind recommends writing down what you want to say in advance and taking your notes with you.
Things worth noting down:
- What you have noticed – mood, sleep, appetite, energy, concentration, interest in things
- How long – roughly when it started, and whether it has been getting better or worse
- Impact – what you have stopped doing, or find much harder, at home or work
- Possible triggers – recent losses, stress, illness, money or relationship worries
- Past history – any previous depression, anxiety, or periods of unusually high mood
- Family history – relatives with depression, bipolar disorder or other mental health conditions
- Medicines – everything you take, including supplements and anything you have recently started or stopped
- Alcohol and drugs – an honest idea of how much, as it affects treatment choices
- What you would like – for example, information, talking therapy, or to discuss medication
What the GP will ask
The NHS says a GP will usually ask about:
- your general health and medical history
- your mental health history
- your home life and relationships
- your lifestyle
- any recent stressful events
- whether you have had any thoughts of suicide or self-harm
Being asked about suicide can feel unexpected, but it is a routine and caring question. It does not mean the GP assumes the worst. It helps them understand how to keep you safe and what support to offer.
NICE also recommends that clinicians ask about any history of elevated mood. This is to check whether low mood might be part of bipolar disorder, which is treated differently. See types of depression.
The NHS notes that what you tell a GP is confidential. The only exception is if there is a significant risk of harm to you or others.
Questionnaires
A GP may ask you to fill in a short questionnaire about your symptoms. A common one is the PHQ-9, which asks nine questions about common symptoms of depression. NHS Talking Therapies services also use questionnaires at the start of treatment and at later sessions.
Questionnaires help measure severity and track progress. They do not make the diagnosis on their own. The GP will combine your answers with everything else you have discussed.
NICE groups depression as less severe or more severe, and a PHQ-9 score was one of the guides it used. This grouping helps decide which treatments to offer first.
Tests to rule out other causes
There is no blood test or scan that diagnoses depression. However, some physical conditions can cause symptoms that look like depression, such as tiredness, low energy and poor concentration.
The NHS says a GP may suggest blood or urine tests to rule out other conditions. A common example is a thyroid function test, because an underactive thyroid can cause symptoms similar to depression. Your GP will decide which tests, if any, are right for you.
After the appointment
Depending on what you discuss, the GP may:
- suggest waiting a short time and reviewing you again, for milder symptoms
- recommend guided self-help or a group activity programme
- refer you, or suggest you refer yourself, to NHS Talking Therapies
- discuss starting an antidepressant
- refer you to specialist mental health services if your depression is severe, complicated or you are at risk
NICE recommends that treatment is a shared decision, based on your symptoms, your preferences and what has helped before. Treatment for depression explains the options in more detail.
It is fine to take information away and think about it. You can also ask for a follow-up appointment.
Self-referral to NHS Talking Therapies
In England, you do not need to see a GP first to get talking therapy for depression. You can refer yourself to an NHS Talking Therapies service online.
The NHS says you need to live in England and be aged 18 or over (16 or 17 in some areas). The service will contact you to discuss whether it can help and how long you may need to wait. Treatment is free.
In Scotland, Wales and Northern Ireland, access to talking therapy is organised differently. Speak to your GP or check your local NHS health board.
Self-referral is a good option if you would prefer not to discuss your mood with a GP, or if talking therapy is what you want. You can still see a GP later if you want to discuss medication.
Seeing a private psychiatrist
Some people choose to see a psychiatrist privately. This does not always need a GP referral. Reasons people give include wanting a specialist opinion on the diagnosis, wanting a medication review, or feeling that treatment so far has not worked.
If you go privately, check that the doctor is on the General Medical Council (GMC) register. The GMC register shows whether a doctor is on the specialist register. You can also ask whether a summary will be sent to your GP, so that your care stays joined up.
A private psychiatrist is not a replacement for crisis care or for your GP. Seeing a psychiatrist explains when a specialist can help and how the NHS and private routes compare.