Depression: Symptoms, Causes and Where to Get Help in India

Quick answer: Depression is more than feeling sad for a few days. Doctors look for a low, empty or irritable mood, or a loss of interest in things you used to enjoy, lasting most of the day, nearly every day, for at least two weeks, along with other changes such as poor sleep, low energy, guilt, trouble concentrating or thoughts of death (World Health Organization). It has no single cause. Life events, physical illness, family history, alcohol and brain chemistry usually combine.

Depression is common and treatable. In India, many people first notice it as body pain, weakness or tiredness rather than sadness, and most never get treatment. If you are thinking about ending your life, call Tele-MANAS on 14416 (free, 24x7) or 112 in an emergency right now.

Symptoms of depression

The NHS groups the signs into three kinds. You don't need all of them. A doctor looks at how many you have, how long they have lasted and how much they affect daily life.

The two-week rule

Everyone has bad days, and grief after a loss is normal. The NHS advises seeing a doctor if you've had symptoms most of the day, every day, for more than two weeks. Sooner is better if the symptoms are stopping you from working, studying or looking after yourself.

Why it often looks like a "body problem" in India

A study of 741 people with a first episode of depression at 16 centres across India, published in the Indian Journal of Psychiatry (Grover and colleagues, 2013), found that physical complaints were extremely common. About 76% reported lack of energy or weakness, 74% headache, 71% tiredness and 64% leg pain. Most had more than ten such complaints.

So a person may visit several doctors for headaches, weakness or "gas" and get normal test results, while the real problem goes unnamed. If tests keep coming back normal and you also feel low or have lost interest in life, mention your mood to your doctor.

Also read: Belly Fat: Causes, Safe Waist Size for Indians and How to Reduce It

How depression shows up in different people

According to the US National Institute of Mental Health (NIMH) and Mayo Clinic:

• Men are more likely to show anger, irritability, physical complaints or heavier drinking, and less likely to ask for help.

• Teenagers may seem irritable or sulky, fall behind at school, feel worthless, or start using alcohol or drugs. Self-harm is a warning sign that needs help straight away.

• Children may be clingy, anxious, or refuse to go to school.

• Older adults may report pain, tiredness or memory problems more than sadness. Mayo Clinic stresses that depression is not a normal part of growing older.

• New mothers can develop postpartum depression, which is more intense and longer lasting than the short-lived "baby blues" in the first days after birth.

What causes depression?

WHO describes depression as the result of a complex interaction of social, psychological and biological factors. Usually there is no single trigger.

• Life events: bereavement, job loss, money trouble, exam failure, relationship breakdown, abuse or trauma. The NHS also lists giving birth.

• Family history: depression can run in families, though having a parent with it doesn't mean you will get it.

• Physical illness: NIMH and Mayo Clinic note links with diabetes, heart disease, stroke, cancer and long-term pain. Mayo Clinic lists thyroid problems among the hormone changes that can be involved.

• Medicines: Mayo Clinic says some blood pressure medicines and sleeping pills can contribute. Don't stop any prescribed medicine on your own. Ask the doctor who prescribed it.

• Alcohol and drugs: WHO lists harmful alcohol use as a risk factor, and alcohol can make depression worse.

• Lifestyle: WHO also mentions physical inactivity. Isolation and long-term stress play a part too.

Depression is not a sign of weakness or a lack of willpower, and it isn't something a person can simply "snap out of".

How common is depression in India?

The National Mental Health Survey (NMHS) 2015–16, carried out by NIMHANS for the Ministry of Health, found:

The survey found depression was more common in women, in middle age and in big cities. A second national survey has been announced, but its results were not yet published when this article was written. Globally, WHO estimates that about 5.2% of adults live with depression.

The treatment gap is the most important number here. The survey's summary report puts it at 85.2% for depression, and a 2019 peer-reviewed analysis of the same survey in BMJ Open at 79.1%. Either way, roughly four in five Indians with depression were not getting treatment, often because of stigma, cost, or not knowing that it is a treatable illness.

Depression, anxiety and bipolar disorder

Depression often comes with anxiety. Our guide to anxiety symptoms and causes explains the overlap.

It also matters to tell depression apart from bipolar disorder. In bipolar disorder, low periods alternate with periods of unusually high energy, little need for sleep, racing thoughts or risky behaviour (mania or hypomania). Treatment is different, so tell your doctor if you have ever had such "high" phases. Other types NIMH describes include persistent depressive disorder (milder symptoms lasting at least two years) and depression with psychotic symptoms. For conditions involving psychosis, see our explainer on schizophrenia.

Also read: Schizophrenia: Symptoms, Causes and How It Is Treated

How depression is treated

Only a doctor or mental health professional can diagnose depression and decide on treatment. In general terms:

• Talking therapies come first, according to WHO. These include cognitive behavioural therapy (CBT), interpersonal therapy, behavioural activation and problem-solving therapy.

• Antidepressant medicines may be added for moderate or severe depression, prescribed and monitored by a doctor. WHO says they are not needed for mild depression. NIMH notes they can take several weeks to work, so it's important not to give up early or stop suddenly.

• Self-care helps alongside treatment: staying active, keeping regular sleep and meal times, spending time with people you trust, and cutting down alcohol. It doesn't replace treatment for moderate or severe depression.

In India, you can start with a family doctor, a government hospital's psychiatry department, a district mental health programme clinic, or Tele-MANAS.

Where to get help in India

• Tele-MANAS: 14416 or 1800-89-14416. The Ministry of Health's free, 24x7 mental health helpline, launched in October 2022. According to the Press Information Bureau (PIB), it runs 53 cells across all 36 states and Union Territories, in about 20 languages depending on your state. It can connect you to a counsellor and, if needed, to a psychiatrist or local services.

• Emergency: 112, or go to the nearest hospital emergency department if someone has harmed themselves or is about to.

• The older KIRAN helpline was merged into Tele-MANAS in 2024, so use 14416.

Under the Mental Healthcare Act, 2017, every person has a right to access mental healthcare from services run or funded by the government. Section 115 says that a person who attempts suicide is presumed to be under severe stress and shall not be tried or punished, and that the government must provide care and rehabilitation.

When to get help urgently

Seek help straight away (call 14416, or 112 if there is immediate danger) if you or someone you know:

• talks about wanting to die or being a burden

• has made a plan, or has harmed themselves

• has stopped eating or drinking, or can't get out of bed for days

• hears or sees things others don't

If you're worried about a friend or family member, ask them directly and calmly how they're feeling, listen without judging, and help them make the call. Asking about suicide does not put the idea in someone's head.

This article is general health information, not a diagnosis. If you're unsure, speak to a doctor.

Frequently asked questions

What are the first signs of depression?

Often a loss of interest in things you used to enjoy, poor sleep, tiredness and withdrawing from people. In India, body aches, headaches and weakness are also common early complaints.

How long does depression last?

It varies. Without treatment, an episode can last months. With treatment, many people improve within weeks to a few months, and some need longer-term care to prevent it coming back.

Can depression go away on its own?

Mild low mood after a difficult event can lift with time and support. Depression that lasts more than two weeks and affects daily life should be checked by a doctor, because treatment works better and faster than waiting.

Is Tele-MANAS free?

Tele-MANAS (14416) is a free, round-the-clock government helpline run by the Ministry of Health. You can talk to a trained counsellor in your language, and it can link you to further care if needed.

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