Chronic Depression

Why Specialist Treatment for Chronic Depression Matters

Chronic depression is not simply feeling low. It can involve long lasting changes in mood, motivation, sleep, appetite, and the way the nervous system processes stress. When symptoms persist, it is often because multiple factors are contributing at the same time, such as long term stress, physical illness, chronic pain, sleep disruption, medication effects, and reduced daily structure. A specialist approach helps identify which factors are driving symptoms now, rather than repeating generic solutions.

Consultant led assessment helps ensure that treatment is safe, appropriate, and tailored to your history and current needs. It also supports realistic planning by focusing on measurable outcomes such as improved sleep, better daily function, reduced intensity of symptoms, and more stable routines.

Consultant Led Assessment and Diagnosis

Your care begins with a detailed consultation that may include:

• Review of symptom history, severity, and duration
• Discussion of prior treatments and response
• Medication review including side effects and interactions
• Screening for contributing medical factors such as sleep issues, chronic pain, hormone factors, or nutritional contributors
• Assessment of anxiety, trauma related symptoms, or mood instability where relevant
• Discussion of daily function, work impact, relationships, and coping strategies
• Consideration of risk factors and safeguarding where appropriate

Where needed, your consultant may recommend collaboration with mental health professionals such as psychiatrists, psychologists, or counsellors to ensure coordinated care and continuity.

Targeted, Evidence Based Treatment Pathways

Chronic depression often improves most with a structured plan that combines more than one approach. Depending on your assessment, your consultant may recommend:

Medication review and optimisation to ensure current treatments are appropriate, effective, and well tolerated, and to reduce avoidable side effects that can worsen fatigue or low mood.

Psychological therapy support such as CBT and ACT to improve coping skills, reduce unhelpful thinking patterns, strengthen routine, and build practical strategies for managing difficult periods.

IV ketamine infusion in selected cases as a specialist option for people with persistent symptoms who may benefit from a consultant supervised infusion pathway, with clear safety checks and follow up planning.

Treatment planning focuses on what is most likely to help your specific pattern of symptoms, with regular review and adjustment as needed.

Focused on Long Term Stability and Function

The goal is not only symptom reduction but also improved daily function and long term stability. Your consultant will work with you to:

• Improve sleep routine and energy management
• Reduce symptom flare ups and improve recovery after difficult days
• Build sustainable structure, pacing, and daily habits
• Support gradual return to work or activities when appropriate
• Coordinate care with therapy providers and other clinicians
• Monitor progress with clear goals rather than vague measures

Many people benefit from a step by step plan that builds momentum over time. Progress may be gradual, but it can be meaningful when the right treatment combination is used consistently.

When to Seek Urgent Help

If you experience suicidal thoughts, feel unsafe, or are at risk of harming yourself or others, seek urgent support immediately. You can contact NHS 111, your GP out of hours service, or attend A and E in an emergency. If there is immediate danger, call 999.

Book a consultation to discuss a personalised plan for chronic depression and the most suitable treatment options for your situation.