Depression and Low Mood

Stories, signs to notice and what to do

Grey Weeks

Kavya, sixteen, used to dance in her room and chat for hours with her cousin in Chennai. Over the last two months she stopped answering calls, quit her dance class and began sleeping through weekend afternoons. Her marks fell. When her mother asked what was wrong, she said, "Nothing. I'm just tired," and closed the door.

Her father thought it was laziness and lectured her about wasting her talent. Kavya felt worse. She told her diary she was 'useless' and a burden. She was eating very little, irritable one day and numb the next, and she had stopped looking forward to anything.

Her class teacher noticed her red eyes and talked to her quietly. She called the parents and suggested a doctor. The doctor explained that this was more than a bad mood: it had lasted more than two weeks, changed her sleep, appetite, energy and thoughts, and stopped her usual life. With counselling, regular routines, her family listening, and some small activities, Kavya began to feel the grey lift. Her father apologised for the lecture, and she danced again by the end of the year.

Kavya later told her counsellor that what helped most was not advice but the first evening her mother simply sat beside her and said nothing, and stayed.

How to recognise it

• Low or irritable mood most of the day for two weeks or more.
• Loss of interest in things once enjoyed, withdrawal from friends.
• Changes in sleep, appetite and energy; trouble concentrating; school marks falling.
• Feelings of worthlessness, guilt or being a burden.
• In teenagers, irritability and anger can show more than sadness.

What this story explains

This story shows how depression differs from normal sadness and how it shows up in young people.

Probable root causes

• Changes in brain chemistry and family history of depression.
• Stressful events such as exam pressure, bullying or family conflict.
• Self-critical thinking patterns and low self-esteem.
• Hormonal and developmental changes in adolescence.
• Loneliness, poor sleep and little activity.

What to do

1. Sit down privately and say what you have noticed with kindness.
2. Listen without lecturing, correcting or comparing.
3. Keep sleep, meals and a little daily movement going.
4. Help her return to one small activity she used to enjoy.
5. Involve the school counsellor and a doctor early.
6. Ask directly and calmly whether she has thoughts of not wanting to live, and if yes, stay with her and contact the local emergency number or go to the nearest hospital.

Whom to consult

• Family doctor or paediatrician as a first step.
• School counsellor for daily support and academic adjustments.
• Child and adolescent psychologist or psychiatrist if low mood continues beyond two weeks or affects daily life.
• Emergency service or hospital at once if she talks about ending her life.

Do and don’t

How to behave and communicate

• Use a quiet, caring tone: "I have noticed you seem very low. I am here and I am not angry."
• Let silences be; do not fill them with advice.
• Reflect: "It sounds like everything feels heavy."
• Ask open questions: "What has been the hardest part?"
• Thank her for telling you.

The Quiet Farmer

Ramesh, fifty-one, farms three acres near Nagpur. After two poor harvests and a loan he cannot repay, he has become silent and short-tempered. He no longer joins the evening chat at the tea stall. He wakes before dawn, cannot go back to sleep and sits staring at the field. He complains of headaches and body pain.

His wife says he shouts over small things and refuses to see a doctor. "Men do not get sad," he tells her. "I am just worn out." He has started drinking more in the evenings. When his son asks him to come for a wedding, he says, "Go without me. I am no use to anyone."

The village health worker visited and sat with him for an hour without talking about the loan. Slowly, Ramesh said that nothing felt worth doing any more. The worker explained that depression in men often looks like anger, tiredness, pain and drinking rather than tears, and that it can be treated. Ramesh went to the district clinic with his son. With treatment from a doctor, a loan counselling meeting and daily walks to the tea stall, he began to rest and think more clearly. His wife said, "The old Ramesh is coming back, but quieter and kinder."

How to recognise it

• Irritability, anger or withdrawal rather than open sadness.
• Early waking, tiredness and aches that have no clear physical cause.
• Increased drinking or other substance use.
• Statements like 'I am no use' or 'my family would be better off without me'.
• Loss of interest in work, friends and festivals for weeks.

What this story explains

This story shows how depression can look different in men and how money stress, stigma and drinking can hide it.

Probable root causes

• Long-term money worries, debt and uncertainty.
• Social belief that men must be strong and never show weakness.
• Brain chemistry and family history of mood problems.
• Alcohol, which worsens mood and sleep.
• Isolation from friends and community.

What to do

1. Spend time with him without a topic, perhaps over tea or a walk.
2. Name what you see: "You seem worn down for weeks, and I am worried."
3. Offer to go with him to the clinic and do not make it a big fuss.
4. Reduce alcohol access and support him cutting down.
5. Link him with practical help for the money problem.
6. If he speaks of ending his life, stay close, remove access to danger and call the local emergency number or go to the nearest hospital.

Whom to consult

• Family doctor or primary health centre first.
• Psychiatrist if mood stays low for more than two weeks, sleep and appetite are disturbed or there is hopelessness.
• Counsellor or clinical psychologist for talking support.
• Local community or trusted elder for practical and financial guidance.

Do and don’t

How to behave and communicate

• Use a respectful, unhurried tone and avoid direct confrontation.
• Try: "You carry so much for us. I would like to carry some with you."
• Listen more than you speak.
• Let him choose the setting for talking.
• Show steady presence, even if he says little.

After the Baby

Fatima gave birth to a healthy girl six weeks ago in Dubai, far from her mother in Karachi. Everyone says she should be happy. Instead she cries while feeding and wakes at night even when the baby sleeps. She worries she is a bad mother and sometimes thinks her family would manage better without her.

Her husband works long hours and says, "Everyone is tired with a newborn." Her mother-in-law visits and tells her to eat and rest. Fatima smiles for visitors, then weeps in the bathroom. She feels no joy when the baby smiles and is ashamed of that.

At the baby's check-up, the nurse asks how Fatima herself is doing. Fatima bursts into tears. The nurse explains that a few days of weepiness after birth are common, but low mood lasting weeks, with guilt and no joy, is postnatal depression, an illness that needs care and is nobody's fault. Fatima sees her doctor and also talks to a counsellor. Her husband takes night feeds twice a week, and she calls her mother each evening. Over some weeks, the weight begins to lift.

Fatima later joined a small group of new mothers at the clinic. Hearing others say the same words she had hidden made her feel, for the first time in weeks, understood and less alone.

How to recognise it

• Low mood, tearfulness, guilt or numbness lasting more than two weeks after childbirth.
• Struggling to bond or feeling no joy with the baby.
• Poor sleep even when the baby sleeps, little appetite, strong anxiety.
• Thoughts of being a bad mother or of not wanting to live.
• Hiding feelings from family out of shame.

What this story explains

This story shows depression in women, linked to hormones, life changes and pressure to be happy, and why it must be noticed early.

Probable root causes

• Large hormonal changes after delivery.
• Sleep loss and the demands of a newborn.
• Lack of family or practical support, especially far from home.
• Pressure to be a 'perfect' mother.
• Past depression or difficult pregnancy and birth.

What to do

1. Tell someone how you really feel, such as a partner, nurse or doctor.
2. Share baby care so she can get a longer block of sleep.
3. Keep simple routines of meals, daylight and a short walk.
4. Connect daily with a supportive person.
5. Do not wait for it to pass; seek professional help early.
6. If there are thoughts of harming herself or the baby, keep the baby safe, stay with her and call the local emergency number or go to the nearest hospital.

Whom to consult

• Doctor or gynaecologist at the postnatal check, or family doctor, as soon as low mood lasts beyond two weeks.
• Psychiatrist if symptoms are heavy, with thoughts of self-harm or harm to the baby.
• Counsellor or clinical psychologist for talking support.
• Health visitor or nurse at the baby clinic, who can arrange next steps.

Do and don’t

How to behave and communicate

• Use a soft tone: "You are not alone in this, and you are not a bad mother."
• Listen without hurrying to fix.
• Ask: "What would help most today?"
• Praise something she did well.
• Offer presence and practical help rather than advice.

Grandfather Stops Reading

Joseph, seventy-three, lives with his son's family in Kochi. Since his wife died last year and his knees stopped him from his daily walk, he has been sitting in the same chair. He used to read the paper cover to cover. Now it lies folded. He eats little, says he is tired, and sometimes mentions he forgets things.

His family wonders if he is 'just getting old'. His daughter-in-law notices he stopped going to church and sleeps badly. He told the neighbour, "There is no point in going on," but said it so quietly nobody took it seriously.

When his grandson asked him to read aloud together, Joseph's eyes filled. The family took him to the doctor, who checked his blood, medicines and memory and explained that depression in older people often shows as tiredness, forgetfulness and aches, and is not a normal part of ageing. With treatment, a daily walk with the grandson, visits from old friends and a role in school pick-ups, he slowly started reading again. The doctor also explained that if memory problems persisted, it was important to check separately for dementia.

The family also learned to watch for sudden changes in his mood, and they agreed to tell the doctor early if his low spirits came back, rather than waiting until he stopped eating again.

How to recognise it

• Withdrawal, loss of appetite and weight, and lasting tiredness.
• Memory and concentration complaints that began alongside low mood.
• Body aches and sleep problems with no clear medical explanation.
• Remarks like 'there is no point' or 'I am a burden', even if said quietly.
• Following a loss, illness or loss of independence.

What this story explains

This story shows depression in older adults, how it hides behind ageing, and its overlap with memory problems.

Probable root causes

• Bereavement and loneliness.
• Physical illness, pain and reduced mobility.
• Loss of role, routine and independence.
• Some medicines and sleep problems.
• Changes in the brain and earlier mood history.

What to do

1. Take every remark about not wanting to live seriously and talk gently about it.
2. Arrange a full check-up that includes mood, memory, medicines and vision or hearing.
3. Keep a daily routine with light activity and sunlight.
4. Reconnect with friends, faith groups and family tasks.
5. Give a role, such as helping with homework or cooking.
6. If he talks of ending his life, stay with him and contact the local emergency number or go to the nearest hospital.

Whom to consult

• Family doctor or geriatrician for a full health and medicine review.
• Psychiatrist for older adults if low mood lasts more than two weeks.
• Neurologist or memory clinic if memory problems continue or worsen.
• Counsellor or faith leader for grief support.

Do and don’t

How to behave and communicate

• Speak slowly and clearly, with warmth and respect.
• Try: "Papa, I have missed our chats. Tell me about Mummy's cooking."
• Allow time for answers.
• Face him, make eye contact and listen to repeated stories patiently.
• Show you value him, not just his care needs.

The Message at Midnight

Daniel, twenty-four, lives in Leeds and shares a flat with two friends. He has lost his job, his relationship ended, and for weeks he has barely left his room. One night he sends a message to his friend Chris: "Sorry for everything. You'll be better off without me." Then his phone goes silent.

Chris is frightened. He wonders if he is overreacting, but remembers that people who write such things often mean them. He phones Daniel several times, then rings the flat landline. When Daniel finally answers, his voice is flat. Chris says, "I am worried about you. Are you thinking about ending your life?" After a pause, Daniel says yes.

Chris stays on the phone, asks Daniel to unlock the door and not be alone, and travels over. He tells Daniel he is glad he answered, and together they call the local emergency number. Later, Daniel sees a doctor and a therapist. He learns that the dark thoughts came from depression telling him lies. Months later he says, "The night I thought nobody cared was the night one person asked."

Chris admits he was shaking when he put the phone down. He later spoke to a counsellor himself, since looking after the person who helps matters too.

How to recognise it

• Talk of being a burden, hopelessness or goodbyes, even in a message or joke.
• Withdrawal, giving things away, sudden calm after deep low mood.
• Recent losses such as a job, relationship or loved one.
• Increased drinking or substance use.
• Previous attempts or self-harm, which raise the risk.

What this story explains

This story shows depression and suicide risk, and that asking directly and getting urgent help can save a life.

Probable root causes

• Untreated depression and hopelessness.
• Recent loss, shame or financial crisis.
• Isolation with nobody to talk to.
• Alcohol or drug use lowering control.
• Previous self-harm or suicide in the family or circle.

What to do

1. Take every sign seriously and act, even if you are unsure.
2. Ask directly and kindly: "Are you thinking of ending your life?" Asking does not plant the idea.
3. Stay with the person or keep talking until help is with them.
4. Contact the local emergency number or take them to the nearest hospital.
5. Remove access to anything that could be used for harm, without a fight.
6. Afterwards, support follow-up with a doctor and keep checking in.

Whom to consult

• Local emergency service or the nearest hospital immediately if there is intent or a plan.
• Psychiatrist or family doctor for assessment and treatment soon after the crisis.
• Clinical psychologist or counsellor for ongoing therapy.
• A trusted family member or elder to join the support circle.

Do and don’t

How to behave and communicate

• Use a steady, warm voice: "I am here. You matter to me. Let's get help together."
• Listen fully, without interrupting or rushing.
• Reflect what you hear: "You feel there is no way out right now."
• Avoid cliches such as 'it will be fine'.
• Be honest that you need to bring in others because you care.

This book is for education and general awareness. It does not replace diagnosis or treatment by a qualified professional. If anyone is in danger, contact your local emergency services.