Depression

The rain arrived in Asharh and Nusrat stopped going to the agency. She runs the creative team for half the brands in Gulshan, and now the pitch decks sit unopened while the monsoon slides down the glass. She sleeps eleven hours and wakes heavier. Her friends’ dinner on Friday, cancelled. Saturday’s, cancelled. The tea beside her bed has gone cold again.

An illustration drawn from common experience. The person is invented; the pattern is not.

Understanding depression

Depression does not always announce itself as sadness. More often it arrives as weight: slowness in the morning, flatness where pleasure used to be, a mind that reads the same email four times. The World Health Organization describes a depressive episode as low mood, or a loss of interest, for most of the day, nearly every day, for at least two weeks, usually with changes in sleep, appetite, energy, concentration and self-worth.

Tiredness has physical causes too, from an underactive thyroid to anaemia to the side effects of some medicines. A doctor rules those out first, which is why the first conversation here is medical as well as psychological.

How common is depression?

In 2023, 322 million people in the world were living with depression, WHO estimates. In Bangladesh the national mental health survey of 2018–19 found depressive disorder in 6.7% of adults, about one in fifteen.

The harder number is the gap. Only about one adult in ten with a mental disorder had sought care, an analysis of the survey data found.

Signs and symptoms of depression

• Low, flat or empty mood on most days for two weeks or more
• Losing interest in things you used to enjoy
• Sleeping much more or much less than usual; a changed appetite
• Reading, deciding or concentrating takes visible effort
• Feeling worthless, guilty, or like a burden to others

Treatment for depression

The evidence on what works for depression is better established than for most conditions. Talking therapy, such as cognitive behavioural therapy, and antidepressant medication work about equally well in the short term, and a 2020 network meta-analysis of randomised trials in World Psychiatry found the two together worked better than either alone.

Movement counts as treatment too. A 2024 review in the BMJ, pooling 218 trials and more than 14,000 people, found that walking or jogging, yoga and strength training eased depression, and that more vigorous exercise helped more.

A first consultation with Dr. Tajreen covers mood, sleep, physical health and circumstances, then sets out the options in plain words. Medication, where it is needed, is discussed openly and reviewed over time.

What getting better can look like

In a story like Nusrat’s, the first change is usually small: a walk round Gulshan Lake three mornings a week between showers, agreed in the first session, and a time to talk again. Recovery tends to come unevenly, like the monsoon breaking. Many people notice it first in something minor, such as wanting their tea while it is still hot.

Common questions about depression

How do I know if it is depression and not just sadness?

Sadness usually eases with time or with good news. The World Health Organization describes a depressive episode as low mood, or a loss of interest, for most of the day, nearly every day, for at least two weeks, usually with changes in sleep, appetite, energy, concentration or self-worth. Tiredness can also have physical causes, such as an underactive thyroid or anaemia, so a doctor checks for those too.

Can depression get better without antidepressants?

For many people, yes. Talking therapy such as cognitive behavioural therapy and antidepressant medication work about equally well in the short term, and a 2020 network meta-analysis of randomised trials found the two together worked better than either alone. Exercise also eased depression in a 2024 BMJ review of 218 trials. The right choice is made with a doctor, and any change to a medicine already prescribed is made with that doctor too.

When to see a psychiatrist

If low mood has lasted more than two weeks, or ordinary life has started to feel like work, it is worth a conversation. If you are having thoughts of ending your life, please seek help today.

Care here is personal: built around your history, your health and what you want to change, and reviewed with you as it goes.

If you or someone else is in immediate danger, call 999 or go to the nearest hospital emergency department.

Sources

• World Health Organization, “Mental disorders” fact sheet, September 2026
• National Mental Health Survey of Bangladesh 2018–19, NIMH and WHO
• Huque et al., BMC Psychiatry, 2025
• Cuijpers et al., World Psychiatry, 2020
• Noetel et al., BMJ, 2024