Symptoms of Depression

Depression is one of the most common mental health conditions, yet it can look quite different from one person to the next. Some people describe a persistent low mood or a loss of interest in things they once enjoyed. Others notice changes in their sleep, appetite, or energy levels long before they recognise what is happening. However, there are also a handful of core symptoms that most people with depression will experience and it’s these symptoms that mental health professionals use to make a diagnosis. At Central Minds, our psychologists support individuals experiencing depression every day, and we understand how varied and personal this experience can be.

Physical Symptoms of Depression

Depression is not only an emotional experience. It has a very real physical dimension that is often the first thing people notice, and sometimes the hardest to connect back to their mental health.

Energy and Sleep

• Persistent fatigue or low energy, or finding that everyday tasks take more effort than they used to
• Changes in sleep, difficulty falling or staying asleep, waking very early, or sleeping far more than usual
• Slowed movement or speech, a noticeable change in pace that others may observe, sometimes described as feeling heavy or sluggish

Appetite and Physical Wellbeing

• Changes in appetite or weight, eating noticeably more or less than usual, which may lead to weight changes over time
• Unexplained physical discomfort, persistent headaches, digestive problems, or general body aches that do not have a clear physical cause
• Reduced interest in physical self-care, finding it difficult to maintain everyday routines such as eating regularly, bathing, or getting dressed

Psychological and Emotional Symptoms of Depression

The psychological experience of depression varies widely. For some people it feels like persistent sadness. For others, it is more of a numbness, or an absence of feeling.

Emotional Symptoms

• Persistent low mood, feeling sad, empty, or tearful for much of the time, on most days
• Loss of interest or pleasure, finding that activities, hobbies, or people that previously brought enjoyment no longer feel engaging or meaningful
• Feelings of worthlessness or excessive guilt, self-critical thoughts that feel difficult to challenge, often disproportionate to any actual circumstances
• Emotional numbness, a sense of feeling detached, flat, or disconnected from the people and experiences around you
• Increased irritability or agitation, feeling more easily frustrated, restless, or on edge than usual

Cognitive Symptoms

• Difficulty concentrating or making decisions, thoughts that feel slow, foggy, or hard to organise
• Negative thinking patterns, a persistent tendency to interpret situations in a more negative light, or to feel hopeless about the future
• Thoughts of self-harm or that life is not worth living, these thoughts are important to take seriously; support is available and things can improve

If you or someone you care about is experiencing thoughts of self-harm, please do reach out to us or contact a crisis helpline.

Common Signs of Depression

While individual episodes of low mood are a normal part of life, depression tends to be more persistent and affects how a person functions across different areas of their life. The signs below may indicate that what you are experiencing goes beyond everyday stress or sadness.

Stress and depression are closely connected. Sustained periods of pressure or burnout can contribute to the development of depression, and addressing both is often part of a thorough clinical approach.

How Depression Symptoms Can Change Over Time

Depression does not always stay the same throughout a person’s life. It is worth being aware of how symptoms can shift:

• Symptoms that begin physically, such as fatigue or appetite changes, may gradually become more psychological, or vice versa
• Depression that was previously manageable can become more significant during periods of transition, such as a career change, relationship difficulties, or major life events
• Withdrawal and avoidance often develop gradually and can quietly reduce the range of activities and connections that feel accessible
• Co-occurring difficulties, such as anxiety, low self-esteem, or perfectionism, frequently occur alongside depression and can make symptoms harder to untangle without professional support

How Depression Differs from Low Mood

It is natural to experience periods of low mood, particularly in response to difficult life events. Depression is different in that it tends to be more persistent, more pervasive, and more disruptive to daily functioning.

Both experiences are valid and worth taking seriously. A psychologist can help you understand what you are experiencing and whether professional support would be helpful.

You May Benefit From Support If…

It can sometimes feel difficult to know whether what you are experiencing warrants professional support. The following may be helpful indicators:

• You have been feeling low, empty, or unmotivated on most days for two weeks or more
• You have lost interest in activities or people that previously mattered to you
• Sleep, appetite, concentration, or energy have been noticeably affected for several weeks
• Depression is affecting your relationships, work, or day-to-day functioning in a consistent way
• You find yourself withdrawing from others or relying on alcohol or other substances to get through difficult periods
• You have been managing on your own for some time without noticing any improvement
• You are experiencing thoughts of self-harm or that life is not worth living

Meet our therapists specialising in working with Depression in Hong Kong

Dr. Sharmeen Shroff

Clinical Psychologist

With over 14 years of experience, Dr Shroff has worked in community mental health centres, private psychology clinics, medical clinics and both outpatient and inpatient units in hospitals in Hong Kong, the United Kingdom and the USA. She is one of the few clinical psychologists in Hong Kong that have been intensively trained to practice psychotherapy from a psychodynamic depth perspective.

Dr. Kaili Chen

Clinical Psychologist

Dr. Chen has worked in the field of psychology since 2010 in several non-profit organizations and community mental health centers. Before settling in Hong Kong, she has lived in Singapore, Thailand, Malaysia, China, and the United States, and understands firsthand the stresses expats face living abroad and the intricacies of multicultural lifestyles.

Bhavna Bharvani

Clinical Counsellor Relationship Counsellor

Bhavna is a US-trained Licensed Professional Clinical Counsellor, registered with the California Board of Behavioural Sciences (LPCC 10182). She started out practicing in San Francisco, where she worked with individuals, couples, teenagers, and LGBTQIA+ folks with chronic and complex trauma. She worked across a range of settings including community mental health, schools, and residential substance use treatment centers

Dr. Natalie Loong

Clinical Psychologist

Dr. Natalie Loong is a California licensed clinical psychologist with years of experiences working in community mental health, outpatient, residential, and private practice settings in Hong Kong and the United States. As a bilingual psychologist, Dr. Loong provides services in both English and Cantonese and has extensive experiences working with adults, adolescents, and children from diverse cultural and…

Teresa Chan

Cognitive Behavioural Psychotherapist

Teresa is a UK-trained specialist who has worked one-to-one with clients in the field of clinical mental health since 2011. Born and raised in the UK, she qualified as an accredited Cognitive Behavioural Therapy (CBT) practitioner and spent 8 years working within the National Health Service (NHS) before relocating to Hong Kong in 2018. A native English speaker who also communicates in Cantonese, Teresa holds an undergraduate and master’s degree in Psychology, alongside postgraduate training specialising in CBT.

Dr. Melissa Chan

Clinical Psychologist

Dr. Chan is a UK trained Clinical Psychologist, who has worked in the field of mental health taking up clinical and research roles in the community and academic settings for ten years. She is experienced in treating people with symptoms of depression and anxiety disorders (e.g. social anxiety, bipolar tendencies etc). She also works with people who are struggling with low self-esteem, stress, grief and bereavement, adjustment difficulties and those…

Dr. Aurélie Comes

Clinical Psychologist & CBT Therapist

Aurélie is an experienced Cognitive Behavioral Therapist (CBT) who trained and worked in the UK’s National Health Service. In addition to her CBT specialty, she also qualified as an Eye-Movement Desensitization Reprocessing (EMDR) Practitioner.

Josanna Lai

Clinical Psychologist

Born and raised in Hong Kong, being fluent in English and Cantonese, Josanna has worked as a clinical psychologist for over twenty-six years in Hong Kong and Australia in diverse clinical settings including child assessment center, inpatient PTSD wards, outpatient psychiatric center, university counseling service, NGO for special education needs and certainly private practice.

Dr. Christine Mok-Lammé

Clinical Psychologist

Dr. Mok-Lammé is a US trained clinical psychologist licensed in the States of Colorado and Massachusetts. She has worked in the field of psychology in various settings since 2012. She has a wealth of experience working with adults who face difficulties due to complex traumas, challenging family dynamics, and relationship problems.

Michael Beckham

Clinical Counsellor

Michael Beckham is a US-trained and licensed Psychotherapist with 19 years of experience helping clients navigate life’s challenges with compassion, expertise, and care. He assists his clients in understanding how they see themselves, how they see the world, and how they see their place in the world.

Dr. Karen Wai Liem

Clinical Psychologist, Counselling Psychologist, and Aviation Psychologist

Dr. Liem is a Clinical Psychologist, Counselling Psychologist, and Aviation Psychologist based in Hong Kong. She provides psychotherapy for adolescents, adults, and couples facing psychological or relational challenges. With over 15 years of clinical experience in Hong Kong and overseas, she has worked in diverse settings.

Dr Elaine Ching

Clinical Psychologist

Dr. Ching is a UK trained Clinical Psychologist, offering support to adults with difficulties around anxiety, low mood, stress and burnout, self-esteem, childhood or event specific trauma, interpersonal relationships, and life adjustments (e.g. relocation, grief, chronic physical health, third culture kids). She also has experience with individuals with individuals with emotional

Stephanie Rose

Counselling Trainee

Stephanie Rose is a Supervised Counselling Trainee. Stephanie takes a person-centered approach to counselling; helping clients to explore and connect with their values, personal goals and strengths to navigate challenges and work towards positive changes in their lives. With a professional background in corporate settings, having previously worked at Nissan and Deloitte, Stephanie has a good understanding of work-related issues and pressures that impact wellbeing. 

Dr. Edward C. K. Lam

Clinical Psychologist

Edward is a U.S.-trained and licensed Clinical Psychologist in the state of Massachusetts, now bringing his expertise to Hong Kong. With extensive experience across various settings, Edward has helped clients become stronger, more independent, and resilient in the face of challenges. He creates a supportive and non-judgmental environment where clients can explore their struggles and engage more fully in life.

Jill Caroll

UKCP Registered Psychotherapist, Certified Transactional Analyst (P), MBACP Counsellor and; EMDR Practitioner, Couples Therapist

Jill is a UK trained Psychotherapist who has recently relocated back to London after working in Hong Kong for 5 years. As well as her own successful private practice in London (2012-2019) she has experience of working in the NHS in an IAPT service and in a London Hospital in Women’s Health, gynaecological oncology team as a Psychotherapist.

Dr Steven Livingstone

Clinical Psychologist & Systemic Family Therapist

Steven’s clinical work is rooted in systemic and relational approaches, helping individuals, couples, and families make sense of distress in the context of their relationships and life experiences. He draws on evidence-based models including Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Open Dialogue, integrating these with compassion-focused and mindfulness-informed principles.

Oliver Ip

Mental Health Counsellor & Psychotherapist

Oliver is a US-trained psychotherapist and Licensed Mental Health Counsellor (LMHC, New York; 014804). He has worked in both community mental health and private practice providing clients of diverse backgrounds with the care, support, and skills they need. He has helped his clients work through issues such as anxiety, depression, relationship issues, neurodivergence, identity exploration (including culture, gender, sexuality), addictions, shame, and trauma (both acute and chronic/complex).

Meet Our Full List Of Counsellors Here!

FAQs About Symptoms of Depression

Can depression cause physical symptoms even when I do not feel particularly sad?

Yes. Depression does not always present as visible sadness. Some people experience it primarily through physical symptoms such as fatigue, unexplained aches, disrupted sleep, or changes in appetite, without necessarily feeling low in the way they might expect. This is sometimes referred to as somatic depression, and it is more common than many people realise.

How long do symptoms of depression typically last?

This varies between individuals. A clinical diagnosis of depression generally requires symptoms to be present for at least two weeks, but many people live with untreated depression for considerably longer. With appropriate support, symptoms can improve meaningfully. A psychologist can help you understand your individual symptoms and develop practical strategies to manage them.

Are symptoms of depression the same in everyone?

No. Depression presents quite differently from person to person. Some people experience primarily emotional symptoms; others find the physical dimension most prominent. The specific combination of symptoms, their intensity, and what may have contributed to them differs widely, which is why an individualised clinical assessment is valuable. However, there are also a handful of core symptoms that most people with depression will experience and it’s these symptoms that mental health professionals use to make a diagnosis.

Can depression symptoms be a sign of something else?

Some symptoms of depression overlap with other conditions, including anxiety, bipolar disorder, burnout, and certain physical health conditions. A psychologist can carry out a thorough assessment to understand the full picture, ensuring any support offered is well-matched to what you are actually experiencing.

Do I need a referral to speak with a psychologist at Central Minds?

No referral is needed to contact us directly. However, if you are planning to use insurance, we recommend checking with your provider beforehand, as some insurers do require a referral letter. You can find more information on our insurance and fees FAQ.

How is depression treated?

Depression responds well to psychological treatment. Approaches such as Cognitive Behavioural Therapy (CBT) and Psychodynamic Therapy are well-evidenced and help people to understand unhelpful thinking patterns, build practical coping strategies, and gradually re-engage with activities and relationships. Our psychologists work with each person individually to find an approach that fits their needs. You can learn more on our depression expertise page.