What is Depression?
Depression is one of the most common psychiatric conditions, affecting approximately 1 in 6 people in the UK at some point in their lives. It is far more than simply feeling sad or 'down' — depression is a serious medical condition that affects how you think, feel and function in everyday life.
The condition encompasses a wide spectrum, from mild, persistent low mood (dysthymia) to severe depression that may include psychotic symptoms. Without appropriate treatment, depression can significantly impair relationships, work and quality of life. With the right support, however, the vast majority of people make a full and lasting recovery.
At North London Psychiatry Practice, Dr Sivasanker offers comprehensive psychiatric assessment and a full range of evidence-based treatments — including for those whose depression has not responded to standard therapies.
Important: If you are in crisis or experiencing suicidal thoughts, please call the Samaritans on 116 123 (free, 24/7) or go to your nearest A&E.
Book a Consultation
Speak to Dr Sivasanker about depression treatment.
Request Appointment 020 3488 0809Symptoms of Depression
Persistent Low Mood
Feeling sad, empty, hopeless or tearful for most of the day, most days — lasting two weeks or more.
Sleep Disturbance
Difficulty sleeping (insomnia) or sleeping excessively; waking early in the morning is a particularly common feature of depression.
Loss of Energy
Persistent fatigue and exhaustion, even without physical exertion. Simple tasks feel overwhelming.
Loss of Interest
Anhedonia — the inability to feel pleasure in activities previously enjoyed, including hobbies, socialising and relationships.
Cognitive Difficulties
Poor concentration, difficulty making decisions, and a slowing of thought processes that can affect work and daily functioning.
Negative Thinking
Persistent feelings of worthlessness, excessive guilt and a pessimistic view of oneself, others and the future.
How We Treat Depression
Antidepressant Medication
Dr Sivasanker will carefully assess which antidepressant — if any — is most suitable for your individual presentation, taking into account your symptoms, medical history and previous treatment response. Medication is reviewed regularly and adjusted as needed.
About Medical Treatments →Psychological Therapies
Cognitive Behavioural Therapy (CBT) and other evidence-based talking therapies are highly effective for depression. Dr Sivasanker can provide referrals to specialist therapists as part of a comprehensive treatment plan.
About Psychological Treatments →Ketamine Therapy
For treatment-resistant depression, ketamine infusions can produce rapid and significant improvements in mood. Dr Sivasanker has considerable expertise in this novel therapy, which offers hope for patients who have not responded to conventional treatments.
About Ketamine Treatment →ECT & TMS
Electroconvulsive therapy (ECT) and Transcranial Magnetic Stimulation (TMS) are highly effective treatments for severe or treatment-resistant depression. Dr Sivasanker is a national expert in these neuromodulation therapies.
About ECT →Watch: Understanding Depression
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Depression — Frequently Asked Questions
Everyone experiences periods of sadness, but clinical depression is characterised by symptoms that are persistent (typically lasting two weeks or more), pervasive across many areas of life, and significantly impairing your ability to function. If you are unsure, a consultation with a psychiatrist like Dr Sivasanker will provide clarity through a thorough assessment.
Treatment-resistant depression is generally defined as depression that has not responded adequately to at least two different antidepressant medications given at adequate doses and for an appropriate duration. Dr Sivasanker has specialist expertise in this area and offers a range of advanced treatments including ketamine, TMS and ECT for patients in this situation.
Antidepressants are not addictive in the way that alcohol or illicit drugs are. However, some people do experience discontinuation symptoms when stopping them abruptly, which is why they should always be reduced gradually under medical supervision. Dr Sivasanker will discuss all of this with you before prescribing.
The duration of treatment varies depending on the individual and the severity of the depression. Many people start to notice improvements within 4–8 weeks of starting medication. A typical course of treatment is 6–12 months, though some people with recurrent depression may benefit from longer-term maintenance. Dr Sivasanker will discuss your individual prognosis at your consultation.
Yes. You do not need a GP referral to see Dr Sivasanker privately. You can self-refer using our appointment form or by calling us directly. We do recommend informing your GP that you are seeking private psychiatric input.
Yes. Dr Sivasanker has a clinic in Elstree/Borehamwood which serves patients from across Hertfordshire, including Watford, St Albans, Hemel Hempstead, Hatfield and surrounding areas. See our Hertfordshire page for more information.