The Lyceum

Why Depression May Go Unrecognised: Assessment Led Guidance

Specialist CBT therapy for anxiety, OCD, depression and more in West London

Depression can present in many different ways. Some people describe persistent low mood, loss of interest, fatigue, sleep changes or difficulty concentrating. Others describe physical symptoms, irritability, withdrawal or a sense of going through the motions. A guide cannot diagnose depression or determine whether a pattern of low mood is clinically significant. An assessment can consider the pattern, its impact, physical health, sleep, medication, other possible explanations and the person's goals. Physical symptoms such as fatigue, pain, appetite change, sleep disruption or concentration difficulties can have many possible causes, including physical health conditions, medication, neurodivergence, grief, relationship difficulties and other factors. New, severe or changing physical symptoms should be discussed with an appropriate medical professional rather than automatically attributed to depression. Research has explored why depression may go unrecognised. Possible reasons include presentations that do not match common descriptions, overlap with physical health conditions, concerns about stigma, limited time in primary care consultations, and individual differences in how distress is described or understood. A guide cannot determine which of these factors, if any, applies to an individual. CBT may be considered after individual assessment where depression is affecting daily life. It can involve exploring the links between thoughts, emotions, behaviour and the short and longer term effect. Any behavioural work should be planned with a suitably qualified clinician after discussion of the rationale, alternatives, safety and pacing. For related information, see depression therapy at https://lyceumclinic.co.uk/therapy/depression/, depression in West London at https://lyceumclinic.co.uk/guides/depression in west london/, depression statistics at https://lyceumclinic.co.uk/guides/depression statistics caution/ and cultural barriers to depression treatment at https://lyceumclinic.co.uk/guides/depression cultural barriers west london/. If there is immediate danger, thoughts of self harm, an inability to stay safe or a sudden marked deterioration, call 999, attend A&E or use urgent local crisis or medical support.

Frequently asked questions

Can a guide diagnose depression or determine why it went unrecognised?

No. A guide can describe general patterns. An individual assessment can consider your specific experience, health, safety and context.

Can physical symptoms be assumed to be depression?

No. New, severe or changing physical symptoms should be discussed with an appropriate medical professional rather than automatically attributed to depression.

Can CBT help with depression?

CBT may be considered after individual assessment. Whether it is appropriate, and what it would involve, depends on the person's assessment, health, safety and goals.

When should I seek urgent support?

If there is immediate danger, thoughts of self harm, an inability to stay safe or a sudden marked deterioration, call 999, attend A&E or use urgent local crisis or medical support.

Related pages

  • CBT for low mood and depression
  • Depression in West London guide
  • CBT for depression evidence
  • Behavioural activation therapy
  • Book a free 15 minute consultation
  • A therapist's caution: why West London's low depression rates need to be read carefully
  • Depression Therapy Waiting Times in West London: Assessment Led Guidance
  • Depression or burnout? How to tell the difference
  • Depression, Work, and Your Rights: What West London Employees Need to Know
  • Explore all clinical guides

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Written by Sanah Younis, BABCP accredited CBT Therapist at The Lyceum Clinic.

Last clinically reviewed: 14 August 2026

Clinical information on this page is general and does not replace personalised assessment. If you are in immediate danger, call 999 or attend A&E.

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