Depression Treatment in Kathmandu: Signs, Types and What Helps

What depression is, and what it is not

Everyone feels low at times. Depression is different: the low mood or loss of interest is persistent, affects almost every part of life, and does not lift with rest or good news. It is not laziness, a lack of willpower or a punishment. It involves changes in how the brain handles stress and mood, shaped by genes, health, life events and circumstances.

Signs of depression

• Feelings: persistent sadness, emptiness, hopelessness, guilt, irritability, or feeling numb.
• Interest and energy: losing pleasure in things you used to enjoy, constant tiredness, moving or speaking more slowly.
• Thinking: trouble concentrating or deciding, negative thoughts about yourself or the future, thoughts of death.
• Body: sleeping too little or too much, changes in appetite or weight, headaches, aches and pains with no clear cause.
• Behaviour: withdrawing from family and friends, neglecting work, study or self-care.

In Nepali: डिप्रेसन, उदासी, निराशा, केही गर्न मन नलाग्ने, निद्रा र भोकमा परिवर्तन.

Types and related conditions

Doctors distinguish major depression (a distinct episode), persistent depression (milder but long-lasting), depression after childbirth, and depression that occurs with anxiety. Low mood can also be part of bipolar disorder, which needs different treatment, so a careful assessment matters.

Causes and risk factors

There is rarely one cause. Family history, long-term stress, loss and grief, physical illness, poor sleep, alcohol or drug use, loneliness, money worries and migration stress can all contribute. Depression can also follow thyroid problems, vitamin deficiencies or some medicines, which is why a doctor checks for physical causes.

Why depression is often missed in Nepal

Many people first mention headaches, stomach trouble, weakness or trouble sleeping rather than low mood. Others worry about log kya bhanchhan (what people will say) or believe it will pass on its own. Seeing a psychiatrist is private, and telling the doctor about both your body and your feelings helps them understand what is happening.

How depression is assessed

The doctor talks with you about your mood, sleep, energy, thoughts, history and stresses, asks about safety, and may use a short questionnaire. Blood tests may be suggested to look for thyroid, vitamin or other problems. Someone who knows you well can add useful information if you wish.

Treatment

• Talking therapy. Cognitive behavioural therapy (CBT) helps you change unhelpful thoughts and habits, and behavioural activation gradually rebuilds routines and enjoyment.
• Antidepressant medicine. Helpful for moderate to severe depression. It is not addictive, usually takes about two to six weeks to work, and is normally continued for months after you feel well to prevent relapse. It should not be stopped suddenly.
• Together. Therapy and medicine often work better in combination for more severe depression.
• Everyday support. Regular sleep, movement, contact with people you trust, less alcohol, and treating any physical illness.

What recovery looks like

Improvement is usually gradual: sleep and energy often return first, then mood and interest. Setbacks happen and do not mean treatment has failed. A follow-up plan helps you spot early warning signs and act quickly.

When it is urgent

How we help

Our consultant psychiatrists assess depression, explain the diagnosis in plain words, and agree a plan with you, including CBT and medicine where suitable. Visit us at People's Plaza or Kalanki, or consult online in Nepali or English. See our depression services or book a consultation.