Low mood and anxiety are the commonest reasons adults see a doctor and both respond to treatment. A GP assesses you, checks the physical causes, and starts talking therapy or medication where it is right. A consultation is £150 and a psychiatric assessment is £895.
Message the clinic and a doctor replies within 24 hours.
Any of these needs to be seen the same day. If you are severely unwell, go to your nearest emergency department or call 999.
Low mood becomes depression when it lasts most of the day, most days, for 2 weeks or more, and takes the pleasure out of things that used to give it. Severity is judged on how much of your life it is taking rather than on how sad you look.NICE NG222, 2022
Anxiety becomes a disorder when the worry is out of proportion, hard to control, and getting in the way of work, sleep or people. The two travel together more often than not, and treating one usually improves the other.NICE CG113, 2020
Both have physical mimics worth excluding. An underactive thyroid produces low mood, tiredness and cold intolerance, and it is treated by treating the thyroid rather than the mood.NICE NG145, 2019
Iron deficiency causes tiredness, poor concentration and low mood well before it shows on a blood count. The reading that finds it is ferritin, and a figure under 30 is treated as depletion whatever the haemoglobin says.Gut Snook, 2021
Low vitamin D is common in the UK between October and March. Correcting it does not treat depression, and leaving it uncorrected leaves one contributor to the tiredness in place.NICE PH56, 2017
Send us what you are seeing and we will tell you what it is likely to be.
The first appointment is a conversation with time in it. What has changed, for how long, what is at risk, what you have tried, and what you want back. Risk is asked about directly, because not asking is what makes it dangerous.NICE NG222, 2022
A blood panel is taken where the picture suggests a physical contributor. Thyroid, ferritin, full blood count and vitamin D. Results come back in a day or two and are read alongside the rest rather than in isolation.New England Journal of Medicine Camaschella, 2015
Guided self help and structured exercise
First line for less severe depression, with evidence behind both. They are offered rather than mentioned, because a recommendation with no referral attached is where most plans stop.NICE NG222, 2022
Cognitive behavioural therapy
First line for anxiety disorders and effective for depression. Where you already have a therapist we work alongside them rather than starting again.NICE CG113, 2020
Antidepressant medication
A network meta analysis of 21 drugs across 522 trials found all of them more effective than placebo, with meaningful differences between them in effect and in how well people tolerate them. Which one is chosen is a real decision rather than a coin toss.The Lancet Cipriani, 2018
Both together
Medication and therapy combined outperform either alone for moderate to severe depression, and that is the usual recommendation at that severity.NICE NG222, 2022
A consultant psychiatrist
For severe illness, for a diagnosis that is unclear, for bipolar features, and where treatment has not worked. A full hour with a written plan, usually within the week.NICE NG222, 2022
Antidepressants take 2 to 4 weeks to show an effect and up to 6 to 8 weeks for the full one, and the first 2 weeks can feel worse rather than better. That is the period most people stop in, which is why the review is booked at the start rather than offered later.NICE NG222, 2022
The inconvenient half. In the trials all 21 antidepressants beat placebo and the differences between the drugs were modest, and a large part of what people feel is not attributable to the drug itself. That does not make them ineffective. It does mean therapy, exercise and what is going on in your life are not optional extras alongside them.The Lancet Cipriani, 2018
Treatment continues for at least 6 months after you feel well. Stopping at the point of recovery is the commonest reason for relapse, and coming off is done gradually with a doctor rather than at once.NICE NG222, 2022
Answer the two questions the assessment starts from. Over the last 2 weeks, how often have you felt down, depressed or hopeless, and how often have you had little interest or pleasure in doing things. Score each 0 to 3 and bring both numbers.NICE NG222, 2022
Track sleep, alcohol and movement for a fortnight. Hours slept, units drunk, minutes walked. Those three change mood measurably and they are the parts of the plan that belong to you rather than to a prescription.NICE CG113, 2020
Write down what you want back rather than what is wrong. Sleep, concentration, patience with your family, wanting to see people. Treatment is judged against that list at 4 weeks, and it is a better measure than any score.
Do not buy a wide hormone or micronutrient panel to explain low mood. Thyroid, ferritin, full blood count and vitamin D cover the physical causes that matter, and the broader panels add markers nobody acts on.New England Journal of Medicine Camaschella, 2015
Do not book a consultant psychiatrist first if you have not seen a GP. Most low mood and anxiety is treated well in general practice, and a £895 assessment is the right first step for the severe and the complicated rather than for everyone.NICE NG222, 2022
Step 1
30 minutes, in person or by video. What has changed, for how long, what is at risk, and what you want back.
Step 2
Thyroid, ferritin, full blood count and vitamin D where the picture suggests it. Results in a day or two, read alongside everything else.
Step 3
Therapy, medication or both, with the review booked before you leave. Where a consultant psychiatrist is the right next step, an hour long assessment usually within the week.
Ask before you book if you are not sure this is the right appointment.
A GP, in most cases. Most low mood and anxiety is treated well in general practice. A consultant psychiatrist is for the severe, the complicated, an unclear diagnosis and cases that have not responded, and the GP will say plainly when that is you.
Only if it is right for you and you agree. Guided self help, exercise and therapy are first line for less severe depression and for anxiety. Medication is for moderate to severe illness or where therapy alone has not worked, and the two together outperform either at that severity.
Two to 4 weeks for a first effect and 6 to 8 for the full one, and the first fortnight can feel worse before it improves. That is when most people stop, which is why the review is booked at the start rather than left to you to arrange.
A network meta analysis of 21 drugs across 522 trials found all of them more effective than placebo, with real differences between them in effect and tolerability. The effect sizes are modest, which is why therapy, exercise and circumstances are treated as part of the plan rather than as extras.
A GP appointment is usually available the same or the next day, in person or by video. A consultant psychiatrist assessment is usually within the week. If you are in crisis today, call 999 or Samaritans free on 116 123 rather than waiting for an appointment.
Yes. Your record is yours and nothing goes to your employer or another doctor without your consent, with one exception, which is an immediate risk to life. That exception would be discussed with you rather than acted on silently.
A GP consultation is £150 for 30 minutes. A blood panel covering thyroid, iron and vitamin D is £350. A full hour with a consultant psychiatrist, with a written plan, is £895. The review by telephone after starting treatment is £59.
At least 6 months after you feel well, because stopping at the point of recovery is the commonest cause of relapse. Coming off is done gradually and with a doctor rather than all at once, and that plan is made before you start.
This page is general information about a condition and it is not a diagnosis. Treatment depends on what a doctor finds when they examine you, and no outcome is guaranteed. If you are severely unwell, or if any of the warnings at the top of this page apply to you, go to your nearest emergency department or call 999.
Gut, British Society of Gastroenterology
Guidelines for the management of iron deficiency anaemia in adultsSnook, 2021
New England Journal of Medicine
Iron deficiency anaemiaCamaschella, 2015
NICE
Vitamin D, supplement use in specific population groupsPH56, 2017
NICE
Thyroid disease, assessment and managementNG145, 2019
NICE
Generalised anxiety disorder and panic disorder in adults, managementCG113, 2020
NICE
The Lancet
Comparative efficacy and acceptability of 21 antidepressant drugs, a systematic review and network meta analysisCipriani, 2018
Written and reviewed by the clinical team at The Wellness. Last reviewed 8 September 2026.
Tell us what is going on and a doctor will say what to book, or whether you need to be seen today.