Depression is characterised by a markedly low mood, changes to sleep and appetite, diminished pleasure in activities, fatigue, lack of motivation and persistent negative thoughts about the self. The mind may try to problem solve by “working out” the negative thoughts. This then results in the mood dropping further. The mind goes back to think about it some more, the mood drops further still. This process is called rumination. As well as rumination we may also engage in less activity and withdraw from our social support network.