Depression is one of the most common reasons people look for a private psychiatrist, and it is also one of the conditions where a GP can do a great deal. It is worth being clear about which situation you are in before you pay for anything.
Start with what a GP can already do
A GP can diagnose depression, prescribe an antidepressant, review it, and refer you into NHS services. The NHS says that if a GP thinks you would benefit from an antidepressant, you will usually be prescribed a selective serotonin reuptake inhibitor, or SSRI, and that symptoms should begin to improve within four weeks of starting. It also says that once you feel better you will need to keep taking the same dose for at least four to six months.
If you have had one episode of low mood, have not tried medication before, and your GP is willing to review you properly, a private assessment is unlikely to tell you anything your GP could not. The honest answer in that case is to use the NHS route and keep your money. The NHS page on treating depression in adults sets out the standard pathway.
Five situations where a psychiatrist adds something
A consultant psychiatrist spends the whole appointment on your mental health, has a deeper working knowledge of psychiatric medication, and is not limited to a ten-minute slot. That matters most in these situations.
Two treatments have not worked. If you have taken two antidepressants at an adequate dose for an adequate length of time and are still unwell, the next decisions get technical: whether to switch class, whether to add a second medicine, whether the dose or duration was genuinely adequate in the first place. The NHS notes that where several antidepressants have not helped, a specialist may add a medicine such as lithium to existing treatment. These are specialist decisions, and this is the most common reason people book.
There is doubt about the diagnosis. Low mood is a symptom, not a diagnosis. The question a psychiatrist is trained to ask is what else could produce this picture: bipolar disorder, undiagnosed ADHD, an anxiety disorder driving the low mood, burnout and exhaustion rather than depression, or a physical illness. Bipolar disorder matters especially, because antidepressants alone can be the wrong treatment. The NHS says bipolar disorder “can take time to diagnose because it affects everyone differently and the symptoms are similar to other mental health conditions”, and that a GP will refer to a psychiatrist where it is suspected. Its page on diagnosing bipolar disorder explains why. Anyone who has had a period of unusually high, driven or sleepless energy should say so at assessment, even if it felt good at the time.
Your medication history is complicated. Four antidepressants over fifteen years, two of them stopped for reasons nobody wrote down, is difficult to untangle in a short GP appointment. A medication review exists precisely for this.
Side effects are the problem. Sexual side effects, weight change, sedation, emotional blunting and withdrawal symptoms on missed doses all have alternatives worth considering. People often stop a medicine that was working rather than raise the side effect, then relapse.
The episodes are severe or keep coming back. Recurrent depression raises different questions from a first episode, particularly about how long to stay on treatment and what relapse prevention looks like.
What the assessment actually covers
The initial appointment with Happy Clinic is a 60-minute video consultation with a GMC-registered consultant psychiatrist. It is a structured conversation, not a questionnaire.
Expect to cover your current symptoms and how long they have lasted; sleep, appetite, concentration and energy; what you can no longer do that you used to do; any thoughts of harming yourself; every psychiatric medicine you have taken, at what dose, for how long, and why it stopped; alcohol, cannabis and other drug use, asked without judgement because it changes treatment; physical health, other medicines and anything relevant in your family history; and periods of elevated mood or unusual energy.
The output is a diagnostic opinion, a treatment plan, and a written clinical summary sent to you, and to your GP with your consent. If the answer is that you do not need what a psychiatrist offers, you should be told that.
What a psychiatrist can change about medication
This is the concrete part. Within a treatment plan, the options are usually some combination of the following.
| Option | When it tends to be considered |
|---|---|
| Starting a medicine | No previous antidepressant trial, or none for many years |
| Switching | No response after an adequate trial, or intolerable side effects |
| Adjusting dose | The medicine helps but the dose was never optimised |
| Augmenting | Partial response to an antidepressant that is otherwise suiting you |
| Stopping or reducing | The medicine is not earning its place, or it is time to come off carefully |
| Changing nothing | The current plan is reasonable and needs time, not another change |
Prescriptions issued during an appointment are included in the fee, and repeat prescriptions for existing patients are handled separately through the prescriptions process. Physical health monitoring and blood tests, where needed, are usually arranged with your GP.
The limit that matters most: therapy
Happy Clinic does not provide psychological therapy. It can advise on which therapy is likely to suit you and why, but the therapy itself has to come from somewhere else.
This is worth saying plainly, because for a lot of depression therapy is the more important half of the treatment. The NHS says that “a combination of an antidepressant and CBT usually works better than having just one of these treatments”. If you are in England you can refer yourself to NHS talking therapies without going through a GP, using the NHS find a service page. Waiting times vary by area, so it is often sensible to put that referral in before your psychiatry appointment rather than after it. In Scotland, Wales and Northern Ireland the equivalent services are arranged differently, and your GP is the quickest way to find out what is available locally.
Follow-up and monitoring
A medication change is not a single event. Any new antidepressant needs a few weeks before its effect can be judged, and side effects usually appear before benefit does. Follow-up appointments are 20 minutes and exist to answer three questions: is it helping, is it tolerable, and does anything need to change.
Longer term, most people are better served by their own GP holding the prescription, with a psychiatrist involved when something needs rethinking. That is cheaper and safer than indefinite private follow-up, and the clinical summary is written so your GP can take it on. The Royal College of Psychiatrists’ depression information is a useful independent read alongside it.
What it costs
An initial psychiatric assessment is £400 for 60 minutes. Follow-up appointments are £200 for 20 minutes. A repeat prescription request for existing patients is £150 and is subject to clinical review. Fees are paid in advance, and prescriptions issued during an appointment are included, though pharmacy charges are not. Fees checked September 2026 — see the fees page for the current list.
For a straightforward course of treatment, a realistic budget is the assessment plus one or two reviews. If you are weighing that against the NHS route, the NHS or private page compares the two honestly.
How to prepare
Half an hour of preparation makes a 60-minute appointment considerably more useful.
- Write a medication list: every psychiatric medicine, the dose, roughly when you took it, and why you stopped. Your GP surgery can print this.
- Note when this episode started and what was happening at the time.
- Write down your two or three most important questions, and ask them early rather than at minute 55.
- If you have ever had a spell of unusually high energy, reduced need for sleep or uncharacteristic risk-taking, write that down too.
- Have somewhere private to sit with a decent connection, and your pharmacy details to hand.
Consultations, diagnosis and prescriptions are provided by Happy Clinic, which is registered with the Care Quality Commission (CQC). More detail on how appointments run is on the first appointment page, and the online psychiatry page explains how video consultations work in practice.
Speak to a Consultant Psychiatrist
Book a secure video consultation with Happy Clinic, for adults aged 18 and over anywhere in the UK. No GP referral is needed and appointments are often available within days.
This page is general information and is not a substitute for personal medical advice. Consultations, diagnosis and prescriptions are provided by Happy Clinic, which is registered with the Care Quality Commission (CQC). If you are in crisis, call 999, go to A&E, call NHS 111 or call Samaritans free on 116 123.