PIP for depression, which activities score points and how to describe your worst days

How depression maps to PIP

PIP is a functional assessment — it does not ask what your diagnosis is, it asks what you can and cannot do across 12 activities. Depression affects functioning in several distinct ways: motivational deficit (inability to initiate tasks), cognitive slowing (difficulty concentrating, reading, making decisions), social withdrawal (inability to engage with others), self-neglect (failure to wash, dress, eat), and crisis risk (suicidality, self-harm). Each of these maps to one or more PIP activities.

The activities most commonly scored for depression are:

• Activity 9 — Engaging with other people face to face: social withdrawal, inability to interact with unfamiliar people, overwhelming distress in social situations.
• Activity 4 — Washing and bathing: self-neglect, inability to initiate personal care without prompting or assistance.
• Activity 1 — Preparing food: motivational deficit, inability to concentrate on cooking safely, cognitive slowing making preparation take more than twice as long.
• Activity 2 — Taking nutrition: loss of appetite, failure to eat without prompting.
• Activity 8 — Reading and understanding signs, symbols and words: concentration impairment meaning the claimant cannot read or follow written instructions reliably.
• Activity 10 — Making budgeting decisions: cognitive impairment preventing management of money or bills.
• Mobility Activity 1 — Planning and following journeys: inability to leave the house alone due to depression, agoraphobic avoidance as a depressive symptom.

The majority-of-days test (Reg 7)

Regulation 7 of the Social Security (Personal Independence Payment) Regulations 2013 provides that where a claimant's ability varies — as it typically does in depression — they satisfy a descriptor if they meet it on more than 50% of days over a 12-month period (or the period since onset, if shorter). This is the majority-of-days test, and it is the most important rule for episodic or fluctuating mental health conditions.

Depression is characteristically episodic. A person may function reasonably well for a fortnight, then spend ten consecutive days unable to leave bed, wash, or cook. Under Regulation 7, if the bad days exceed the good days in aggregate, the claimant scores the descriptor for the bad days. A person who is severely functionally impaired on four days out of seven scores on the basis of those four days.

In practice, DWP assessors sometimes assess on the basis of the claimant's presentation on the day or on reported "good days". This is legally incorrect. If a decision or assessment report appears to have applied a best-day rather than majority-of-days standard, cite Regulation 7 expressly in your Mandatory Reconsideration or appeal submission.

Daily Living descriptors for depression

Activity 1 — Preparing food. Motivational deficit is the most misunderstood aspect of depression in PIP claims. An assessor may note that the claimant "is physically capable of cooking". But if severe depression means the claimant cannot initiate the task without prompting (descriptor 1e, 2 points), or cannot do so safely because cognitive slowing and dissociation create a risk when using a hob (descriptor 1d, 4 points), they score. Describe specific incidents: "On three days last week I did not eat a cooked meal because I could not bring myself to cook. My partner had to prompt me."

Activity 2 — Taking nutrition. Descriptor 2b (2 points) applies where the claimant needs prompting to take nutrition. Severe depression causing complete appetite loss and failure to eat without reminder qualifies. Descriptor 2d (4 points) applies where the claimant requires assistance to cut food or manage a meal — relevant where cognitive or motor slowing makes eating difficult.

Activity 4 — Washing and bathing. Self-neglect is a recognised symptom of severe depression. Descriptor 4b (2 points) applies where the claimant needs prompting to wash. Descriptor 4c (2 points) applies where they need a bath or shower to be prepared for them. Descriptor 4d (3 points) applies where they need physical assistance to wash. Many people with severe depression do not wash for days at a time — describe this specifically, including frequency and what intervention (if any) prompts eventual washing.

Activity 8 — Reading and understanding signs, symbols and words. Cognitive impairment in depression — often described as "brain fog" or "pseudo-dementia" in clinical literature — can prevent the claimant from reading and understanding written information reliably. Descriptor 8b (2 points) applies where the claimant needs someone to read or interpret written information for them. If concentration is so impaired that the claimant cannot reliably follow written instructions (e.g. medication leaflets, letters from DWP), this descriptor applies on a majority-of-days basis.

Activity 9 — Engaging with other people face to face. Depression-driven withdrawal, inability to initiate social interaction, and overwhelming distress in social settings all score here. Descriptor 9b (2 points) requires prompting to engage. Descriptor 9d (4 points) applies where engagement causes significant distress. Descriptor 9e (8 points) applies where engagement causes overwhelming psychological distress — applying the threshold from MH v SSWP [2016] UKUT 531 (AAC). Many people with severe depression are effectively housebound and unable to interact with anyone outside their household on most days.

Mobility component

Mobility Activity 1 — Planning and following journeys. Depression can prevent someone from leaving the house entirely on the majority of days. Descriptor 1c (8 points) applies where undertaking any journey would cause overwhelming psychological distress. Descriptor 1d (10 points) applies where the claimant needs prompting to undertake any journey. Descriptor 1f (12 points) — enhanced Mobility — applies where even a familiar journey cannot be undertaken without accompaniment.

Even where the depression presents primarily as lethargy and withdrawal rather than anxiety, inability to leave the house alone on the majority of days qualifies for Mobility Activity 1 descriptors. A GP or CMHT letter confirming social isolation and inability to attend appointments independently is valuable evidence.

Evidence that wins claims

• CMHT letter or care plan: Document diagnosis, PHQ-9 scores (a score of 20+ indicates severe depression), care coordinator involvement, crisis plan, and medication. This is the most authoritative evidence available for a depression claim.
• GP letter: Should confirm: diagnosis and date of onset; full antidepressant history including dose escalations (e.g. sertraline escalated to 200mg, then switched to venlafaxine, then mirtazapine augmentation); referrals to CMHT or IAPT; the GP's view of functional impact on daily living. Ask specifically for the letter to address how your depression affects your ability to wash, cook, leave the house, and interact with others.
• Prescription records: Treatment-resistant depression often involves multiple medication trials — lithium augmentation, antipsychotic augmentation (quetiapine, aripiprazole), or combination antidepressants. This history demonstrates severity far more effectively than a single drug on a low dose.
• Hospital admission, A&E or crisis team records: Any psychiatric inpatient admission, A&E attendance for self-harm or suicidal crisis, or crisis team involvement is powerful objective evidence that the condition is severe. Request these records under Subject Access Request from your NHS trust and attach copies to your PIP2.
• Suicide risk documentation: If your GP or CMHT has recorded suicide risk assessments, these are directly relevant to the safety limb of the Reg 4(2A) reliability test. A claimant with active suicidal ideation cannot perform activities safely — this should be made explicit in your submission.
• Carer or family statement: A written statement describing what a typical bad day looks like, what tasks the carer assists with, and how often — signed and dated — can be the deciding factor at tribunal when medical evidence is incomplete.

How to describe your worst days

The single most common reason depression PIP claims are under-scored is that claimants describe their best days, or use vague minimising language. On the PIP2 form and in any supporting statement, follow these principles:

• Be specific and concrete. "I find it hard to cook" is weak. "On most days I do not eat a cooked meal because I cannot motivate myself to prepare one. I eat cereal or nothing. This has been the case for at least the past three months" is scoreable.
• Quantify frequency. "Most days", "at least four days out of seven", "every day during a low episode, which lasts on average two weeks per month" — these all apply the Reg 7 majority-of-days standard to your own experience.
• Describe the consequence of not doing the activity. "I have not washed in four days. My partner eventually runs a bath for me and stays nearby because I have previously harmed myself in the bathroom." This scores Activity 4 and addresses the safety limb.
• Do not compare yourself to a worse case. "Other people have it worse" has no legal relevance. PIP is assessed against the descriptors, not against other claimants.
• Describe the impact of treatment too. Even on medication, if your PHQ-9 remains at 18 and you cannot function independently, the treatment is not resolving the functional limitation. Treatment does not disqualify a claim — DWP must assess residual limitation after treatment.

At the assessment

PIP assessments for depression carry well-documented risks. Assessors may record: "appeared well-kempt", "maintained eye contact", "conversed appropriately" — and use these to infer the condition is not severe. These inferences are legally questionable: the DWP PIP Assessment Guide requires assessors to consider the majority of days, not solely the assessment day.

Counter-measures:

• Request the assessment report immediately after the appointment and before the decision. Submit corrections in writing to DWP.
• Bring a companion — a family member or support worker who can describe what they observe.
• Tell the assessor explicitly that you are having a better day than usual today, and that this is not representative of the majority of your days.
• If you cannot attend due to depression, contact DWP before the appointment. Request a home visit or paper-based decision — both are available.

If refused

Request Mandatory Reconsideration within one month. In your letter, cite Regulation 7 (majority of days), Regulation 4(2A) (reliability test), and the specific descriptors you believe should have been scored. Attach any new evidence — an updated PHQ-9, a crisis team letter, a more recent GP letter. If MR fails, appeal to the First-tier Tribunal within one month.

For the complete process from claim to tribunal, including how to find a welfare rights adviser, see our PIP: the complete claim guide. If depression is also preventing you from working, see our guide on LCWRA on Universal Credit, which is a separate entitlement that may run alongside PIP.

Frequently asked questions