Why is my depression getting worse?

Depression is a mental health condition that leads to loss of interest in regular activities, social withdrawal, and intense feelings of sadness. If you’ve experienced depression, also called major depressive disorder (MDD), you know how deeply it affects your quality of life and day-to-day functioning. The good news is that depression is extremely treatable, and many people find relief through cognitive behavioral therapy (CBT), medication, and other treatment options.  

However, it’s possible for someone’s experience with depression to change over time. Life stress, new medical conditions, and lifestyle changes can all cause depression to return or worsen.  

If you’re experiencing worsening depression, you’re probably thinking, “Why is my depression getting worse?” In this article, we’ll review nine possible reasons for your worsening symptoms and how to handle this change.  

9 reasons for worsening depression  

There is a wide range of factors that may cause your depression to worsen, ranging from substance misuse to stress to lack of exercise. Regardless of why your depression is worsening, it’s important to discuss these life changes with your doctor so they can help you find the right treatment plan. It’s also helpful to know what triggers a worse depressive episode for you, so that you can make lifestyle changes and feel prepared in case a similar situation arises in the future.

1. Poor sleep quality

Good sleep helps you regulate your emotions and handle stress and life changes more easily. So it’s no surprise that an ongoing lack of good sleep habits may damage your mental health. Several things may be causing your lack of sleep, including sleep apnea, stress, insomnia, or physical pain.  

2. Substance use

Some people turn to substances to cope with the distress that comes with mental health conditions like depression. In fact, one-third of people with major depression also struggle with their relationship with alcohol. Substance abuse often worsens depression symptoms by increasing social isolation and feelings of sadness and loneliness.

3. Medication side effects

Finding the right antidepressant can be life-changing. However, if your medication isn’t working for you, it’s possible it can make your depression worse. A possible side effect of many antidepressants is worsening depression and suicidal thoughts. If you experience this side effect, tell your doctor immediately.  

It’s also possible for antidepressants to stop working and for your depression to return—a phenomenon called breakthrough depression.

4. Life changes

Big life changes like losing your job, moving, ending a relationship, getting divorced, or having a child often come with a lot of stress and an adjustment period. It’s common for depression to return or worsen during these periods.  

Moving or ending a relationship may result in changes in your support system, especially if you move away from family or lose touch with your close friends. Losing your job may also cause significant stress, including financial stress, that many people have a difficult time coping with. Life changes like pregnancy or menopause cause hormonal changes that can lead to depression. Learn about postpartum depression here.  

5. Stress

Stress isn’t always caused by massive life change. Sometimes small things, like juggling a busy routine, having a demanding job, or raising a family can put enough stress on a person that it affects their mental health. Chronic stress causes inflammation that impacts your brain, worsening depression for some.  

Your stress may also lead to anxiety, which can also affect your depression. Here’s more on how and anxiety and depression are related.

6. Physical pain

Not only can severe depression cause pain, but physical pain can cause depression. If you already struggle with depression and experience an accident or event that causes ongoing physical pain, it may cause a worse depressive episode.  

7. Social isolation

Loneliness and a depressed mood often go hand in hand. Feeling lonely may lead you to isolate yourself from loved ones and avoid social situations, especially if you also struggle with social anxiety. This isolation often worsens feelings of loneliness and symptoms of depression.  

8. Medical conditions

Chronic medical conditions may lead to clinical depression, or make depression worse, for a variety of reasons. For example, depression may be a side effect of certain medications. Ask your primary care doctor if you think an underlying medical issue is the reason for worsening depression.

Additionally, a medical diagnosis is a big change. It causes stress, lifestyle changes, and alters your day-to-day routine. This anxiety is enough to worsen depression for many people. On top of added stress, certain medical conditions, like Parkinson’s disease or strokes, actually change your brain, making it more likely for you to experience symptoms of depression.

9. Poor diet and lack of regular exercise

A healthy lifestyle, including regular physical activity, is shown to improve depression symptoms. If you use a healthy diet and exercise to help treat your depression, and then are no longer able to do so, your depression may worsen. Whether you stop exercising due to a medical condition, changes at work, a busy schedule, or other reasons—it’s possible your depression symptoms will return or intensify.

What should you do if your depression gets worse?

If your depression gets worse, it’s important to check in with a mental health professional and your support system. That means making an appointment with your psychiatrist, therapist, or another trusted healthcare professional to let them know what’s going on. They’ll be able to help you create a treatment plan—or adjust the one you already have—to meet your changing needs. This may include changing medications, changing doses, or increasing the frequency of your therapy sessions. Don’t worry, you’re not the first one to experience worsening depression and they’ll be prepared to support you.  

It’s also a great idea to check in with your friends and family members to let them know what’s going on. Social isolation and loneliness are hallmarks of depression, so working to combat those feelings by connecting with the people that care about you may help you start feeling better and serve as a good reminder that you’re not alone.  

Signs of worsening depression

Here are a few symptoms to look out for that may indicate worsening depression.

• Increased difficulty making decisions
• Increased feelings of worthlessness
• Lower energy levels
• Self-harm or suicidal thoughts
• Worsening sleeping patterns
• Weight loss or weight gain

Can you be depressed forever?

The short answer is no, depression is highly treatable and you can feel back to yourself after seeking treatment. Depressive symptoms can present differently for someone at different times in their life, so it's important to work with a psychiatrist to come up with an individualized plan for treatment in the context of your symptoms. Antidepressants are effective options that can balance serotonin or other brain chemicals to help relieve your symptoms, and it’s typically safe to restart them after stopping, too.

However, it’s important to know that depression commonly occurs in recurrent depressive episodes. Each depressive episode typically lasts anywhere from a couple of weeks to several months. The length of your depressive episodes—and the length of time between them—depends on a number of factors, including the underlying causes, how quickly you seek treatment, and whether you’re experiencing treatment-resistant depression. It may be years before you experience another episode.  

If your depression has lasted for a significant period of time, you may be experiencing persistent depressive disorder (PDD). Persistent depressive disorder is identified by mild to moderate depression symptoms that last for at least two years.

Every person experiencing depression is different. That’s why it’s important to speak to a mental health professional about the symptoms you experience. They can help you develop the right treatment plan for you and a realistic timeline for recovery.  

Ready to start treatment? Meet Talkiatry, a national psychiatry practice that provides in-network care. We’ll help you find an effective treatment plan that may include medication, therapy, or both. Schedule a first visit within days by completing a short online assessment.

The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.