9 Common Depression Triggers - Verywell Health
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Depression is a mental health condition that causes emotional and physical symptoms such as persistent sadness and a loss of interest in activities you used to enjoy. About one in six people will experience depression at some point in their lifetime. Untreated, depression can make daily functioning difficult in many areas of life.
While there are several types of depression, this article refers specifically to major depressive disorder (MDD). MDD is episodic in nature, meaning it can come and go. Some people have only one MDD episode. The risk of recurrence, though, is about 60% after one episode, as high as 70% with two episodes, and about 90% after three or more episodes.
This article explains the common triggers for depression. Learning them can help you to avoid an episode, or at least recognize the need for treatment when one is beginning.
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Symptoms Of Depression
Symptoms of depression can range from mild to severe. They must last at least two weeks and indicate a change in your previous level of functioning to meet the criteria of clinical depression.
These symptoms of depression can include:
- Feeling sad or in a depressed mood
- Losing interest in activities you once enjoyed
- Changes in appetite
- Problems with sleep
- Fatigue, or decreased energy
- Feelings of guilt or worthlessness
- Problems with thinking, such as difficulty concentrating or making decisions
- Thoughts of death or suicide
What Does "Trigger" Mean?
The term "trigger" is often used to describe the cause of deep sadness, anxiety, or other feelings, typically in people experiencing posttraumatic stress (PTSD). This "trigger" may be a smell, sound, or sight. It may be a physical location, or an anniversary of a traumatic event. The word also can indicate a cue that leads to symptoms in other mental health conditions, such as depression.
Triggers For Depression
Anything can be a trigger for depression, depending on the unique individual. There are, however, some factors that are more commonly associated with depressive episodes.
Stressful Events and Loss
The death of a loved one is what we typically think of when we hear about loss. There are many other life events that also can be experienced as feelings of loss.
It is normal and expected to feel sadness and grief following these events. People may even describe themselves as feeling depressed. These feelings alone do not indicate clinical depression, but they can come before it or develop into depression. It is also possible to experience both grief and major depression at the same time.
Some differences between grief and depression include:
Painful feelings come in waves, and may be intermixed with positive feelings.
Self-esteem is not typically negatively influenced.
If thoughts of death occur, they are usually about "joining" the lost loved one.
The low mood and lost interest in activities occur most of the time for at least two weeks.
Feelings of worthlessness or self-loathing are common.
Thoughts of death and suicide focus on feeling worthless or unable to cope with the pain.
Stressful events not related to loss can also be triggers for depression. Both positive and negative life changes can be triggers. These might include:
- End of a relationship
- Job loss
- Experiencing violence
- Living through a major disaster
- Abuse
- Financial stress
- The addition of a new family member
- Getting married
- Retiring
- Graduating
Hormonal Changes
Puberty, pregnancy, and menopause cause significant changes in the body and typically are also life-changing events. The hormonal changes and the mental stress from these major changes can trigger depression for some people.
Postpartum depression (PPD) is a major depressive disorder following the birth of a child. Typically, it occurs in the person who gives birth. There is limited research on how it affects their partners, but a 2019 study suggests the birth can trigger depression in about 10% of men who are partners too.
Other Conditions Or Illnesses
The stress from any condition or illness can trigger depression, but there are some that have been specifically studied as being associated with depression.
Thyroid
According to a 2012 overview paper, overt hypothyroidism is rare in depression. However, mild or subclinical hypothyroidism is much more common.
Heart Disease
Harvard Health reports that up to half of heart attack survivors have a low mood, with many experiencing significant depression. The depression associated with heart disease has been linked to slower recovery, future cardiovascular problems, and higher risk of mortality within about six months.
Other Conditions
Other medical conditions that have been associated with mood disorders such as depression include:
- Degenerative neurological conditions, such as Alzheimer's disease
- Stroke
- Certain nutritional deficiencies, such as low vitamin B12
- Some endocrine disorders
- Some immune system conditions
- Some viruses and other infections
- Cancer
- Erectile dysfunction
- Head injuries
Which Came First?
It isn't always easy to tell if a medical condition, such as thyroid dysfunction, or the depression symptoms came first. These symptoms may resolve when the primary condition is treated.
Seasonal Changes
When episodes of depression occur with the change of seasons, it is called seasonal affective disorder (SAD). The formal diagnosis is major depressive disorder with seasonal pattern. SAD affects about 5% of adults in the U.S.
For most people with SAD, symptoms become worse in the fall and winter months when there are shorter daylight hours and less sunlight. Less commonly, some people experience the symptoms of SAD in the summer. SAD episodes typically last about 40% of the year.
Substance Use
Nearly half of the studies included in a 2017 systematic review found that baseline depression or anxiety was associated with later smoking behavior, such as starting to smoke or increasing the amount of smoking.
The review also found that over a third of the studies showed baseline smoking exposure was associated with later depression or anxiety. It's unclear if people who are depressed smoke to self-medicate, if smokers are more prone to developing depression, or some overlap of both.
Alcohol use can make depression symptoms worse as well. According to the National Alliance on Mental Health, people with substance use disorder are at a significantly increased risk of having a major depressive episode.
Lack Of Quality Sleep
Both depression and sleep disturbances can influence each other. This means that poor sleep can contribute to the cause of depression, while depression can interfere with sleep. Because they are so interconnected, it's not always possible to know which came first.
Of adults with depression, approximately:
- 75% experience insomnia, or inability to sleep well
- 20% have obstructive sleep apnea
- 15% have hypersomnia (excessive sleeping, particularly during the day)
It's also common for people with depression to cycle back and forth between insomnia and hypersomnia during a depressive episode.
Dietary And Exercise Habits
Healthy eating and exercise habits are important for physical and mental health.
Diet
The results of a 2020 systematic review of the research suggest that some foods may reduce the risk of depression. Others may increase the risk, when considered as overall dietary habits.
Dietary habits that may lower the risk of depression include:
- Balanced food choices
- Following an anti-inflammatory diet
- High intake of vegetables, fruits, and fish
- Adequate intake of folic acid, magnesium, and different fatty acids
- Limited processed foods
Diets that included higher amounts of these foods were associated with an increased risk of depression:
- Added sugar such as soda
- Processed foods
- Foods that contribute to increased inflammation in the body
Exercise
A 2020 narrative review found exercise may be an effective treatment for major depression in some adults. The results varied, though, and more research is needed to understand the level of exercise involved and how well it works over time.
This review showed that three sessions of physical exercise per week for 12–24 weeks typically reduced the severity of depression symptoms a medium to large amount.
Exercise also was found to increase by 22% the chance that people would not fall back into depression symptoms, when compared with treatment as usual.
These results are promising but not conclusive. Exercise routines may need to be ongoing to continue the benefits they provide.
Medications
Symptoms of depression can be a side effect of some medications, such as:
- Steroids
- Blood pressure medication
- Birth control pills
Talk to your healthcare provider about any medications you are taking. Be sure to include over-the-counter and herbal medicines, and let them know if you notice any side effects.
Stopping Treatment
If and when to stop treatment can be a difficult decision.
A 2020 study of 201 people with major depressive disorder found that one third to half of the participants had a recurrence of depression within one year of stopping treatment.
Another study found that stopping antidepressant treatment during remission led to a recurrence in 40% to 50% of the participants. In contrast, maintaining the treatment for six to 12 months after remission lowered the risk to 13% to 20%.
Other research found similar evidence to support extended antidepressant treatment for up to 12 months after remission of an acute depressive episode. It suggests possible use of long-term antidepressant treatment as a way to lower the risk of further depression episodes.
Can Depression Triggers Be Prevented?
Depression triggers cannot always be prevented, but there are ways to lower the risk.
Steps you can take include:
- Practice healthy eating, sleeping, and exercise habits.
- Write down your symptoms and what was happening when they occurred, looking for patterns or indications of what may have triggered you.
- Follow your treatment plan as indicated. Don't make changes or stop without discussing it with your healthcare provider.
When to See a Healthcare Provider
See a healthcare provider or mental health professional if you experience symptoms of depression for most of the day, every day, for at least two weeks.
Summary
Major depressive disorder tends to come in episodes. These episodes may be triggered by a diverse range of factors, from the loss of a loved one to seasonal changes or medication side effects.
In some cases, another health condition may contribute to symptoms of depression. These symptoms may improve when the condition is treated. In other cases, such as with sleep disorders, the difficulty sleeping and the symptoms of depression work to influence each other.
Depression triggers cannot always be predicted or prevented, but when triggers are known, steps can be taken to mitigate them.
A Word From Verywell
You may not know what triggered your depression episode, but understanding factors that are commonly associated with depression may help to lower your risk of having more of them.
If you are experiencing depression or want to learn ways to help prevent future episodes, talk with your healthcare provider or mental health professional.
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