Deal With Your Major Depressive Disorder Triggers

Everyone experiences depression differently, and triggers can vary widely from person to person, says Christina Gentile, PsyD, a clinical health psychologist at UCLA Health in Los Angeles.

“Triggers can differ not only in what happens, but in how that experience affects the person. The same event may be manageable for one person and deeply destabilizing for another,” Dr. Gentile says.

“A single event can absolutely trigger a depressive episode. Other times, depression develops after stress has been building for a while. The common thread is that the person’s ability to cope and recover becomes overwhelmed,” Gentile says.

Most triggers tend to fall into a few key categories.

Bereavement and Loss

Grief is a natural response to loss, but for some people, it can also trigger an MDD episode, says Chivonna Childs, PhD, a psychologist at Cleveland Clinic who specializes in treating people with anxiety, depressive disorders, trauma, and post-traumatic stress disorder (PTSD).

“Some of the common triggers for MDD are the loss of a loved one, the loss of a job, or the loss of a relationship,” Dr. Childs says.

Depression and grief can overlap during times of bereavement.

Research suggests that while many people gradually adapt after the death of a family member, some people who are bereaved have depressive symptoms that can last for years.

Facing unemployment, the end of a relationship, or the loss of one’s health or sense of identity can also increase the risk of depressive symptoms, Childs says.

It can be especially difficult when it feels sudden, unexpected, or life-altering. Beyond the loss, people are left navigating uncertainty, she says.

“When you have a loss, you’re now wondering, ‘How am I going to handle this? What am I going to do?” Childs says. “You don’t know what’s next.”

For some people, a single loss may be enough to trigger depression. For others, depression develops — or recurs — after multiple losses accumulate over time.

“It just becomes a compounding event. You keep losing, or you keep getting disappointed, or other events keep triggering that feeling of depression, of loss, of sadness,” Childs says.

Major Life Changes

Major life changes are also common triggers for depression, Gentile says.

Research offers examples, such as debt and financial stress, divorce, or a serious illness or injury.

One research review of six randomized, controlled trials found that people in treatment for depression who reported three or more of these major life transitions faced significantly worse outcomes than those with none.

“A trigger is more likely to become clinically significant when it feels inescapable, uncontrollable, isolating,” Gentile says. Depressive symptoms can also be exacerbated when you’re without support or practical help, access to treatment, or time to rest and recover.

Daily Stressors

Sometimes it isn’t a life-changing moment that triggers depression, but daily stressors accumulating over time, Gentile says.

This can look like work burnout or job dissatisfaction, financial pressures, caregiving demands, or constant time constraints.

“Daily stressors may not look dramatic from the outside, but over time they can keep the brain and body under prolonged strain,” she says, noting that chronic stress can disrupt sleep, appetite, energy, motivation, and emotional regulation.

Genetics and Family History

Some people may be biologically more vulnerable to depression than others.

Childs says family mental health history is one of the first things doctors ask about during an assessment, because it can provide some context about your risk factors.

People who have a parent or sibling with depression may be two to three times more likely to develop the condition than those without a family history. That means their depression risk is 20 to 30 percent, versus 10 percent for people without a familial link.

But genetics alone does not decide whether someone will develop the condition, Gentile says. There are many more moving parts: your stress levels, life experience, physical health, lifestyle, and support systems. “Genetics are not destiny … family history may increase vulnerability, but it does not determine someone’s future,” she says.

Chronic Pain and Other Medical Conditions

A new medical diagnosis, ongoing illness, or a chronic pain condition can increase the risk of depression.

These can also be ways of experiencing loss, especially if they affect your daily routines and sense of control, or they create feelings of uncertainty and fear of what comes next, Childs says.

One study of more than 6.5 million people in Denmark found that those diagnosed with a medical condition had more than double the risk of developing MDD than people without a medical condition. Depression risk was highest in the first month after diagnosis.

Chronic pain is also tied to depression. A research review found that about 39 percent of adults with chronic pain had symptoms of depression, and about 37 percent had an MDD diagnosis. Depression symptoms were highest among people with fibromyalgia.

Childs says many major health conditions also involve loss — such as the loss of a former routine, identity, or ability. “It’s that uncertainty that can really cause problems,” she says.

Some medications used to treat chronic conditions also warn of depression as a potential side effect. They include corticosteroids (steroids), blood pressure medications, birth control medications or hormone replacement therapy, and medications to treat seizures, anxiety, and sleep problems, among others.

Hormonal Changes and Life Stages

Hormonal fluctuations can affect your mood and may lead to depression in a subset of people.

Hormonal changes that cause depressive symptoms can occur during pregnancy and postpartum, around menopause, and with conditions that affect hormone levels, such as thyroid disorders.

A major depressive episode may occur within the first three months after having a baby, for example.

These hormonal transitions do not automatically lead to depression, but they may increase vulnerability in some people, especially when they’re combined with factors like chronic stress, physical health problems, poor sleep, or limited social support, Childs says.

Alcohol and Substance Use

For some people, alcohol and drugs become a way to cope with stress, grief, or difficult emotions.

“A lot of times there can be a comorbidity with alcoholism or substance use. What it is, is self-medication,” Childs says. “Instead of going to a therapist, talking to someone we trust or using positive coping skills, those are somewhat maladaptive coping skills.”

Research suggests that heavy alcohol consumption, recreational drug use, and poor sleep are linked to an increased likelihood of depressive symptoms.

Overall, these lifestyle habits interrupt sleep, energy levels, motivation, daily routines, and emotional balance, Gentile says.

Social Isolation and Loneliness

Feelings of loneliness and isolation can also trigger depression. One study of about 5,400 people pointed to a “vicious cycle” of depression and loneliness — people who feel lonely are more likely to develop depression, and those with depression are more likely to become lonelier, the study’s author wrote.

Gentile says social isolation isn’t just about spending time alone. “It can mean losing access to emotional support, perspective, shared activities, and a sense of connection,” she says.