What Can Cause Depression to Get Worse?

Medically reviewed by: Shane Trujillo, EdM
Monday, May 1 2023

If you’ve been diagnosed with depression, you’re not alone. According to the National Alliance on Mental Illness, 21 million people in the U.S. experience depression. 

You may be working with a mental health professional to manage your symptoms of depression. If you're in therapy, you and your therapist will work together to determine whether your symptoms are improving. If you are going through life changes that affect your progress or you feel that you’re not getting better, talk to your therapist. It’s important to let your therapist know how you’re feeling so they can help you.

Read on to learn about depression and signs that it could be getting worse.

What is depression?

Depression is different than when you’re feeling in a “funk” or have “the blues.” Depression is a common and serious mental health condition that affects how you feel and your behaviors. Depression symptoms can be mild or moderate or severe and can include feelings of sadness, loss of interest in activities, changes in appetite, feeling guilty or worthless, or thoughts of death or suicide. If symptoms of depression last for at least two weeks, it’s best to talk to a doctor or mental health professional. They can screen for depression and help with next steps.

What can cause depression to get worse?

1. Dwelling on the negative

When you focus on negative thoughts, it can be hard to see the bright side of things. Common unhelpful ways of thinking could be:

  • You think something is true when it isn’t quite based on fact. This is called emotional reasoning.. You might say “I’m not funny or smart enough around people so therefore I am not an interesting person.”
  • You overlook the positive and focus only on the negative. An example is, “I thought I was a good artist, but people did not react well to my last work, so I must be a failure.”
  • You think in black and white and go to extremes. Does this thought sound familiar? “Why do bad things always happen to me?”

If focusing on the negative is causing your symptoms to get worse, your therapist will help you challenge these thoughts to see things from a different perspective.

2. Other mental and physical conditions

Your mental and physical health are closely related. If you are managing a chronic illness, such as diabetes or heart disease, it can increase your risk for depression or make it worse. Vice versa, if you have a mental health condition, it could make managing your physical health difficult. That’s why it’s important to pay attention to your mental and physical health, and talk to your doctor or therapist if you see any changes. 

3. Withdrawing from others

Wanting to spend time alone isn’t necessarily a sign of depression. In fact, doing things on your own helps you focus on yourself and enjoy things differently. Imagine walking through an art museum or doing some shopping by yourself. What a great way to enjoy “me time” and do things at your pace. But if you’re withdrawing from others more than usual, it’s time to pay attention.

Check your calendar. Are you spending less time than usual with friends and family? Do you decline invitations, even casual ones, because you want to be alone all the time? Do you avoid responding to phone calls, texts, or emails? If any of these sound familiar, bring them up with your therapist.

4. Relationship issues

Having healthy relationships can be extremely fulfilling and give you a sense of self-worth and connection. But if you’re experiencing problems in your relationships with friends or family, or there’s tension in your romantic relationships, it can make depression worse. 

Be open with those around you — let them know you need their support. You may already be receiving care for your depression but you can also consider marriage and couples’ counseling to help improve the health of your relationships. 

5. Unhealthy stress

There’s good stress and there’s not-so-good stress. Beneficial stress is short term and helps prepare you mentally and physically to handle a challenge. Not-so-good stress can affect physical health and increase a person’s risk for anxiety and depression, particularly episodes of major depression. If left untreated, it can lead to physical health issues such as high blood pressure, heart disease, and diabetes.

6. Poor sleep

Sleep is your body's way to get the rest it needs to fight disease.  The quality of your sleep affects your physical and mental well-being, your metabolism, and ability to manage chronic disease. It can also affect your mood. Poor quality sleep can affect depressionanxiety, and other mental health conditions. So, make getting proper sleep a priority. When your body gets the rest it needs, it can help you manage your physical and mental health.

7. Substance abuse

If you’re depressed, you may be inclined to misuse substances, such as drugs or alcohol, or engage in unhealthy activities, such as gambling.  If you find that you’re reaching for that extra glass of alcoholic beverage or that you’re headed for the casino as soon as it’s payday — and it’s impairing your ability to function and/or affecting your relationships, it’s time to talk to your therapist.  

What to do if your depression symptoms are getting worse

Talk to your therapist

Therapy is not a straight line. It’s a journey that has twists and turns and where the real work will happen in between sessions. As you make progress toward your goals, it’s natural to have some setbacks. If you feel you’re not making progress, have an honest conversation with your therapist. It’s okay to let down your guard and be open with them. Your therapist is there to help guide you and get you back on track. 

Adjust your treatment plan, if needed

As you progress through therapy, your therapist may ask you to answer a few questions about your mental well-being and function. These are called clinical questionnaires, or CQs for short. Your responses to these questions are a way for your therapist to track your progress and for you to be involved in your care. Throughout your therapy journey, CQs can help your therapist better understand if you’re meeting your goals, whether your treatment is on track, or if changes to your treatment plan need to be made.

If you haven’t already, seek professional help

If you’re not seeing a mental health professional and you’re experiencing these concerns, it might be time to consider talking to one. Sometimes, problems can be too difficult to deal with on our own. They might last and interfere with our ability to function or fully enjoy our lives. There is no right time to seek therapy — the best time is when you recognize you need help and are ready, with the support of a licensed professional, to get your life back on track. SonderMind can help connect you with a licensed mental health professional when you’re ready.

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