When you think of stress, it probably brings negative emotions to mind. But some stress is good for you, like the anticipation you feel when you start a new relationship or job. It can fuel excitement and make you want to do and achieve more. Stress can also help you be prepared to face challenges or respond to dangerous situations.
Good stress doesn’t stick around. It boosts your mood to meet the moment, then goes away. If you’re under stress for long periods of time, it can become overwhelming and affect you both physically and emotionally.
“Our stress response does pretty good in the short term, but it doesn’t do very good if you activate it in the long term,” says David Prescott, PhD, associate professor of Health Administration and Public Health at Husson University in Bangor, ME.
“If we stay under chronic stress, our physiological stress response is taxed beyond what it’s designed to do, and it starts to impair us.”
Hi, I’m Dr. Craig Sawchuk, a clinical psychologist at Mayo Clinic. And I’m here to talk with you about depression. Whether you’re looking for answers for yourself, a friend, or loved one, understanding the basics of depression can help you take the next step.
What is depression?
Depression is a mood disorder that causes feelings of sadness that won’t go away. Unfortunately, there’s a lot of stigma around depression. Depression isn’t a weakness or a character flaw. It’s not about being in a bad mood, and people who experience depression can’t just snap out of it. Depression is a common, serious, and treatable condition. If you’re experiencing depression, you’re not alone. It honestly affects people of all ages and races and biological sexes, income levels and educational backgrounds. Approximately one in six people will experience a major depressive episode at some point in their lifetime, while up to 16 million adults each year suffer from clinical depression. There are many types of symptoms that make up depression. Emotionally, you may feel sad or down or irritable or even apathetic. Physically, the body really slows down. You feel tired. Your sleep is often disrupted. It’s really hard to get yourself motivated. Your thinking also changes. It can just be hard to concentrate. Your thoughts tend to be much more negative. You can be really hard on yourself, feel hopeless and helpless about things. And even in some cases, have thoughts of not wanting to live. Behaviorally, you just want to pull back and withdraw from others, activities, and day-to-day responsibilities. These symptoms all work together to keep you trapped in a cycle of depression. Symptoms of depression are different for everyone. Some symptoms may be a sign of another disorder or medical condition. That’s why it’s important to get an accurate diagnosis.
What causes depression?
While there’s no single cause of depression, most experts believe there’s a combination of biological, social, and psychological factors that contribute to depression risk. Biologically, we think about genetics or a family history of depression, health conditions such as diabetes, heart disease or thyroid disorders, and even hormonal changes that happen over the lifespan, such as pregnancy and menopause. Changes in brain chemistry, especially disruptions in neurotransmitters like serotonin, that play an important role in regulating many bodily functions, including mood, sleep, and appetite, are thought to play a particularly important role in depression. Socially stressful and traumatic life events, limited access to resources such as food, housing, and health care, and a lack of social support all contribute to depression risk. Psychologically, we think of how negative thoughts and problematic coping behaviors, such as avoidance and substance use, increase our vulnerability to depression.
The good news is that treatment helps. Effective treatments for depression exist and you do have options to see what works best for you. Lifestyle changes that improve sleep habits, exercise, and address underlying health conditions can be an important first step. Medications such as antidepressants can be helpful in alleviating depressive symptoms. Therapy, especially cognitive behavioral therapy, teaches skills to better manage negative thoughts and improve coping behaviors to help break you out of cycles of depression. Whatever the cause, remember that depression is not your fault and it can be treated.
To help diagnose depression, your health care provider may use a physical exam, lab tests, or a mental health evaluation. These results will help identify various treatment options that best fit your situation.
Help is available. You don’t have to deal with depression by yourself. Take the next step and reach out. If you’re hesitant to talk to a health care provider, talk to a friend or loved one about how to get help. Living with depression isn’t easy and you’re not alone in your struggles. Always remember that effective treatments and supports are available to help you start feeling better. Want to learn more about depression? Visit mayoclinic.org. Do take care.
Understanding the psychological mechanisms of how stress can lead to depression can help you prevent it. This is especially important for people who have had a prior episode of depression and would like to prevent relapse.
Stress has direct effects on mood. Early initial symptoms of lowered mood can include irritability, sleep disruption, and cognitive changes, such as impaired concentration. However, the indirect effects of stress are often what causes depression to take hold.
1. Stress disrupts a person’s healthy coping strategies.
When people experience stress, they often stop engaging in some of the healthy coping strategies that usually help keep their mood on track. In other words, when stress triggers a lowered mood, it’s more likely that the person will skip their typical healthy mood regulation strategies—resulting in further mood problems.
Example: Stress at work can lead to overworking; as a result, the person doesn’t go to yoga class, go running, read before bed, or catch up with close friends as much.
2. Early initial low mood symptoms generate further stress.
When a person is stressed and begins to experience some initial changes in their mood, these symptoms often generate further increased stress.
Example:
- the person has an irritable outburst at work and gets a complaint
- impaired concentration results in a mistake—either a major mistake or just a small mistake, like leaving something important at home
3. Stress can disrupt relationships.
Overworking, irritability, and withdrawal can all cause increased arguments. Someone who is absorbed by their own stress may become less emotionally available to their partner.
Especially when an individual has had problems with depression in the past, it can be frightening for partners to see signs that make them concerned that their loved one could be becoming depressed again. Sometimes, partners start to think about leaving the relationship; this then becomes an additional source of stress for the couple.
4. Stress can increase unhealthy coping.
Unhealthy coping mechanisms can have direct effects on mood—e.g., excessive alcohol use leading to lower mood—as well as indirect effects, like excessive alcohol use leading to relationship problems, which then lead to lower mood. Avoidance coping increases both stress and anxiety. (Learn more about avoidance coping in this article.)
5. Routines and structures may be disrupted.
Self-regulatory strength is like a mental muscle—using it helps keep it strong. Life stress and initial lowered mood often lead to people abandoning routines of eating healthy meals and sleeping at consistent times. This, in turn, sometimes begins a slippery slope of under-regulation.
Moreover, having consistent routines like regular eating helps regulate mood.
5 Practical Tips for Depression Prevention
- Become aware of what healthy coping strategies are important for maintaining your mood but that tend to go out the window when you’re stressed or overworking.
- Identify early warning signs that are a signal that you need to make some changes. This can include noticing yourself getting irritable at work, making repeated mistakes due to lack of concentration, or something similar.
- Make a short list of things you could do when you notice the early warning signs. For example, if you notice that you’ve been overworking, you could start scheduling catch-ups with friends for immediately after work so that you feel compelled to leave on time.
- Identify barriers to being able to implement your ideas when you’re under stress. What could you do to overcome those barriers? For example: “If I don’t have money to go to dinner, I could arrange to meet friends for coffee.”
- Your relationships are an important resource. What can you do to avoid straining them when you’re stressed?
Simple things can help—like making sure you say something positive before you say something negative when you first see your partner or roommates at the end of the day.
Having a therapist you can touch base with when your mood starts to go downhill can also help, particularly if your partner or a close friend sometimes feels like they’re the only one supporting you. If you book a booster session with your therapist, consider having a close other accompany you to the session so your therapist can get their perspective.
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