Depression is a debilitating, devastating illness. In Darkness Visible: A Memoir of Madness, author William Styron perfectly captures the pain of depression:
“The pain is unrelenting, and what makes the condition intolerable is the foreknowledge that no remedy will come — not in a day, an hour, a month, or a minute. If there is mild relief, one knows that it is only temporary; more pain will follow. It is hopelessness even more than pain that crushes the soul. So the decision-making of daily life involves not, as in normal affairs, shifting from one annoying situation to another less annoying — or from discomfort to relative comfort, or from boredom to activity — but moving from pain to pain. One does not abandon, even briefly, one’s bed of nails, but is attached to it wherever one goes.”
Depression is caused by a combination of nature and nurture, according to Deborah Serani, PsyD, a clinical psychologist who specializes in treating people with mood disorders. “[N]eurobiology sets the stage for some to have depressive symptoms.”
Nurture is how you grow up, she said. This may include “the experiences that shape you, and moments along the way that can either help protect you from your genetic leanings or worsen them.”
Serani, who’s also experienced clinical depression, has a long lineage of loved ones with the illness. “I was genetically wired for it and experienced a chronic sadness and fatigue as a child and teenager. My personal journeys in life pressed negatively on me and weakened my resolve to fight my depressive symptoms.”
(This piece from Harvard Health Publications has additional insights into the complex causes of depression, including the brain, hypothyroidism and medication.)
Depression triggers “are usually very personal,” said Serani, author of two books on depression. But there are common types of factors that spark depression.
Clinical psychologist Shannon Kolakowski, PsyD, named these triggers:
- The end of a relationship, such as a breakup or divorce.
- The death of a loved one.
- Unhealthy or stressful environment or event. “About 80 percent of people who experience depression have a recent stressful life event.”
- High conflict with your partner.
- Major life transitions, such as retiring, starting a new job or moving to a new city.
- Painful negative feelings, such as hopelessness, rejection or loneliness.
- A partner with depression. Because they’re struggling with depression, your partner may be “showing less interest or compassion toward you, being more critical or negative, or withdrawing from you. This also causes arguments and can lead to feeling isolated, hopeless, lonely, experiencing self-doubt, and ultimately can lead to depression.”
Serani noted that “calendar dates are the biggest triggers.” These include birthdays, anniversaries and holidays, she said. “Dates become benchmarks for moments in our lives, and these are often filled with deep [and possibly difficult] emotions.” This is why it’s vital for people who have depression to pay attention to the calendar, she said.
Another big trigger is the news, she said. If you live with depression, Serani suggested not watching or listening to the news. Instead, learn “about the day’s events from just gleaning the home page on the Internet.”
“Knowing your personal triggers [and responding to them adequately] can really help you prevent a depressive relapse,” said Kolakowski, author of the book When Depression Hurts Your Relationship. For instance, if one of your triggers is being sensitive to rejection, the next time you’re in a situation where rejection is possible, such as not getting a promotion, ask for support in advance.
Serani has structured some parts of her life to prevent potential triggers – both big and small. For instance, she limits certain people from her life, and doesn’t watch sad movies. Once you know your triggers, she said, it’s also important for others to respect them. “Don’t let [people] minimize your needs or boundaries.”
Depression is a serious, complex illness. But it’s also treatable. Learn more in our section on depression.