There are several factors that can make depression worse, so it can be important to know how to manage them and when to seek help.

Low moods are common to experience every now and then. For many people, negative emotions come and go, but for others, sadness becomes a state of being. If you are feeling sad or low for an extended period of time and it has affected your ability to function, you may be experiencing depression.

Anyone who has experienced depression knows that the symptoms are not always within your control whether it’s a negative emotional spiral you can’t seem to escape or a lack of motivation to do the activities you once enjoyed.

While it may be best to seek help, lifestyle changes can also make a major difference when it comes to alleviating symptoms. Learning what’s contributing to your depression is the first step to healing. Then, you can take action towards improving your mental health, whatever that may look like for you.

1. Unhelpful thinking styles

When it comes to your mental health, understanding your negative thought patterns and reframing your perspective can be essential. Dr. Cornelia Gibson, LMFT, Ed.D. explains three of the most common negative thinking patterns:

  • Emotional reasoning — the narrative we tell ourselves that isn’t actually based in fact. This could look like:
    “I feel like I’m not a good friend so that must be true.”
  • Discounting the positive — dwelling on the negative and choosing not to see the upside of a situation. You might think: “I failed that homework assignment, and even though I got an A on all of the rest of my assignments, that doesn’t matter. I’m a failure.”
  • All or nothing thinking — when someone thinks in extremes, or black and white terms. An example might be: “Good things never happen to me. I always have bad things happen in my life.

Negative thought patterns are a common component of depression and it can be helpful to learn how to shift this way of thinking.

A mental health professor can help you learn how to do this. They’ll help you identify which thinking style you identify with and then help you challenge those thoughts.

2. Low self-esteem

Your sense of self-worth can also directly impact your mood and behavior.

“When someone has low self-esteem they tend to have a low self-image and speak badly about themselves,” says Dr. Gibson. “Learning to recognize and reduce negative self-talk would be helpful. Also, asking others who love and care about you to point out your strengths would be helpful.”

Here are some tips to build your self-esteem and reduce negative self-talk:

3. Isolation

Withdrawing from others can be a symptom of depression. If you aren’t feeling good about yourself, it’s common to want to be alone, but doing so can make your depression worse.

Instead, it can help to hold yourself accountable to maintaining a social life. Start by setting small goals and over time, it will become more of a habit.

“Setting a specific, measurable, realistic, and timely (SMART) goal for yourself to allow others into your life would be helpful,” Dr. Gibson states. “A SMART goal could be, reaching out to one family member or friend via text, email, or phone, each week for the next four weeks.”

4. Relationship issues

Whether you’re experiencing issues with a family member, friend or stress in your romantic relationship, this can make symptoms of depression worse. For this reason, finding healthy ways to communicate is essential.

Dr. Gibson recommends seeking a win/win situation when engaging in tough conversations. This is when both parties feel good about the conversation in the end. That could mean, no name calling, no “you” statements, and more “I” statements.

You may also want to be open with your loved ones about your mental health and what you need from them to feel supported. In some cases, professional support may be needed to learn how to best intervene or address an issue.

5. Stress

Stress can contribute to an increase in the severity of depression. 2020 research shows that consistent exposure to stress can trigger depressive episodes.

Stress chemicals are the underlying cause of many depression symptoms. Whether it’s a change in appetite, hypertension, or a weakened immune system, these symptoms can be the result of chronic stress.

For many of us, stress is related to being too busy helping others and not focusing on our own needs first. Instead of overexerting yourself, try practicing saying no when it’s appropriate. It may feel strange or wrong to do, but you may quickly realize that the world didn’t end after you said no.

It can also help to remember that you weren’t rejecting someone, you were simply drawing a boundary.

6. Sleep disturbance

As many as 70% of people with depression report experiencing sleep disturbance. For some, sleep disturbance can be what’s causing a person’s depression, and for others, sleep disturbance can exacerbate a person’s already developed depression. Either way, good sleep is essential for strong mental health.

A 2019 study revealed sleep disturbance can lead to a negative cycle that’s difficult to get out of. A lack of sleep can lead to low energy, high levels of stress, and irritability, which are common symptoms of depression. And feeling irritable and stressed can cause tossing and turning at night.

In contrast, some people with depression experience hypersomnia, which is when they oversleep and feel excessively tired during the day. A 2016 study found hypersomnia can make depressive symptoms worse and can cause treatment resistance.

“One way to address sleep disturbance would be setting specific times to wind down in efforts to sleep. Another tactic would be to eliminate distractions (turn off the television, put down the cell phone, etc.) and set the mood (turn off lights, close curtains/blinds, etc.) for sleep,” says Tomanika Perry-Witherspoon, LMSW, CEO of Growing Counseling Services.

You can also try moving your body more during the day so that you feel more tired at night. This can mean going for walks, practicing yoga, or heading to the gym. Try to choose something you enjoy so that you are able to make exercise part of your routine.

7. Alcohol

Depression and alcohol can lead to a negative cycle. If you’re depressed, you may be inclined to drink and the more you drink, the worse your symptoms may get, according to a 2019 study.

“Alcohol can make one’s depression worse, as it’s a depressant and impacts one’s brain functioning,” Perry Witherspoon explains.

“Ways to address this matter would be to decrease or eliminate alcohol consumption. The signs that someone might need professional support is when the depression begins to impact a person’s functioning at home, school, work, hygiene, or in the community.”

There are instances when a person may require additional support. Dr. Gibson explains that someone may want to seek professional help when any of the following occur:

  • symptoms get worse after a two-week period
  • thoughts of harming yourself or someone else
  • when symptoms interfere with your daily life, such as a need to take time off from work or a need to take time away from other responsibilities.
  • other people have noticed changes and suggested you get help

One potentially helpful way to address and manage depressive symptoms is to identify what factors could potentially be making your depressive symptoms worse, and then begin making small lifestyle changes.

Factors that can make depression worse, include stress, sleep disturbance, and unhelpful thinking patterns. It’s important to remember, however, depression isn’t your fault and you’re not alone in getting help.

Speaking with a mental health professional can be a great first step to feeling like yourself again. A therapist can help you learn strategies to manage your depressive symptoms and create healthier habits.

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