Mood Episodes in Depression

Symptoms of a Depressive Episode

A depressive episode is defined by the specific symptoms that occur during such an episode. To be diagnosed as being in a depressive episode, a person must show at least five of the following symptoms^[1]:

• A depressed or low mood.
• Lack of interest or pleasure in usual hobbies and activities.
• Significant weight changes, which can involve either weight loss or weight gain, or either reduced or increased appetite.
• Struggling with sleep, which could include either sleeping too little or sleeping more than usual.
• Changes in motor functioning, which could involve either slowed movements (formally called psychomotor retardation), or purposeless movements like pacing (called psychomotor agitation).
• Lacking energy and feeling fatigued.
• Feeling worthless or experiencing excessive, unwarranted guilt.
• Struggling to think, make decisions, or concentrate on important tasks.
• Experiencing suicidal thoughts or making a suicidal attempt.

As indicated above, some of the symptoms of depression are physical, such as changes in weight or sleeping habits, as well as changes to movement patterns. Others are cognitive, such as difficulty with thinking or concentrating. Finally, depression involves emotional symptoms, like feeling worthless and guilty and showing a depressed or low mood.^[1]

Subject matter expert

Simone Hoermann Ph.D.

Personality disorders, anxiety, and depression

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Depressive Episode Risk Factors and Triggers

When depression hits, a person may sometimes be surprised. It can be helpful to learn the triggers that can increase the risk of a depressive episode. Once these triggers are identified, a person can look out for them and try to take steps to prevent a depressive episode from taking hold. Some common depression triggers include^[2][3]:

• Life stressors.
• Lack of sleep.
• Food restriction.
• Lack of social support.
• Relationship problems.
• Poor coping skills.

Beyond triggers for depression, there are risk factors that can increase the risk of depressive episodes in general. These include^[3][4][5][6]:

• History of childhood trauma/abuse.
• Experiencing bullying as a child.
• Genetic factors.
• Having a family member with a mental illness.
• Witnessing domestic violence.
• Experiencing pain.
• High BMI.
• Chronic diseases.
• Financial struggles.

How Long Do Depressive Episodes Last?

To be diagnosed with depression, a depressive episode must last at least two weeks.^[1] However, there can be variation in the length of episodes. Research suggests that depressive episodes can become chronic. In a study of adults diagnosed with depression, the average depressive episode lasted around 10 months.^[7]

Furthermore, 12% of people in the study did not recover from depression after three years. Study results also revealed that people with better physical and mental health before the depressive episode experienced shorter episodes of depression.^[7]

Some depression episodes are less severe than others. People with milder forms of depression tend to recover sooner. In the study noted above, those with minor episodes of depression had an average duration of 8.7 months. The median duration was just 3 months, suggesting that the average number could have been skewed by some outliers with long-lasting episodes.^[7]

How to Manage Depressive Episodes

People who experience depression understandably want to learn how to get out of a depressive episode. If you’re looking for information on how to stop a depressive episode, lifestyle changes can be helpful. Making such changes may feel challenging when you’re in the midst of a depressive episode, especially if you’re fatigued and having trouble with concentration.

However, taking the initiative to make lifestyle changes can reduce the length of a depressive episode, which is beneficial in the long term.^[8]

Some helpful lifestyle changes include^[8][9]:

• Getting physical exercise, even just a few days per week.
• Establishing a consistent sleep schedule that provides adequate rest.
• Eating nutritious foods.
• Spending time outdoors to boost mood.
• Taking part in hobbies and activities you enjoy.

Lifestyle changes for depression can also be part of an overall plan of self-care. Practicing self-care can make depression symptoms more manageable and help you to regain functioning during a depressive episode. Getting regular exercise and regularly eating nutritious foods can be part of a healthy self-care plan. It’s also important to make time for activities you enjoy, connect with friends and family, and give yourself time for relaxation as part of a self-care plan.^[10]

Treating Depressive Episodes

Self-care and lifestyle changes can be helpful for depression; however, getting out of a depressive episode often requires professional treatment. Depression is typically treated with talk therapy, medication, or a combination of the two.^[11]

Talk therapy involves working with a therapist to process your emotions and discuss the challenges you face. In talk therapy sessions, you can learn new ways of thinking that help reduce depressive thoughts. A specific type of therapy called cognitive-behavioral therapy (CBT) can help you change negative thinking patterns. Interpersonal therapy, which focuses on improving communication and building supportive relationships, is also beneficial for depression.^[11]

Some people may find that therapy alone isn’t sufficient for relieving depression. In this case, medications can be helpful. There are various types of antidepressant medication, and it can take some time for these medications to work. Many people start to feel better after a month or two, but if a medication doesn’t work, your doctor may select another option for you.^[11]

If depression doesn’t respond to medication and/or therapy, there are alternative treatments available. For example, a type of brain stimulation called transcranial magnetic stimulation (TMS) may be beneficial. This therapy targets brain areas responsible for mood, and it’s approved for treatment-resistant depression. Additionally, ketamine infusions have been successfully used to help those with treatment-resistant depression.^[11][12]

Can You Prevent Depressive Episodes?

Managing risk factors and making healthy lifestyle changes can be beneficial for improving depression symptoms.^[8][9] There are also steps you can take to reduce your risk of future depressive episodes. It may not be possible to prevent depression in every case, but you can certainly lower your likelihood of relapsing after a period of feeling better. Researchers have evaluated factors that can potentially prevent the recurrence of depressive episodes. Based on research, one of the most important things you can do to prevent relapse is to stay in treatment. Once you begin talking to a therapist and taking medication, you may begin to feel better. However, that doesn’t mean it’s time to completely stop treatment. Staying connected with a therapist, even just for occasional maintenance sessions, can help prevent future episodes.^[13]

How to Support Someone Experiencing a Depressive Episode

Social support can be critical for someone living through a depressive episode. If a loved one is experiencing depression, you can support them with the following strategies^[11]:

• Offer a listening ear when they’re struggling, without passing judgment or blaming them for their symptoms.
• Remind them that depression can improve with treatment, and it’s important to attend their appointments.
• Help them get into and stay connected with treatment by providing them with information about mental health services, reminding them about appointments and medication, or even taking them to an appointment for support.
• Invite them to go out and do things, such as taking a walk or getting coffee; they may struggle with a lack of motivation, but your encouragement can get them active and socially engaged again, which generally improves symptoms.

When to Seek Professional Help

Everyone feels down and experiences stress from time to time, but depression is more than just the normal ups and downs of life. If you’re showing symptoms like sadness, low energy, and lack of pleasure in usual activities that interfere with your quality of life you’re likely in a depressive episode. Self-care strategies and healthy lifestyle changes can be beneficial for managing these episodes, but oftentimes, professional treatment is warranted. Depression is a diagnosable health condition, and there is no shame in reaching out for treatment.^[11]

When you’re ready to seek treatment, there are several options for locating depression resources. First, you can search online for mental health providers in your area. Alternatively, you can contact a local community mental health center or therapy clinic and ask to make an appointment with a professional who specializes in depression. Finally, you can talk to your primary care doctor about your symptoms. They may recommend medication and/or refer you to a therapist who can treat depression.

Depressive episodes can be challenging and make it difficult to function in daily life. However, treatment is available, and depression can and does improve. Reach out to talk to a professional and learn helpful strategies for managing depression. If you’re in crisis or having thoughts of killing yourself, dial 988 to be connected to the Suicide & Crisis Lifeline.