04.13.23
What’s the Deal With Situational Depression?
Feeling sad for a few days after a breakup isn’t it.
If you just experienced a major change, like getting fired from your job or going through a breakup, you might be running out of tissues to soak up your rage tears. You might also feel so worthless and blah that the only thing you have energy for is Grey’s Anatomy. And when you’re not watching your favorite surgeons, you’re lying awake at night wondering how you failed so hard and why the heck you feel so awful. Turns out, it might be situational depression.
What is situational depression?
It’s sort of what it sounds like. Situational depression is depression that comes on after a stressful or traumatic life change (or, ya know, a situation) like a breakup, an illness, or a death, explains David Hellerstein, MD, professor of clinical psychiatry and director of Depression Evaluation Service at Columbia University and author of The Couch, the Clinic, and the Scanner.
And while mental health pros often refer to this condition as situational depression, its technical name is “adjustment disorder with depressed mood” or, if you’re experiencing depression and anxiety symptoms, “adjustment disorder with mixed anxiety and depressed mood,” according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).
Whatever you call it, situational depression isn’t just feeling sad after a life change. If you have this condition, you’ll likely spend a lot of energy ruminating over whatever just happened, and the sadness part can be so intense that you can’t concentrate at work or be in the moment with loved ones, explains psychiatrist Beth Salcedo, MD, medical director of The Ross Center and a former board president of the Anxiety and Depression Association of America. These symptoms can bubble up a few days after The Situation or up to three months later, according to the DSM-5-TR.
On top of that, your sense of sadness, hopelessness, grief, or anger about what went down probably feels “out of proportion” to how other people might react in your situation, says Dr. Salcedo. For example, if it’s been months and you’re still calling out of work because you can’t stop crying post breakup and you barely get out of bed, a mental health pro might say it’s a sign of situational depression. That said, keep in mind that what’s considered too much can be subjective, adds Dr. Salcedo.
Situational depression vs. major depression
People with situational depression and major depression can both feel extremely low, have suicidal thoughts, struggle to sleep, eat more or less than usual, lose interest in activities they’re normally game for, and feel like they’re “walking through concrete” trying to get everyday tasks done, Dr. Salcedo says.
So, to suss out whether you’re dealing with situational or major depression (also known as major depressive disorder), a therapist or psychiatrist will ask about your history of depression. If you’ve been through something like this before, it’s possible that you’re currently experiencing a recurring episode of major depression, says Dr. Hellerstein. If you haven’t, it’s more likely to be the situational kind, he adds. While, yes, it’s possible for life drama to bring on a major depressive episode, if you’ve never felt this way, it’s likely situational. Basically, you were doing “fine,” then something happened—you got broken up with, got fired, got sick—and your depression symptoms started, says Dr. Hellerstein.
A mental health pro might also ask about whether you feel stuck on what happened and the consequences of it. That’s a defining symptom of situational depression, Dr. Hellerstein notes. So, if you can’t stop thinking about what your ex said or spiraling about your bank account post layoff, it’s more likely that’s what’s going on with you.
The number of depressive symptoms you’re experiencing can also clue mental health pros into whether you have situational or major depression. With the latter, you’d feel less interested in doing life or super sad and have four additional symptoms like fatigue, suicidal thoughts, sleep struggles, or eating issues. A situational depression diagnosis (aka adjustment disorder with depressed mood) only requires that you feel really low, per the DSM-5-TR.
How long your symptoms actually last is another way therapists and psychiatrists can tell the difference between major depression and situational depression. Symptoms of situational depression usually don’t last longer than six months after you deal with whatever’s happening, but if the problem isn’t easily solved (like financial issues post divorce) symptoms can keep on keepin’ on, according to the DSM-5-TR. That said, if you fix your money troubles and are still extremely depressed, you may be dealing with major depression, which can stretch on for over a year.
How do you treat situational depression?
Situational depression can sometimes go away on its own, says Dr. Hellerstein. But mental health pros can use medication and talk therapy to treat it, just as they would with major depression. Antidepressants, like selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs), can improve your symptoms by increasing the amount of serotonin or norepinephrine—or both—in your brain. With talk therapy, you’ll learn coping skills, like how to avoid catastrophizing about what you’re going through, Dr. Salcedo says.
Adding some lifestyle changes can also help you start to feel better, says Dr. Salcedo. Sure, situational depression makes it harder to do things like get enough sleep, move your body, call your inner circle, or keep up with activities you enjoy, but these are generally good ways to cope with stress and control anxiety and depression, Dr. Hellerstein notes.
Bottom line: Situational depression can take months to resolve, but with some therapy and/or meds, you might be able to get past it more quickly, assures Dr. Salcedo. “Even if it feels like it makes sense that you feel this way because you have this major stressor, it can't hurt to talk to somebody about it and to get the tools for managing it,” she says.
Wondermind does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a replacement for medical advice. Always consult a qualified health or mental health professional with any questions or concerns about your mental health.
