Living with depression can mean a mix of good days and bad.
On good days, your mood might lift until you feel lighter, clearer, and more like yourself. On bad days, the muffling fog might return, sending your mood spiraling down and leaving you feeling slow, drained, and numb.
While depression symptoms can begin to ease in time, especially with help from a mental health professional, they do sometimes intensify, with or without treatment.
Depression that goes from bad to worse can feel even more overwhelming. When your mood fails to lift after a few very bad days, you might begin to wonder, “Is this permanent?”
If you’re already working with a therapist or taking medication, you might feel as if there’s nothing more you can do, which can leave you with a distressing sense of hopelessness.
Know this, though: You have many options for support. Not every approach works for everyone, so getting relief is often a matter of finding the right treatment for you.
Here’s what to know about getting support for worsening depression.
If you typically have mild or intermittent depression symptoms, you might notice immediately if they suddenly become more severe or persistent.
Still, the different types of depression can involve a range of symptoms, and changes might creep up slowly instead of falling on you all at once.
You might not always recognize small but steady changes in your day-to-day mood until you suddenly feel a whole lot worse than you usually do.
If any of the following signs sound familiar, it’s worth talking to your primary care doctor, therapist, or another healthcare professional about a new approach to treatment. If you haven’t yet started treatment for depression, talking to a therapist about these symptoms is a good next step.
Almost nothing sparks your interest
Depression commonly involves a decrease in your energy levels and a loss of pleasure in your favorite hobbies and other things you usually enjoy. As you work toward recovery, you’ll usually find your interest in these activities slowly begins to return, along with your energy.
With worsening depression, you might notice the opposite.
You might also have trouble mustering up enough energy to go to work or take care of basic responsibilities, like paying bills or preparing meals. Even necessary self-care, like showering and brushing your teeth, might feel beyond your current abilities.
You spend more time alone
With depression, you might find it challenging to enjoy the company of others for a number of reasons.
You may not feel up to socializing simply because you have less energy. Emotional numbness can make the social interactions you usually enjoy seem pointless.
Feelings of guilt, irritability, or worthlessness can also complicate your mood and make avoidance seem like the safer option.
There’s nothing wrong with spending time alone when you enjoy it. An increasing sense of loneliness, on the other hand, can make your mood even worse. You might begin to feel as if no one understands or cares about your experience.
Your mood gets worse at certain times of day
Changes in how you experience symptoms might also suggest worsening depression.
Your symptoms may have previously remained mostly stable throughout the day.
Now, you notice they intensify in the morning or evening. Or perhaps they feel much worse on some days instead of remaining fairly consistent from day to day.
You notice changes in eating and sleeping patterns
Depression often affects appetite and sleep habits.
Sleep changes often happen on a similar spectrum. You could have a hard time staying awake and feel exhausted enough to sleep all day — but you could also struggle to fall asleep or wake up often throughout the night.
Trouble sleeping at night can mean you need to nap during the day to catch up, so you might end up drifting off at unusual times. This can affect your energy and concentration and further disrupt your sleep.
Intensifying emotional distress
If you have depression, you’ll likely notice the following:
- a pessimistic outlook or catastrophic thinking
- feelings of guilt, shame, or worthlessness
- a sense of numbness
- problems with concentration or memory
These feelings sometimes increase over time, so you might find yourself:
- fixating on negative thoughts
- worrying what others think of you or believing loved ones consider you a burden
- crying more often
- considering self-harm as a way to ease distress or numbness
- having frequent thoughts of suicide, even if you don’t intend to act on them
If this distress persists or continues to get worse even with treatment, connect with a healthcare professional right away.
It’s not unusual for mental health symptoms to fluctuate over time.
These changes may not always have a clear cause. Sometimes, though, they happen in response to specific triggers.
A few factors that could help explain worsening depression symptoms include:
Your treatment plan
Depression symptoms sometimes respond best to a combined treatment approach, rather than therapy or medication alone.
There’s also a possibility you might be dealing with treatment-resistant depression. Not everyone responds to antidepressants in the same way, and it might take some time to find the most effective treatment.
A different mental health condition
If you experience depressive episodes as part of bipolar disorder or another mental health condition, they may not improve until you get the right diagnosis and treatment.
Sleep loss, which might relate to anxiety or other mental health symptoms, could also make symptoms worse.
Medication side effects
Depression symptoms can develop as a side effect of certain medications. The label of any prescription medications you’re taking will offer more information on potential side effects.
If you suspect a link between your medication and depression symptoms, consider talking with your healthcare professional about alternative medications.
Alcohol and other substances might temporarily worsen symptoms of depression.
Self-medicating or regular substance use can also contribute to more persistent, severe depression and have other health consequences over time.
Some people do experience symptoms of depression in waves or intermittent episodes. This means you could experience days, even weeks, of relief and then notice your symptoms suddenly come back or intensify.
In other words, worsening depression is sometimes just the nature of depression — but that doesn’t mean it’s permanent, or that treatment won’t help.
Professional support is the best way to improve symptoms of depression. If your symptoms fail to ease within a few days or continue to get worse, it’s best to talk to your therapist or doctor as soon as possible.
If you’re already taking medication or working with a therapist, they can help you get guidance on next steps.
It never hurts to schedule an appointment as soon as you start to feel worse. You can always cancel later if you begin to feel better, but that way you’ll have the appointment if you need it and won’t have to worry about availability.
At your appointment
Explain the changes and patterns you’ve noticed. These might include:
- how long you’ve had more severe symptoms
- whether they got worse slowly or all at once
- if anything else in your life has changed
- any medications you’re taking
Generally speaking, the more information you provide, the better. Things may not seem relevant to you, but they could help your therapist understand more about your depression and recommend a more helpful treatment approach.
It’s also important to describe any new symptoms you’ve noticed, like restlessness, unexplained pain, anger, or racing thoughts. Maybe you feel unusually happy or energized after several days of depression. Or perhaps you occasionally hear voices or other things that no one else hears.
You might write these symptoms off to increased stress, lack of sleep, or other causes, but they can suggest other conditions, such as depression with psychotic features or bipolar disorder. Getting the correct diagnosis could be the key to improvement.
Medication, therapy, or both?
Not everyone improves with therapy alone.
Some therapists may wait to recommend talking to a psychiatrist about medication until you ask, so be sure to let them know if you’d like to try a combined approach.
Whether you’re considering therapy, medication, lifestyle changes, or all of the above, you have plenty of options.
Many therapists use cognitive behavioral therapy to treat depression, but that’s not the only effective treatment.
Other helpful approaches include:
- interpersonal therapy
mindfulness-based cognitive therapy
- humanistic therapy
- group therapy
If your current medication isn’t working, your psychiatrist or doctor might prescribe something else. They might also prescribe a combination of medications to treat severe symptoms, particularly if you also experience anxiety or episodes of psychosis.
Adding alternative treatments and other coping strategies to your treatment plan can also make a difference.
A few to consider:
In short, there’s no single best treatment for depression. When your current treatment no longer helps, a different approach could lead to improvement.
It’s absolutely normal to feel frustrated and powerless when depression intensifies and your usual coping methods no longer seem to make much difference.
This bleak outlook doesn’t have to become your reality. These tips can help you get support.
Tell someone you trust
Opening up to a loved one about your depression may not directly relieve your symptoms, but it can help you feel less alone.
Friends and family can offer emotional support, compassion, and reassurance. They might also help by offering support with essential tasks, like preparing food or getting to the doctor.
Talking about depression can be difficult, especially when you feel guilty about your symptoms or worry about burdening your loved ones. It can help to start by talking to a supportive friend or family member who already knows you have depression, so you don’t have to expend the energy to explain.
Reach out during a crisis
Depression can quickly become overwhelming. In moments of extreme pain, you might think of nothing but how to stop your distress.
Having thoughts of suicide or self-harm? A crisis helpline can offer immediate support and help you find strategies to stay safe until those feelings begin to pass.
- Reach the National Suicide Prevention Lifeline at 800-273-8255. This service is available 24/7. You can also chat online.
- Reach the Crisis Text Line (24/7) by texting HOME to 741741.
Call your therapist
It’s possible your therapist could have some last-minute availability for an immediate appointment.
Even when they can’t fit you in for a session for a few days, they can usually still offer guidance on finding support in the meantime.
Sometimes, just knowing you have an appointment coming up can offer a measure of relief.
Don’t have a therapist? Start your search:
- American Psychological Association
- American Psychiatric Association
- National Institute of Mental Health
Interested in trying online therapy? Learn more about Healthline’s top 10 picks for online therapy services.
When you suspect your depression is getting worse, talking to a mental health professional can help you get the support you need to begin feeling better.
It can feel discouraging, to say the least, when the first few treatments you try don’t lead to improvement. Just remember, you know yourself — and your symptoms — better than anyone else. Don’t hesitate to try different approaches until you find one that works.
Crystal Raypole has previously worked as a writer and editor for GoodTherapy. Her fields of interest include Asian languages and literature, Japanese translation, cooking, natural sciences, sex positivity, and mental health. In particular, she’s committed to helping decrease stigma around mental health issues.