Why does depression come in waves?

In this blog we will attempt to answer the question “why does depression come in waves?”

We will also briefly discuss what could be the cause of these fluctuations in mood, what depression actually is, and how one can help themselves if they have depression. 

Why does depression come in waves?

There are a few reasons that could explain why one might feel like depression comes in waves. The possible reasons include:

• Depression manifest as depressive episodes
• Atypical depression
• Cyclothymia
• Bipolar Disorder
• Mood brightening

Depressive episodes

One has to understand that an individual with a diagnosis of depression is experiencing a depressive episode. 

A depressive episode in a major depressive disorder is a period of low mood and other depression symptoms that lasts for 2 weeks or more.

During a depressive episode a person experiences all the symptoms related to a major depressive episode and with the treatment and support required, this depressive episode can improve.

Usually depressive episodes last weeks to a few months and with treatment it can be lifted. This change in mood- the ups and downs- can be an explanation as to why one feels like depression comes in waves. 

One might feel depressed during a depressive episode versus when they are no longer in a depressive episode. People with depression have a high risk of relapse which tends to increase with the amount of relapses. 

Atypical depression

Another reason why you might be experiencing waves of depression could be because you have Atypical depression which refers to depression that temporarily goes away in response to positive events. 

This means that while you might be depressed for long periods of time, when there are favourable changes in circumstances, you feel happy and the depressed mood is lifted. 

Cyclothymia

Another explanation as to why one might feel like depression comes in waves is Cyclothymia , also called cyclothymic disorder.

This disorder is a rare mood disorder that is marked by emotional ups and downs that is similar to Bipolar disorder but not as severe. 

When someone has this disorder, there are noticeable shifts up and down from your baseline mood. This is one reason why you might feel like depression comes in waves of ups and downs. 

So a person with this disorder might be happy and motivated at one time then followed by a period of low moods where they feel down and depressed whereas between these highs and lows you might even feel stable.

Bipolar disorder

Another reason for why you feel like depression comes in waves could be because of another mental disorder called Bipolar disorder. 

In this case, an individual experiences intense and sudden mood shifts. They may feel incredibly tired one moment, but suddenly, for no apparent reason, become keenly alert and energised, according to writers at Mental health Centre. 

People with this disorder tend to feel extremely energetic, motivated, inspired during their manc stage while experiencing a depressive episode during their depressive stage. 

These ups and downs can be linked to a wave of depression where they are depressed and even suicidal versus a high wave of mania where they feel sense of happiness that is exaggerated at different stages of their condition. 

Mood brightening

With a diagnosis of depression, one of the major symptoms is low and depressed moods for most of the time for up to two weeks. While this defining and all consuming symptom can take hold of a person’s life, it does not necessarily mean that this is all there is to it. 

Someone with depression can experience ups as well as downs, according to Susan Krauss Whitbourne for psychologytoday, 

“…the mood patterns of people who fit this diagnosis may not remain consistently on the bottom of the scale.”

Whitbourne goes on to explain that the patterns of the ups and downs in the emotions of someone with depression is different for everyone. 

Discussing a 2020 study by Janna Nelson and colleagues, Whitbourne notes that there have been recorded instances where people with depression did experience what is understood as “mood brightening” where a depressed individual did feel happy after a positive event. 

The researchers of the study did note that people who were depressed were not restricted to negative emotions only. In fact they did express positive emotions and did have moments of “ups” in their daily lives. 

What is Depression?

Depression or clinically known as major depressive disorder, according to the Diagnostic and Statistical Manual of Mental disorders, is a  serious mood disorder where people affected by it experience persistent feelings of sadness and hopelessness. 

Apart from these emotional distress, people with depression can also experience physical symptoms such as chronic pain, or changes in their behaviour such as social withdrawal or slowed movements.

For someone to be diagnosed with clinical depression, symptoms must be present for at least two weeks. Let us look at the various symptoms that must meet the criteria for a diagnosis of depression. 

The Diagnostic and statistical manual of Mental Disorders (5th ed) DSM-V outlines the following criterion to make a diagnosis of depression. 

The individual must be experiencing five or more symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure. 

These symptoms should indicate change from normal functioning. 

• Depressed mood most of the day, nearly every day- either by their own observation or observation made by others.
• Diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
• Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.
• Insomnia or hypersomnia. 
• A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
• Fatigue or loss of energy nearly every day.
• Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
• Diminished ability to think or concentrate, or indecisiveness, nearly every day.
• Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

To be diagnosed with depression, these symptoms must cause significant distress or impairment in social, occupational, or other important areas of functioning. 

These symptoms should also not be the result of substance abuse or another medical condition.

How to deal with depression that comes in waves?

A few things that we can do on an individual’s level to manage and maintain our mental health include:

Seek out therapeutic care

If you notice that you have been having waves of depression versus shifts in mood, the first thing that we advise is that you seek out professional help to understand whether it is depression, cyclothymia, or Bipolar disorder. 

Understanding your condition and diagnosis and Engaging with a therapist, being diligent with your medication, and making the changes you need to make to get better will determine your prognosis.

If the cost of therapy is becoming a burden consider talking to your therapist for a sliding scale option or the possibility of a pro bono case, and if that is not possible ask your therapist to refer you to someone who can take on your case at a much lower rate or for free. 

Your therapist will help you understand what is happening to you, might prescribe you medication if needed, and can help you tap into your own strengths that can help you adapt to challenges, changes, and overcome them.

Join a support group

Another thing you can do for yourself is to join a support group of people struggling with depression so that you can experience emotional support first hand within these communities and over time learn how to manage your challenges by learning from each other. 

It is possible that people with depression can also struggle with a sense of worthlessness, a feeling that you have nothing of value to offer. By joining a group that is open, empathetic, and growing towards healing, you and your experiences can be an excellent sense of support to someone else who is also in their early part of their journey. 

Seek out positive relationships

Like seeking out support in groups, seek out positive relationships in your life that do not judge and rather support you as you get better.

These can be friends, family and even past coworkers who offer support and a shoulder to learn on when you need it. 

These positive relationships can enable you to heal as well as help you as you move forward in life. 

Focus on resting and recovering

The most important thing that you can do for yourself is to rest and focus on recovering, do not rush yourself to get better so that you can go back to school or go back to work. 

Instead, take time to eat well, rest well, exercise, give time to yourself to think and engage in things you used to like doing before you started working- be it reading comics, or playing video games, or walking your pet.

Take effort to engage in things that you love doing, explore new activities if you feel like it and explore the world around you. 

Conclusion

In this blog we have attempted to answer the question “why does depression come in waves?”

We also briefly discussed what could be the cause of these fluctuations in mood, what depression actually is, and how one can help themselves if they have depression. 

FAQ related to why does depression come in waves

What is the actual reason for depression?

There is no single explanation as to what causes depression. It can occur due to many reasons such as neurological abnormality, genetic vulnerability, life circumstances, life experiences, trauma etc. 

What were the warning signs of the coming depression?

One of the major warning signs of an oncoming depression is the feeling of hopelessness and the feeling of not wanting to do things that you liked doing before- a loss of interest. 

What to do when one feels a wave of depression?

If you notice that you have been having waves of depression versus shifts in mood, the first thing that we advise is that you seek out professional help to understand whether it is depression, cyclothymia, or Bipolar disorder. 

Understanding your condition and diagnosis and Engaging with a therapist, being diligent with your medication, and making the changes you need to make to get better will determine your prognosis.

References

Nelson, J., Klumparendt, A., Doebler, P., & Ehring, T. (2020). Everyday emotional dynamics in major depression. Emotion, 20(2), 179–191. doi:10.1037/emo0000541.supp (Supplemental).

Susan Krauss Whitbourne.The Emotional Ups and Downs in the Lives of the Depressed. Psychology Today. Retrieved on 28th March 2022. https://www.psychologytoday.com/us/blog/fulfillment-any-age/202002/the-emotional-ups-and-downs-in-the-lives-the-depressed

Cyclothymia (cyclothymic disorder). Mayo Clinic. Retrieved on 25th march 2022. https://www.mayoclinic.org/diseases-conditions/cyclothymia/symptoms-causes/syc-20371275

Leonard.J. How to cope with a depressive episode. Medical news today.  Retrieved on 25th march 2022. https://www.medicalnewstoday.com/articles/322495

The Ups and Downs of Manic Depressive Disorder. Mental health Center. Retrieved on 25th march 2022.https://www.mentalhealthcenter.org/the-ups-and-downs-of-manic-depressive-disorder/