A person’s behavior may change if depression worsens. They may have less motivation to engage in activities. Worsening depression may also affect sleeping and eating habits.

Symptoms of depression can range from mild to severe.

A person with depression may feel as though their symptoms are getting worse. It is important that people who feel this way speak with a healthcare or mental health professional.

This article looks at signs that depression may be worsening and factors that can impact depression. It also provides tips about what to do if the condition gets worse and where to find help.

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The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) lists the current criteria mental health professionals use to diagnose depression.

However, a 2018 study suggests there is a lack of research into the relationship between these criteria and depression severity. The study also indicates that some depression symptoms may be more significant or prevalent as depression worsens.

Signs depression may be becoming more severe include the following:

Spending more time alone

One of the symptoms of depression is spending more time alone. As the condition worsens, people may withdraw further from friends or family, becoming more isolated or detached.

Difficulty finding things to spark an interest

Studies indicate that a loss of interest or pleasure in activities they typically enjoy distinguishes people with severe depression from those with moderate depression.

People may find that activities or hobbies that previously sparked their interest or provided pleasure no longer appeal to them. They may also lose motivation to engage in experiences they used to enjoy.

Changes in sleeping and eating habits

Symptoms of depression can include issues with sleep and eating habits. A person may have more difficulty sleeping, or they may wake up earlier in the morning. Individuals may also spend more time sleeping than usual or sleep in the daytime.

Some may find that their appetite changes, meaning they have less interest in food than usual or overeat.

Mood changes at particular times

Research suggests that as depression worsens, a person may experience a more depressed mood and feelings of worthlessness or excessive guilt. Additionally, depression may worsen in times of particular stress, such as when a person experiences:

  • illness
  • bereavement
  • financial or employment worries
  • separation from a partner

Intensifying emotional distress

Emotional distress may manifest in several behaviors that are symptomatic of depression. People may:

  • have difficulty concentrating or making decisions
  • display an increase in purposeless physical activity, such as pacing and hand-wringing
  • speak or move more slowly than usual

Suicidal thoughts and feelings also distinguish severe depression from moderate depression. It is important for anyone who experiences these thoughts and feelings to contact a healthcare or mental health professional right away. Help and support is available.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

Various factors can lead to an increase in the severity of depression symptoms. These include stress, inactivity, and rumination, among others.

Rumination

Studies explain that rumination and repetitive negative thinking (RNT) are related to depression and other mental health conditions.

Researchers suggest RNT is essentially a natural process to alert us to not achieving our goals and to motivate us to engage in action. However, excessive RNT in the context of mental health conditions has lost this function.

Read more about rumination.

Stress

Stress and stressful life events may trigger depression or worsen symptoms in some people. Examples of factors that may impact depression include:

  • abuse
  • poverty
  • difficult or unhealthy relationships

Inactivity

Experts suggest that regular exercise can lower the risk of depression and help improve some symptoms of the condition.

However, because depression causes fatigue and a lack of energy, people with these symptoms may find it challenging to engage in physical activity and become more inactive as the condition worsens.

Learn more about exercise and depression.

Poor sleep

A 2021 study indicates that one-third of adults in the United States report getting less sleep than recommended, and approximately 20% live with a mental health condition. It also suggests an association between inadequate sleep and a significantly increased risk of frequent mental distress.

Eating habits

The Office on Women’s Health notes that 43% of adults with depression have obesity, affecting more females than males.

People with depression may have more difficulty eating a healthy diet due to experiencing a lack of energy for cooking or an inclination to eat less healthy foods during periods of low mood, which some may call “comfort eating.”

Weight loss can also be a sign of depression, as many people experiencing the condition find they have a lack of appetite.

Social isolation

According to the Centers for Disease Control and Prevention (CDC), feelings of loneliness or isolation are a risk factor for mental health conditions, such as depression.

The CDC also advises that the following situations can lead a person to see fewer people socially and become more isolated, potentially impacting their mental health:

  • caring for a relative or loved one
  • working long hours
  • economic hardship

An ineffective treatment plan

Generally, a healthcare or mental health professional will work with an individual to develop a treatment plan for depression. This often includes medication, psychotherapy, or a combination of the two.

Sometimes, a treatment plan may not be as effective as expected. A person may need to try various medications or therapies before finding the most effective treatment for them.

Substance use

According to a national survey by the Substance Abuse and Mental Health Services Administration, 13.5% of adults ages 18–25 had both a substance use disorder and a mental health condition in 2021.

A 2019 review of existing research suggests that alcohol use disorder is a risk factor for depression, and the two conditions often occur together.

Medications

A 2018 study found that the use of prescription drugs that can cause depression as a side effect is common in the U.S.

These medications include:

People can speak with a healthcare professional about any concerns they may have about the side effects of their medication.

If an individual feels their symptoms of depression are worsening, it is important that they reach out to a healthcare or mental health professional. There are also several resources available online.

Professional help

A healthcare or mental health professional may be able to recommend changes in a treatment plan or provide further options to help manage symptoms.

Crisis support lines

The National Institute of Mental Health states that if someone feels they may be in immediate danger due to their mental health, they should seek help at the nearest emergency room.

It also lists several crisis support lines, such as the 988 Suicide and Crisis Lifeline.

Speaking to a trusted person

A person may be able to speak to someone they trust about their symptoms, such as a relative, friend, or teacher. The trusted person may be able to provide support in accessing further resources.

Mental health resources

Visit our dedicated hub for more research-backed information and resources on mental health and well-being.

Symptoms of depression may vary in severity from person to person. They may become more prominent over time, or new ones may appear.

People may experience changes in their sleeping and eating habits or begin to spend more time alone. They may find they have less motivation to engage in activities they used to find interesting or enjoyable. In severe cases, someone may experience suicidal thoughts.

It is important for individuals experiencing worsening symptoms of depression to seek help and support from a healthcare or mental health professional or a person they trust. Crisis helplines are also available online, by phone, and through text.