depression that comes and goes

Overview

Depression that comes and goes means you have episodes or attacks of depression. During an episode you may feel very low, lose interest in things you usually enjoy, and find it hard to think clearly. Then, after weeks or months, you might feel much better. This pattern can repeat over time. It is sometimes called recurrent depression.

Yes. Depression is one of the most common health problems worldwide. In the UK, about one in six adults will have depression at some point in their lives, and many people who have it will experience more than one episode.

It can affect children, teenagers, adults, and older people. It is slightly more common in women than in men, but it can happen to anyone.

Symptoms

Common symptoms

• Feeling sad, empty, or tearful for most of the day, nearly every day
• Losing interest or pleasure in family, friends, hobbies, or work
• Feeling tired and having little energy
• Having trouble falling asleep, waking early, or sleeping too much
• Having a poor appetite or eating more than usual
• Feeling worthless, guilty, or hopeless
• Finding it hard to concentrate, remember things, or make decisions
• Feeling irritable or restless

Symptoms in children

• Being unusually clingy or withdrawn
• Not wanting to play or see friends
• Getting angry or irritable quickly
• Talking about being 'no good' or wanting to give up
• Having new aches and pains with no clear cause
• Doing worse at school or losing interest in lessons

Symptoms in older adults

• Feeling tired and low even after light activity
• Withdrawing from family and social activities
• Becoming confused, forgetful, or having trouble concentrating
• Losing appetite and weight without trying
• Having more physical aches and pains
• Feeling anxious or worrying more than usual

Causes

Main causes

• Imbalances in brain chemicals called neurotransmitters are thought to play a role.
• Personal or family history of depression or other mood problems increases the chance, although the exact cause is not fully understood.
• Stressful life events such as losing a job, a relationship ending, serious illness, or childhood trauma can trigger an episode.
• Long-term health conditions such as diabetes, heart disease, or chronic pain can increase the risk.

Risk factors

• Having had depression before
• Having a close relative with depression or an anxiety disorder
• Going through major life changes, such as separation, bereavement, or losing your home
• Having a chronic health condition or disability
• Using alcohol or drugs to cope
• Being socially isolated or having few people to confide in

When to see a doctor

See a doctor urgently if:

• If you have thoughts of hurting or killing yourself, or thoughts of self-harm, seek help right away. Call your local emergency number (such as 999 or 911) or go to the nearest accident and emergency department.
• If you are worried about someone else and think they are in immediate danger, do not leave them alone. Call emergency services right away.

Book a routine appointment if:

• See a doctor (GP) if these symptoms last for more than two weeks or keep coming back.
• You should also see a doctor if depression symptoms are affecting your work, school, family, or daily responsibilities.
• Book an appointment if you have recovered from a previous depression and start to notice the early signs again.

Diagnosis

There is no simple scan or blood test for depression itself. A doctor or specialist will ask about your symptoms, how long you have had them, and how they affect your day-to-day life. They may also use a standard questionnaire to get a clearer picture.

Tests that may be done

• A standard depression questionnaire, sometimes called the PHQ-9 or similar tool, which asks you to rate your mood and symptoms.
• Blood tests to rule out conditions like an underactive thyroid, low iron, or other medical causes.
• Sometimes fasting blood sugar or vitamin levels if the doctor thinks they may be contributing.

What to expect at your appointment

Your doctor will listen and ask you about your mood, sleep, appetite, relationships, and whether you have had these feelings before. Bring a trusted friend or relative if you like, and a list of any medications you are taking. It may feel uncomfortable, but being honest helps your doctor help you.

Treatment

Treatment for depression that comes and goes aims to get you through the current episode and to help prevent future episodes. You and your doctor can choose a plan based on how severe your depression is and what you prefer. Meaningful help can come from talking therapies, lifestyle changes, and—if recommended—medication. Every episode is different, so your treatment may be adjusted each time.

Self-care at home

• Try to follow a regular sleep routine, even at weekends.
• Do a small amount of gentle physical activity, like a short walk, on most days.
• Break large tasks into smaller steps and write down these steps.
• Stay in touch with someone you trust—even a text or phone call can help.
• Limit alcohol and recreational drugs, as they can make mood worse.
• Speak openly with family or friends about what you need.

Medical treatments

Medical treatments for recurrent depression include various types of talking therapy, such as cognitive behavioural therapy (CBT) or counselling. A doctor may also prescribe antidepressant medication to help balance brain chemistry. Sometimes other types of therapy are offered, such as problem-solving or interpersonal therapy. You and your doctor will decide together which approach fits your needs. Some people benefit from a combination of talking therapy and medication. It is important to take any prescribed tablets exactly as directed, and not to stop suddenly. If one treatment does not work, do not despair—there are many options, and it is normal to try a few before finding what suits you.

When is surgery considered?

Surgery is not a treatment for depression. However, if a physical health problem is contributing to your depression (such as a hormone disorder), treating that problem may be part of your care.

Living with this condition

Living with a depression that comes and goes can feel like riding an emotional rollercoaster. On good days, try to keep a normal routine. On low days, be kind to yourself and do what you can. Tracking your mood daily can help you and your doctor spot patterns early.

Lifestyle tips

• Keep a simple daily schedule for meals, sleep, and activity.
• Take medication (if prescribed) at the same time each day.
• Join a hobby group, class, or faith community if that appeals to you.
• Avoid late-night scrolling on your phone before bed.
• Set realistic goals for the week and celebrate small wins.

Diet and exercise

When you can, include vegetables, fruit, and whole grains in your meals, and stay hydrated. A regular, moderate exercise like brisk walking for 30 minutes a day is proven to help mood, but even five minutes is better than none. Talk to a dietitian or your doctor if you are unsure about what suits you.

Mental health and emotional wellbeing

Depression can affect your self-esteem, your energy to connect with others, and your ability to cope with stress. It can strain relationships at home and work. If you have had episodes for years, it is normal to worry about the next one. Talking therapies can teach skills to manage these feelings.

Prevention

There is no guaranteed way to prevent depression, but many people can reduce the number and severity of episodes by staying on their treatment plan, learning to notice early warning signs, exercising, sleeping enough, and getting talked therapy if you notice a downturn. If you have had several episodes, you and your doctor might talk about a long-term care plan.

Vaccines

There is no vaccine to prevent depression. However, staying up to date with general vaccinations that protect against infections may help you avoid illnesses that can trigger mood changes.

Screening programmes

If you have had depression before, your doctor may suggest check-up appointments every few months to review your mood, even when you feel well. This early warning can help you get help as soon as symptoms begin.

Complications

If left untreated

• Depression can become more severe and last longer.
• It can make it difficult to keep a job, stay in education, or manage your home and finances.
• It can strain relationships with partners, family and children.
• It can lead to alcohol or drug dependence as people try to numb the pain.
• It increases the risk of self-harm and suicide.

Long-term outlook

With the right treatment and support, most people with recurrent depression recover well from each episode. Treatment can shorten the low periods and make them less intense. Many people go on to live full and meaningful lives, especially when they learn to spot early symptoms and ask for help early. You are not defined by your depression.

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