It's not unusual to experience both depression and anxiety following some types of trauma or significant life change. And the change doesn't have to be negative such as job loss. Positive events—like having a child or moving to a bigger home—can be stressful and bring on anxiety and bad feelings, too.

The good news is, depression in response to an outside event is often temporary. Though some of the symptoms are shared with other forms of depression—tearfulness, lethargy and loss of interest in work or other activities—the feelings of hopelessness usually subside within six months of the stressful event. (Other forms of depression can be chronic and are usually triggered by emotional or physiological issues.)

According to Angelos Halaris, MD, professor of psychiatry at Loyola University Medical Center in Baltimore, this condition was once referred to as situational depression but is known today as adjustment disorder.

"The term situational depression isn't formally used any longer," she explains. "The more accurate name is 'adjustment disorder with anxiety or depression, or both.'"

Different types of loss can also cause this type of depression. For some, the end of a relationship can be as upsetting as the death of a loved one. Trauma, such as living through a fire or natural disaster and witnessing a care accident, can also cause adjustment disorder which should not be confused with post-traumatic stress disorder (PTSD). Generally, PTSD is a reaction to a life-threatening trauma.

Diagnosing Adjustment Disorder

Unlike other forms of depression, adjustment disorder typically starts in the aftermath of the major change.

"Adjustment disorder can happen as a result of losing a pet or learning that your parent has a terminal illness," says Susan Lindau, MSW, LCSW, adjunct professor at the University of Southern California's School of Social Work. "The difference is that this type of depression is much more external, more environmental, than other depressive disorders." Other forms of depression may occur even in the absence of a specific traumatic event, she explains.

Another reason for this type of depression is a change of status. "It can start when you retire, for example," Halaris says. "The key concept is that you are reacting to a situation, and that the situation is beyond your control." Not having control over a situation stirs up feelings of helplessness and a sense that things will never go back to normal. And when faced with these feelings, it is easy for some individuals to fall into a depression.

Simon Rego, PsyD, ABPP, ACT, associate professor of clinical psychiatry and behavioral sciences in the Albert Einstein College of Medicine and Director of Psychology Training at Montefiore Medical Center in New York City explains how seemingly positive situations can also bring on an episode of adjustment disorder: "Becoming a parent, winning a lottery, or even getting a promotion at work can all potentially trigger this type of response," he says. "It is always caused by an identifiable trigger, so when you can't identify anything negative, consider searching for positive life events too."

Getting Back On Track

Make a conscious effort to turn the situation around by taking productive actions, advises Rego. "If you are depressed over a job loss, take small steps to increase your likelihood of finding another one," he says. "Upload your resume to a job site, start using your social networks, invest your time in a productive way toward seeking work." In addition, he suggests focusing on the here-and-now. "Stop being negative and hard on yourself by offering yourself gentle encouragement."

Try to find some things in your life that are meaningful, and focus more on those than on the situation that has triggered the depression. For instance, say you work in an office and you can't stand your boss, but you are afraid to look for a new job because the market is so tight. "Think about what gives you pleasure and comfort in your life," Lindau says. "Then try to get more of these people or activities into your life." If you love going to concerts or the ballet, line up some future dates and plan to attend some events. If gardening is your thing, make sure to do it as often as possible on weekends.

If you don't exercise, start. "Exercise generates endorphins, and this lowers depression," Lindau says. "Exercise also will help you sleep better." And sleep is especially critical when you are depressed because without sufficient sleep, your brain is unable to process what it needs to on a daily basis, she explains.

Don't take this type of depression lightly. "Since this type of depression does have the potential to intensify, get help," Halaris advises. Remember, there is nothing wrong with reaching out. "It takes a brave person to admit that he or she is feeling awful and needs help," Lindau says. "Acknowledge your vulnerability and get the help you need." Consult your family doctor or a therapist who can help you identify the stressor and teach you strategies for coping with the sadness.

Susan Lindau, MSW, LCSW, reviewed this article.



Sources:

Angelos Halaris, MD. Phone interview February 2014.

Susan Lindau, MSW, LCSW. Phone interview February 2014.

Simon Rego, PsyD, ABPP, ACT. Phone interview February 2014.

Mayo Clinic. "Adjustment Disorders," Web. Accessed 18 February 2014. http://www.mayoclinic.org/diseases-conditions/adjustment-disorders/basics/symptoms/con-20031704