Why Is My Depression Getting Worse? 9 Reasons It Happens and What to Do

Depression is treatable—but that doesn't mean the path is always linear. Many of our patients at Next Step Psychiatry come in saying, "I was doing better, so why do I feel worse now?" If that resonates with you, know that worsening depression is common, understandable, and addressable.

9 Reasons Your Depression May Be Intensifying

1. Poor Sleep

Sleep and depression have a bidirectional relationship. Depression disrupts sleep, and poor sleep worsens depression. Whether it's insomnia, sleep apnea, or inconsistent sleep schedules, addressing sleep issues is critical to managing depression.

2. Substance Use

Alcohol, cannabis, and other substances may provide short-term relief but ultimately worsen depression by disrupting brain chemistry, increasing isolation, and interfering with medication effectiveness.

3. Medication Issues

Sometimes an antidepressant that worked well initially stops being effective—a phenomenon known as breakthrough depression or "poop-out." In other cases, the wrong medication or dose can actually worsen symptoms. Never adjust your medication without consulting your prescriber.

4. Major Life Changes

Job loss, divorce, moving, becoming a new parent—any significant life transition can destabilize your mental health. Even positive changes come with stress that can trigger or worsen depression.

5. Chronic Stress

You don't need a catastrophe to feel overwhelmed. The daily grind of a long commute through Atlanta traffic, financial pressures, and juggling family responsibilities can produce chronic stress that slowly erodes your mental health.

6. Physical Health Problems

Chronic pain, thyroid dysfunction, diabetes, and other medical conditions can worsen depression. If your depression is getting worse, a full medical workup may be warranted.

7. Social Isolation

Pulling away from friends and family is both a symptom and a driver of worsening depression. The less connected you feel, the harder it becomes to reach out.

8. Seasonal Changes

While Georgia winters are milder than up north, shorter days and less sunlight can still trigger seasonal affective patterns that compound existing depression.

9. Lack of Exercise

Physical inactivity reduces endorphin production and cardio fitness, both of which support mood regulation. Even modest increases in activity can make a meaningful difference.

What to Do When Depression Gets Worse

• Contact your prescriber. Medication adjustments, additions, or switches may be needed.
• Be honest about substance use. Your treatment team can't help fully if they don't have the whole picture.
• Consider advanced treatments. Spravato (esketamine) is an FDA-approved option for treatment-resistant depression that we offer at our Lilburn clinic.
• Maintain basic routines. Even when motivation is low, keeping regular sleep, meal, and activity schedules provides a stabilizing framework.
• Reach out. If you're in crisis, call 988 (Suicide & Crisis Lifeline) or go to your nearest emergency room.

Expert Depression Care in Lilburn, GA

Next Step Psychiatry provides personalized depression treatment for patients across Gwinnett County and the Atlanta metro. Our team understands that depression is dynamic, and your treatment plan should be too.

4145 Lawrenceville Hwy STE 100, Lilburn, GA 30047 • 678-437-1659