It's downright scary: More than 20 million Americans can expect to suffer from depression in the coming year. But you don't have to be one of them if you're alert to the events and situations that can turn the blues into something more serious.
Here, the 10 most common depression triggers -- and what to do to prevent them from dragging you down.
Loss of Job and Depression
Why losing a job may trigger depression: In addition to causing financial stress, losing a job can jeopardize your sense of identity and feelings of self-worth. Unemployment and financial stress also strain marriages and relationships, bringing conflict that compounds stress and unhappiness.
Who's most vulnerable: Statistics show that the older you are or the higher you were paid, the longer it's likely to take to find work again. Also, those employed in downsized industries and fields, such as the auto industry, may have to retrain or start over in a new field, which can be frightening and can undermine self-confidence.
What helps: Connect with others in the same situation, whether it's through a job skills class, training program, or job-search support group. Also, if you can afford it, use a career counselor or coach to help you create a plan, stay accountable, and feel supported. Experts also recommend building a support network by reaching out to friends and colleagues and setting up regular events throughout the week. The more you can structure your time with lunches, walks, and other get-togethers, the better. Try signing up for a morning exercise class or schedule regular morning walks to get you going each day.
If time goes by and it doesn't look like you're going to find a replacement job quickly, consider volunteering. It's not only a way to boost your self-esteem and get out of the house but it's also great for learning new skills and making new connections.
Sexual Problems and Depression
Why sexual problems may trigger depression: According to sexual health expert Beverly Whipple, professor at Rutgers University and author of The Science of Orgasm (Johns Hopkins University Press, 2006), depression and sexual problems are interrelated in a vicious cycle. Sexual problems and sexual health issues can trigger depression by removing one of the most effective outlets we use to feel good. But many of the most common antidepressant medications, particularly the group of drugs known as SSRIs (brand names Prozac, Zoloft, Celexa) can sabotage your sex drive and make it harder to achieve orgasm.
Who's most affected: Loss of an active sex life due to age -- or health -- related issues can trigger depression in both men and women, but men may feel the loss more acutely. That's because sexuality is more central to a man's sense of identity, says Whipple: "When a man experiences a loss of libido or sexual dysfunction, his entire sense of self may be affected."
What helps: In a nutshell, get medical or professional help. While talking about sex and the health of our "equipment" isn't easy for any of us, it's essential to breaking the cycle before it leads to depression. If you're experiencing physical changes that are contributing to a loss of interest in sex or to performance issues, it's essential to bring them up with your doctor. And if the problem stems from relationship or other emotional issues, make use of a couples counselor or sex therapist.
If you let embarrassment or shame prevent you from speaking up, you're denying yourself one of the most effective weapons against depression. Recent studies show that having regular orgasms relieves stress, prevents prostate cancer, and releases feel-good brain chemicals that protect against depression. One of Whipple's many studies even shows that regular sex increases your pain-tolerance threshold, reducing chronic pain.
“Empty Nest” Syndrome and Depression
Why “empty nest” may trigger depression: Two of the hardest things to deal with are loss and change, and when a child leaves home you're suddenly hit with both, all at once. "Your entire routine changes, from the minute you wake up in the morning to the moment you go to bed at night," says Celestino Limos, dean of students at Lewis & Clark College in Portland, Oregon. "Parents tend to focus on all the practical details of getting a child ready for college, but they're unprepared for how much the rhythm of their own lives changes from day to day."
Who's most vulnerable: Women seem to suffer more acutely than men, perhaps because their self-identity is more closely associated with being parents, experts say. But men can suffer an acute sense of loss as well, and they may be less prepared for the onslaught of emotions. Those who are divorced or otherwise single are much more likely to be lonely once the kids are gone, but married couples may also find themselves struggling, particularly if the marriage is rocky or they've developed a tag-team approach to family life and don't share many activities and interests. Parents of only children are also more vulnerable.
What helps: Plan in advance. Parenting experts suggest that parents begin exploring independent interests during their child's last year of high school. Sign up for a class one night a week, or subscribe to a travel magazine and think about trips you might want to take.
When your child leaves home, give yourself a few weeks of quiet time to grieve, but don't spend too much time alone. Set up regular events you can look forward to. Organize weekly walks with friends, join a book group, or sign up for a yoga, pilates, or dance class. Plan your weekends ahead of time, so you're not caught off guard with time heavy on your hands. Try something completely new, such as a cooking or language class. When you discover a new interest or passion, having more time available becomes a good thing rather than a liability.
Alcohol and Depression
Why alcohol abuse triggers depression: Recent research backs up what addiction and depression experts have long argued: Alcohol abuse and depression are often linked in what's called a "dual diagnosis" or, colloquially, "double trouble." The reason for this complicated interaction is the effect alcohol has on mood. When you stop into your local tavern for a cold one, you might think you're staving off the blues with some camaraderie and relaxation. But alcohol acts as a depressant in the central nervous system, triggering depression in those who are susceptible.
Who's most vulnerable: Those already prone to depression or those prone to overusing alcohol are at greatest risk. In either group, the combination of alcohol abuse and depression is dangerous. According to studies, between 30 and 50 percent of alcoholics suffer from major depression. And the relationship works the other way too: Studies have found that alcohol use causes relapse in people with depression, and that when people with depression drink they're more prone to suicide.
What helps: Cut back on drinking and seek help for alcohol abuse or addiction. "There's a reason we've got the stereotype of the weepy drunk," says Liliane Desjardins of Pavillion International, a treatment center in Texas. "Alcohol triggers a mood crash." But people who drink too much rarely attribute their misery to drinking, she adds. Instead they blame it on other people and factors.
There's only one solution: Cut back and see if, over time, you feel better. If you repeatedly promise yourself or others not to drink and your efforts fail or your drinking brings other negative consequences into your life, you may need help to stop. Alcoholics Anonymous and other 12-step programs are effective for some people. Others need the physical restriction and concentrated services of a residential alcohol rehabilitation facility or the supervised medical detox of an inpatient program. No matter what type of alcohol treatment program works for you, you'll find it has the additional benefit of preventing depression.