Situational Depression

What is situational depression? This article helps define situational depression and offers information on the causes, risk factors, symptoms, and treatment options for situational depression. Being depressed can be caused by a number of factors, situations are just one.

Situational Depression is a lay term for depression that comes about as the direct result of an identifiable external event or several external events. It is distinguished in people’s minds - if not in reality - from depression that has a biological or genetic cause. In fact, even depression that is explicitly linked to an external event or events may also partake of genetic and biological causes. This article will discuss some of the situations that may precipitate an episode of depression and the treatments most often offered. 

Situational depression is not a clear term because some depressions that are a response to a situation are part of the normal course of life and resolve by themselves (that is, they are non-pathological depressions), while others are mental disorders requiring intervention and treatment. It is also used by some people to refer to an adjustment disorder, a different category of mental disorder than depression. This article will discuss some of the situations that may precipitate an episode of depression and the treatments most often offered when treatment is required.

The situations that may be connected to depression have been categorized in several ways, including:

  • events that are controllable or uncontrollable. Examples would include the choice to purchase a home and being hit by lightning.
  • events that are desirable or undesirable. Examples would include receiving a promotion and being fired.
  • events that limit/end or open opportunities. Examples include becoming a caregiver for a pet and getting a large bonus at work.
  • events that create permanent environmental changes for the person. Examples include being confined to a wheelchair or moving to a new location.
  • events that alter a person’s self-concept, set of beliefs, and expectations. Examples include marriage, ordination to the priesthood, and becoming a new parent.

It is not expected that everyone experiences the same life event in the same way; that is, what one person perceives as desirable may be undesirable to another, etc.

The Social Readjustment Rating Scale (SRRS), developed by Holmes and Rahe (1967) and reassessed in 1997 by Scully et al., is often used to study the onset of psychiatric disorders, including depression. The list includes the following events as the top 15:

  1. Death of a spouse
  2. Divorce
  3. Marital Separation
  4. Jail term
  5. Death of a close family member
  6. Personal injury or illness
  7. Marriage
  8. Fired at work
  9. Marital reconciliation
  10. Retirement
  11. Change in health of family member
  12. Pregnancy
  13. Sex difficulties
  14. Gain of a new family member
  15. Business readjustments

You can easily see the mix of categories in the bulleted list above.

It is important to know that at the same time as researchers have offered refinements - including newer versions of the checklist, tests of the difference between external raters and individuals rating themselves, and new ways to put the events on the list into more context - the idea that important life events can precipitate a major depressive episode - even if other factors may also be involved - has not gone away. Postpartum depression, for example, is so-named because it occurs after the major life of acquiring a new family member through birth. Stressful life events are considered a risk factor for depression.

Treatment of Situational Depression

A variety of treatment options may be used in cases of so-called situational depression. One approach that may is often used in combination with others is the prescription of anti-depressants, particularly selective serotonin reuptake inhibitors (SSRIs). Other types of medication used include tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). These may be combined (carefully!) and/or supplemented by other medications including anti-anxiety medications, for example.

Therapy is an alternative treatment for situational depression, and may be used alone or in combination with prescriptions. Examples of the types of therapy that may be used include psychotherapy, also called counseling, or Electroconvulsive therapy (ECT).

Cognitive/behavioral therapy is one form of psychotherapy that may be used. It is focused on identifying and altering negative beliefs and behaviors in the present. Interpersonal therapy, which focuses on relationship skills, and psychodynamic psychotherapy, which focuses on developing insight into one’s motivations and unconscious thoughts and behaviors, may also be used.

Sometimes the symptoms of situational depression can be severe. In some cases, hospitalization or residential treatment programs may offer the best option.

Related Article: Reactive Depression >>