Does Depression ‘change’ People? 10 Effects of This Disorder on Behavior and the Brain

Your friend used to be the one who organized the group trip, who answered texts within the hour, who laughed too loudly at restaurants. Now she cancels on Friday afternoons, replies two days late with a single word, and sits in the corner at birthdays scrolling her phone with a smile that doesn’t reach anywhere. You find yourself thinking, quietly and guiltily: she’s different. Not herself. And she probably thinks so too, lying awake at 4 a.m., wondering where the person she used to be has gone and whether she’s ever coming back.

That feeling of having been replaced is one of the most common and least discussed experiences of major depression. People describe it as a fog, a dimmer switch, a stranger wearing their face. It rarely announces itself. It tends to arrive as a hundred small subtractions, the unanswered call, the skipped run, the joke you don’t make, until one day the sum is a different life. The shift is real, and so are the changes in thinking, energy, motivation and behavior that come with it. Researchers can even measure some of them in the brain. But “change” and “different person” aren’t the same thing, and the difference matters a great deal for how you treat yourself, or someone you love.

Short version: depression alters how a person functions, not who they are underneath.

This guide answers whether depression changes people, then walks through 10 effects of depression on behavior and the brain, what’s reversible, and what helps.

Does depression actually change who you are?

Partly, and mostly temporarily. Depression changes how you think, feel, behave and relate to others during an episode, and these changes can look like a different personality. But the evidence suggests that most of the “new person” fades as the illness lifts, and your core values, history and traits are still there.

Take Dana, an illustrative composite. At thirty-four she’s the funny, over-prepared colleague everyone leans on. During a depressive episode she goes quiet in meetings, misses deadlines, snaps at a friend, and tells her partner she doesn’t feel anything anymore. Three months into treatment she starts to joke again, and she’s embarrassed to realize how much of the quiet period she barely remembers. Dana didn’t become a different person. A condition took over the controls.

Researchers have studied this question under the heading of personality and depression. Daniel Klein and colleagues reviewed the evidence in 2011 and described several possible relationships. In the vulnerability model, certain traits, especially high neuroticism (a tendency toward negative emotion) and low extraversion, raise the risk of depression. In the complication model, depression distorts personality measurements while you’re ill, so you look more withdrawn or anxious than you’d be when well. In the scar model, an episode leaves a lasting mark on personality or self-concept even after recovery. The evidence is strongest for vulnerability and for the temporary distortion of the complication model, and weaker and more mixed for permanent scarring, although repeated episodes and long-lasting illness may leave lasting changes in some people, such as greater sensitivity to stress.

So what does this mean in plain language? For most people, personality traits tend to return toward baseline with recovery, but experience of depression can leave lingering effects: a more cautious outlook, a heightened awareness of warning signs, sometimes greater empathy. Some people describe feeling changed in a positive way after getting through it, though nobody should feel obliged to find meaning in suffering.

It also helps to separate two kinds of change. State changes are the temporary alterations caused by the illness itself, such as irritability, flat affect or slowed thinking. Trait changes are longer-lasting shifts in personality or outlook. Most of what loved ones notice is state change. That’s good news for recovery and also a reminder not to treat a symptom as a verdict on someone’s character.

The article’s 10 effects (listed next) describe the state changes. Keep in mind that they exist on a spectrum and that not everyone experiences all of them.

And if the person who seems “gone” is you, take this as a prompt to seek help, not as evidence that you’ve lost yourself.

What are the 10 effects of depression on behavior and the brain?

Here’s the full list at a glance, grouped from the most visible to the most hidden. Depression is diagnosed when symptoms last at least two weeks and cause real impairment, and it affects roughly 5 percent of adults worldwide according to World Health Organization estimates. Individuals vary widely, so you won’t necessarily see all ten.

A few notes on reading the table. First, the brain links are descriptive and simplified. Neuroscience of depression is still evolving, effects in group studies are often small, and brain differences don’t diagnose an individual. Second, the effects interact: poor sleep worsens concentration, which worsens self-criticism, which worsens withdrawal. Depression behaves like a system, not a list.

Third, the effects aren’t character flaws. Someone who can’t get out of bed isn’t being lazy, and someone who snaps at loved ones isn’t necessarily unloving. They’re symptoms, much like a cough in pneumonia.

The sections that follow take them in turn, and then look at what’s reversible. Along the way you’ll see where the evidence is strong, where it’s thin and where popular claims, such as “depression is a chemical imbalance,” oversimplify. The idea that a single neurotransmitter deficiency explains depression is not supported by current evidence; the picture involves many systems, including stress hormones, inflammation, neural circuits and life circumstances.

If you’re reading this because you recognize several items in yourself, a good next step is to talk to a primary care doctor (a GP in the UK, Ireland, Australia and New Zealand) or a mental health professional. A diagnosis isn’t something to self-assign from a table, and treatable medical causes such as thyroid problems, anemia and sleep disorders can mimic or worsen depression.

Let’s start with the most obvious: mood and pleasure.

How does depression change mood and the ability to feel pleasure?

It lowers mood and dulls reward. Effect 1 is a persistent low or flat mood, often with irritability or numbness, and Effect 2 is anhedonia, the loss of interest or pleasure in things that used to matter. Together they’re the core of the diagnosis.

Effect 1: Persistent low mood and emotional change. Sadness is the textbook symptom, but many people, especially men and young people, describe irritability, anger or emptiness instead. Others feel nothing, which can be more frightening than sorrow. Emotions can become less responsive to circumstances: good news doesn’t lift you, and small frustrations feel enormous. Some people cry easily; others lose the ability to cry at all.

Effect 2: Loss of pleasure and motivation. The psychologist Diego Pizzagalli has spent years studying anhedonia and, in a 2014 review, described how stress and depression seem to blunt the brain’s reward system, involving the striatum and its connections with the prefrontal cortex. In experiments, people with depression often show reduced responses to rewards and less tendency to adjust behavior toward rewarding options. That doesn’t just mean enjoying less; it can mean wanting less, effort feeling costlier, and the future seeming flat. Importantly, researchers distinguish “liking” (the pleasure of an experience) from “wanting” (the drive to pursue it) and “learning” (updating what’s worth doing). Depression can affect all three, in different proportions for different people.

Picture Sam, an illustrative composite, a keen cyclist who hasn’t touched his bike in four months. It isn’t that he’s decided he dislikes riding. It’s that when he imagines it, the thought produces no spark, only a vague sense of effort. His friends read it as flakiness. He reads it as proof that something’s wrong with him. Neither is quite right.

Practical consequences are significant. Hobbies lapse, social invitations get declined, work drive drops, and sex drive often falls too. Because motivation depends on anticipated reward, waiting to “feel like it” before acting rarely works. This is one reason behavioral approaches focus on action first, a point that returns later.

Not everyone experiences depression the same way. Some people retain the capacity for pleasure but feel exhausted; some experience atypical depression, in which mood can briefly brighten in response to positive events, with oversleeping and increased appetite; others have melancholic features with a profound, unreactive loss of pleasure. Cultural background also shapes how distress is described, sometimes through physical complaints.

A word to loved ones: the person who says “I don’t enjoy anything” is usually telling the truth. Gentle, low-demand invitations tend to help more than pep talks.

How does depression affect thinking, concentration and memory?

It shifts thoughts toward the negative and makes the thinking machinery slower and less reliable. Effect 3 is negative, repetitive thinking, including rumination; Effect 4 is trouble with attention, memory and decisions. Both are measurable, and the second persists in some people even after mood improves.

Effect 3: Negative thinking and rumination. The psychiatrist Aaron T. Beck proposed in 1967 that depressed people hold a cognitive triad: a negative view of themselves (“I’m worthless”), of the world (“nothing works”) and of the future (“it won’t get better”). These beliefs aren’t just consequences of a sad mood; Beck argued they help maintain it, and his work led to cognitive therapy. Alongside this, many people with depression ruminate, passively replaying problems and feelings without solving anything. The psychologist Susan Nolen-Hoeksema showed in 1991 that people with a ruminative response style had longer and more severe depressive episodes than those who responded with distraction or problem-solving, and later work linked rumination with higher risk of developing depression in the first place. In practice, it sounds like: “Why am I like this? What’s wrong with me? Why can’t I just snap out of it?” The questions feel like thinking, but they don’t produce answers.

Effect 4: Concentration, memory and decision problems. A 2014 meta-analysis by Philippa Rock and colleagues, using a standardized computerized test battery, found moderate deficits in executive function, memory and attention in people with depression compared with controls, with effect sizes ranging from about -0.34 to -0.65. In people whose mood symptoms had remitted, moderate deficits in executive function and attention still persisted, which suggests that cognitive impairment is a core feature of depression and not merely a by-product of low mood. The study had limits: it relied on one test battery and group averages, and some of the remitted patients may have had residual symptoms or medication effects. Still, it explains why many people say that after recovery, their thinking doesn’t feel quite as sharp.

Daily impact is easy to recognize. Reading the same paragraph four times. Standing in the supermarket aisle unable to pick a cereal. Forgetting appointments. Taking twice as long to finish routine tasks. At work, these can look like carelessness. At home, like indifference. Neither interpretation is fair.

Practical help: write things down, break tasks into small steps, reduce decisions (routine meals, prepared outfits), and ask for deadlines to be eased during treatment. Cognitive symptoms often improve more slowly than mood, so expect a gap and don’t judge your recovery by it.

And be gentle with the verdict “I’m not as smart as I was.” You’re likely seeing a symptom, not a loss of ability.

Why do sleep, energy and behavior change so much in depression?

Because depression disrupts the body’s basic regulation, and the resulting exhaustion feeds a cycle of inactivity. Effect 5 covers changes in sleep, appetite and energy; Effect 6 covers the behavioral withdrawal and avoidance that follow. Treating the second often helps the first.

Effect 5: Sleep, appetite and energy changes. Sleep disturbance is among the most common features of depression. The psychopharmacologist David Nutt and colleagues argued in a 2008 review that sleep problems are core symptoms of depression, not mere side effects: many patients have insomnia, with difficulty falling asleep, waking frequently or waking too early, while a smaller group sleeps excessively. Poor sleep, in turn, worsens mood, concentration and emotional control, and can raise the risk of relapse. Appetite and weight often change, either up or down, and many people feel a heavy, slowed-down fatigue (“leaden paralysis”) that rest doesn’t fix. Some also show psychomotor changes: slowed speech and movement, or restlessness.

Effect 6: Withdrawal, avoidance and inactivity. With low energy and little reward, people do less. They cancel plans, skip exercise, let chores pile up, stay in bed. In the short term, avoidance brings relief. Over time it removes the very experiences that could lift mood, such as contact, achievement and enjoyment, and it adds guilt and shame. This is the logic of behavioral activation, which grew from early behavioral models of depression. In a 1996 component analysis, Neil Jacobson and colleagues compared full cognitive therapy with its separate parts and found that behavioral activation alone, simply scheduling meaningful, rewarding activities, performed about as well as the full package at the end of treatment and at six-month follow-up. The trial included about 150 people, so it wasn’t definitive, but later research has supported behavioral activation as an effective, relatively simple therapy.

The psychologists Steven Maier and Martin Seligman gave another angle. Seligman’s early learned helplessness work suggested that uncontrollable stress teaches animals to give up. In a 2016 revision, Maier and Seligman argued that the brain’s default response to prolonged adversity is passivity, and that what must be learned is control, a process involving the prefrontal cortex. The implication is encouraging: small experiences of control and effectiveness can counter the passivity.

Consider Marcus, an illustrative composite, who stopped answering the door, then the phone, then the group chat. Each skipped contact made the next one harder. A therapist didn’t ask him to feel better first. She asked him to walk to the corner shop three times a week. The first walk felt pointless. By week three it didn’t.

If this sounds like you, start absurdly small: one shower, one walk, one text. Action first, motivation second.

Why do relationships change when someone is depressed?

Because depression alters communication, energy and emotional availability, and the people around the depressed person respond. Effect 7 is social and relationship change: withdrawal, irritability, feeling like a burden, and sometimes conflict or distance that persists after the episode.

The effects run in both directions. A depressed person may have less to give, struggle to show interest, take things personally or misread neutral comments as criticism. They may also seek reassurance repeatedly, which can wear partners and friends down. This reassurance-seeking is understandable and exhausting in equal measure. In 1976, the psychologist James Coyne proposed an interactional account: people with depression, through reassurance-seeking and a negative mood, can draw out concern at first and then rejection or avoidance from others, which confirms their feeling of being unlovable. His work was early and based on small laboratory studies, but later research has found that depressed individuals do often experience social strain and that depression and relationship problems feed each other.

In a romantic partnership, you might see reduced affection and sex, withdrawal from shared plans, flatness during good times, or flare-ups of irritability. Partners can feel rejected, helpless or resentful, and they sometimes develop their own depressive or anxious symptoms. In families, children may notice a parent’s flatness or irritability and misinterpret it as their fault. At work, absenteeism and presenteeism, being there but not functioning, are common.

Often the biggest shift is internal: a conviction of being a burden. People may withdraw to “protect” others, which deepens isolation. This belief is also linked to suicidal thinking, which is why it deserves attention rather than reassurance alone.

For loved ones, a few principles help:

Don’t take symptoms personally, but don’t accept mistreatment either. Offer specific, low-pressure help (“I’m bringing dinner Thursday”) instead of vague offers (“let me know if you need anything”). Keep inviting, even if the answer is usually no. Avoid pep talks and “just think positive,” which can feel dismissive. Ask directly about safety if you’re worried. And look after yourself, since caring for someone with depression is demanding and burnout is real.

The encouraging fact is that relationships often recover as depression lifts, particularly when both people understand what was illness and what was them. Couples therapy can help when patterns have set in.

If you’re the one withdrawing, try telling one person the truth: “I’m struggling, and it isn’t about you.”

What does depression do to the brain’s structure and stress system?

It’s associated with small but measurable differences in brain structure and with changes in stress hormones and inflammation, though these are group averages and not diagnostic markers. Effect 8 concerns structure, especially the hippocampus; Effect 9 concerns stress physiology and the immune system.

Effect 8: Structural brain differences. The largest imaging study to date comes from the ENIGMA consortium. Lianne Schmaal and colleagues pooled MRI scans from 1,728 people with major depression and 7,199 healthy controls across 15 samples and reported that hippocampal volume was lower in the depression group by about 1.2 percent, a small effect (Cohen’s d of about -0.14). The difference was driven by people with recurrent depression and those whose illness began at age 21 or younger; it was not detected in first-episode patients. Other structures showed less consistent differences, and larger studies have reported modest thinning in some regions of the cortex, including parts of the orbitofrontal and cingulate cortex. Two cautions are essential. These are tiny group-level differences that overlap heavily with normal variation, so a scan can’t diagnose depression. And the direction of cause is unclear: the hippocampus may shrink with prolonged illness and stress, or smaller volume may be a risk factor, or both.

What the hippocampus does helps make sense of the findings. It supports memory and also helps regulate the stress response. If it’s affected by prolonged stress, that may contribute to the memory complaints and exaggerated stress reactions seen in depression. Researchers also describe altered activity in circuits linking the prefrontal cortex, the amygdala (involved in emotional salience and threat) and the cingulate cortex, with some studies showing heightened responses to negative information and weaker top-down regulation.

Effect 9: Stress hormones and inflammation. Many people with depression show overactivity of the HPA axis, the hormonal chain that controls cortisol, and some show raised markers of inflammation. Inflammation can produce “sickness behavior” such as fatigue, low mood, social withdrawal and loss of appetite, which resembles depression, and treating inflammatory illnesses can sometimes alter mood. The evidence suggests that inflammation contributes to depression in a subset of people, not everyone. Claims that depression is “just inflammation” overreach.

Is any of this a reason for despair? No. Brain differences are not destiny. Studies of treatment, including psychotherapy, medication and exercise, show changes in brain activity and connectivity as people recover, and the brain’s plasticity means that circuits can reorganize. Because the effect sizes in structural studies are small, they are more useful for understanding mechanisms than for predicting any one person’s future.

So when headlines say “depression shrinks your brain,” translate: slightly smaller on average in some people, especially after repeated episodes, and probably partly recoverable.

Is the change permanent, and can the brain recover?

For most people, no. Depression is among the more treatable mental health conditions, and most people improve substantially with treatment, though relapse is common and some effects, particularly cognitive ones, can linger. Recovery is the usual outcome, not the exception.

It helps to be precise. Roughly half or more of people with depression improve with a first adequate course of treatment, and many more recover with a second or third step, such as switching or combining therapies. But around half of those who have one episode go on to have another, and the risk rises with each recurrence. That is why maintenance treatment, relapse-prevention skills and early action at the first warning signs matter. Recovery may also be gradual: sleep and energy often improve first, then mood, then thinking and interest.

What about the lasting effects? Possible residues include persisting attention and executive difficulties in some people, as the cognitive research shows, a heightened sensitivity to stress, a tendency to ruminate under pressure and, for some, a stronger awareness of their own vulnerability. These are not inevitable, and they respond to deliberate work: cognitive therapy can reduce ruminative habits, exercise supports cognition and mood, and sleep regularity protects against relapse.

Here’s another way to see it. Depression is like a long illness that leaves you deconditioned. After a long flu, you don’t expect to run a marathon right away; you rebuild. After depression, rebuilding your routines, relationships and confidence takes time, and it’s normal for it to feel awkward. Rushing to “get back to normal” often backfires.

Setbacks deserve a plan. A bad week isn’t necessarily relapse, but a pattern of two or more weeks with returning symptoms such as poor sleep, withdrawal or hopelessness is a signal to act: contact your clinician, restart supports, tell someone close to you. Many people find a written relapse plan useful, listing personal early warning signs, first steps and who to call.

Some people describe benefits that emerge afterward, such as deeper relationships, clearer priorities or greater compassion. Those are genuine for some and shouldn’t be forced on anyone. The point isn’t that depression is secretly good. It’s that recovery isn’t a return to an old self so much as a reintegration of a self that was always there.

If you’re in the middle of it, the most useful fact may be this: the way things feel now is not a forecast.

What helps, for you or someone you love?

A combination of evidence-based treatment, daily structure and support. Psychotherapy, medication and, for some, brain-stimulation treatments all work, and combining approaches often does better than any one alone. The best choice depends on severity, history and preference.

• Psychotherapy: cognitive behavioral therapy, behavioral activation, interpersonal therapy and, for recurrent depression, mindfulness-based cognitive therapy all have good evidence.
• Medication: antidepressants help many people, especially with moderate to severe depression, and take several weeks to work. Decisions about starting, switching or stopping should be made with a prescriber.
• Brain-stimulation treatments such as electroconvulsive therapy or transcranial magnetic stimulation, used for severe or treatment-resistant depression under specialist care.
• Lifestyle foundations: regular sleep, physical activity, daylight, and cutting back on alcohol, which worsens mood and sleep.
• Connection: peer support groups, trusted friends and family, and a clinician who explains what to expect.
• Medical check: thyroid, anemia, vitamin deficiencies, sleep apnea and medication side effects can mimic or worsen depression.

If you’re the person with depression, aim for small, realistic steps. Pick one thing from each day’s list: a walk, a shower, a meal with protein, a text to a friend. Keep appointments even when they feel pointless. Track mood and sleep for a few weeks; patterns often become visible. Tell your clinician if something isn’t working, since there are many options.

If you’re supporting someone, be consistent and patient. Offer practical help, join them for appointments if they’d like, and keep your expectations flexible. Don’t try to be their therapist. Encourage professional help and, if they refuse, keep the door open without nagging.

Treatment doesn’t always work first time. Many people don’t respond to the first antidepressant they try, and psychotherapy may need adjusting. That’s information, not failure. Persistence and honest feedback with your clinician matter more than finding the perfect plan immediately.

Finally, watch for stigma, especially the internal kind. Depression isn’t weakness or a lack of gratitude. It’s a health condition with biological, psychological and social contributors, and getting help is the same kind of sensible as treating a broken bone.

When is depression an emergency?

When someone is thinking about suicide or self-harm, has a plan, feels unable to stay safe, or is losing touch with reality. In those situations, don’t wait for the next appointment. Reach out to a crisis service or emergency number immediately.

If you or someone near you is thinking about suicide or self-harm, call or text now. In the US, call or text 988; in Canada, call or text 9-8-8; in the UK and Ireland, Samaritans is on 116 123, and in Ireland Pieta is on 1800 247 247; in Australia, Lifeline is 13 11 14; in New Zealand, call or text 1737. In an emergency, call 911 (US and Canada), 999 (UK), 112 or 999 (Ireland), 000 (Australia) or 111 (New Zealand).

Warning signs that someone may be at risk include talking about wanting to die or being a burden, giving away possessions, saying goodbye, a sudden calm after a long period of distress, increased drinking or drug use, reckless behavior, and access to means such as medication or firearms. Asking directly, “Are you thinking about suicide?”, does not plant the idea; it often brings relief. Listen without judgment, stay with the person if you can, remove means where possible and help them reach professional support.

Seek prompt professional help (not necessarily emergency services) if symptoms last more than two weeks, interfere with work or relationships, include significant changes in sleep or appetite, or if you’ve had depression before and feel it returning. Mention any history of mania or unusually elevated mood, as bipolar disorder needs different treatment.

Young people, older adults, new parents (postnatal depression is common and treatable), people with chronic illness and those who’ve experienced loss or trauma deserve particular attention. Depression in teenagers can look like irritability, falling grades or withdrawal. In older adults, it may appear as memory trouble, physical complaints or loss of interest and is often missed.

One practical suggestion: write down a short safety plan while you’re relatively well. List your own warning signs, three things that help, two people to contact, a crisis number and steps to make your environment safer. Keep it somewhere easy to find.

You don’t need to be certain it’s “bad enough” to ask for help. If you’re wondering, that’s reason enough.

FAQs about Depression Changing People

Can depression change your personality permanently?

Usually not. Research reviewed by Daniel Klein and colleagues suggests that most of the apparent personality change during depression, such as withdrawal, irritability or negativity, reflects the illness itself and eases with recovery. Some people may be left with lasting differences, such as greater sensitivity to stress, particularly after repeated or long episodes, but evidence for permanent personality “scarring” is mixed. Core values and identity generally remain, even when they are temporarily hard to access.

Why does a depressed person seem like a different person?

Because depression changes mood, motivation, thinking speed, energy and social behavior all at once. Someone who was outgoing may become quiet, someone dependable may become forgetful, and someone warm may become irritable or flat. Loved ones see these changes and conclude the person has changed. In most cases, it’s the illness speaking, not the person’s character, and many people feel strangely unlike themselves too. As symptoms improve, familiar traits generally return.

Does depression damage the brain?

It is associated with small structural and functional differences, but “damage” overstates it. In a large international analysis by Lianne Schmaal and colleagues, hippocampal volume was about 1 percent lower on average in people with depression, mainly in those with recurrent illness or early onset. Those are small group differences, and not everyone shows them. Treatments, including psychotherapy, medication and exercise, are associated with changes in brain function as people recover, so the picture isn’t one of permanent injury.

Is memory loss from depression reversible?

Often partly. Memory, attention and decision-making problems tend to improve as depression lifts, but a meta-analysis by Philippa Rock and colleagues found that moderate deficits in attention and executive function persisted in some people after mood symptoms remitted. Sleep, exercise, treating anxiety, reducing alcohol and cognitive strategies can help. If memory problems are severe, sudden or worsening, especially in older adults, ask a doctor to rule out other causes.

Why do I feel numb instead of sad?

Emotional numbness is a common form of depression. Research on anhedonia, including Diego Pizzagalli’s work, suggests that depression can blunt the brain’s reward and emotional responses, so you feel flat, empty or disconnected instead of tearful. Numbness can be unsettling, and it may also follow trauma or occur with certain medications. It’s worth mentioning to a clinician, who can assess whether depression or something else is involved and discuss options.

How can I help a depressed partner who has become distant?

Try to treat the distance as a symptom, not a rejection. Offer specific, low-pressure support, like cooking a meal or joining a walk, and keep including them without demanding enthusiasm. Avoid pep talks and ultimatums. Encourage them to see a doctor or therapist, and offer to help find one. Ask directly about safety if you’re worried. Look after your own wellbeing too, perhaps with a friend or counselor, since supporting someone with depression is draining.

Can you fully recover from depression?

Yes, many people do. With treatment, most people improve substantially, and many reach remission, meaning few or no symptoms. Relapse is common, though, especially after multiple episodes, so ongoing relapse-prevention strategies matter: staying in treatment as advised, keeping sleep and routines steady, and acting early on warning signs. Recovery is often gradual, with sleep and energy improving before mood and concentration. Some effects, such as cognitive slowing or sensitivity to stress, may linger but can improve with time and support.

When should I worry that depression is serious?

Seek help promptly if low mood or loss of interest lasts more than two weeks, disrupts daily life, or comes with big changes in sleep, appetite or concentration. Treat it as urgent if you or someone you know has thoughts of suicide, a plan, or feels unable to stay safe, and use a crisis line or emergency number straight away. Don’t wait for it to be “bad enough.” Early treatment tends to be more effective, and a primary care doctor is a good place to start.

Bibliography

• Beck, A. T. (1967). Depression: Clinical, experimental, and theoretical aspects. Harper & Row.
• Coyne, J. C. (1976). Toward an interactional description of depression. Psychiatry, 39(1), 28-40.
• Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., Gortner, E., & Prince, S. E. (1996). A component analysis of cognitive-behavioral treatment for depression. Journal of Consulting and Clinical Psychology, 64(2), 295-304.
• Klein, D. N., Kotov, R., & Bufferd, S. J. (2011). Personality and depression: Explanatory models and review of the evidence. Annual Review of Clinical Psychology, 7, 269-295.
• Maier, S. F., & Seligman, M. E. P. (2016). Learned helplessness at fifty: Insights from neuroscience. Psychological Review, 123(4), 349-367.
• Nolen-Hoeksema, S. (1991). Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology, 100(4), 569-582.
• Nutt, D., Wilson, S., & Paterson, L. (2008). Sleep disorders as core symptoms of depression. Dialogues in Clinical Neuroscience, 10(3), 329-336.
• Pizzagalli, D. A. (2014). Depression, stress, and anhedonia: Toward a synthesis and integrated model. Annual Review of Clinical Psychology, 10, 393-423.
• Rock, P. L., Roiser, J. P., Riedel, W. J., & Blackwell, A. D. (2014). Cognitive impairment in depression: A systematic review and meta-analysis. Psychological Medicine, 44(10), 2029-2040.
• Schmaal, L., Veltman, D. J., van Erp, T. G. M., Sämann, P. G., Frodl, T., Jahanshad, N., et al. (2016). Subcortical brain alterations in major depressive disorder: Findings from the ENIGMA Major Depressive Disorder working group. Molecular Psychiatry, 21(6), 806-812.