If you or a loved one are struggling with depression, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database.

Depression can have many causes, all of which are complex and can be difficult to understand. In some cases, feelings of depression can be clearly connected to an experience in someone’s life, such as a tragic loss or a violent event. Other people may be aware they have a family history of mental illness and, as a result, may not be caught off guard by a diagnosis of depression.

However, some people become depressed and don’t know why. They may feel they do not have a “reason” to be depressed—especially if they perceive their life as being “good” or “easy” compared to others.

The pressure to explain or justify how they feel can make depression worse and may prevent people from getting necessary treatment.

The Lived Experience of Depression

A person who is in good physical health, is employed, has a safe home to live in, enough money to care for themselves and their family, supportive friends, and hobbies may struggle to comprehend why they feel persistently sad, angry, or irritable.

In the absence of a clear “trigger” such as the death of a loved one, a divorce, or the loss of a job, they may feel that it doesn’t make sense for them to feel depressed.

The presence of these things in their lives may make someone feel that they have “no right” to be unhappy. If a person’s family does not have a history of depression, they may assume that means they couldn’t be genetically prone themselves.

Likewise, a person may look back at their childhood and become confused and concerned if they don’t find a specific event that would “justify” the depression they are experiencing as an adult.

When they realize the people around them have not experienced depression, they may feel very alone. They may start to worry that others will think they don’t appreciate what they have if they appear sad or down. They may worry about being a burden to others—or seen as a liability.

People with depression may be concerned about speaking up in fear of what might change at school or work, as well as in their relationships.

They may worry that their boss won’t think them capable of doing their job if they know they have depression. When young people in school are depressed, they may be wrongly labeled “slackers” or told that they are not “trying hard enough.”

When a person with depression internalizes these messages, they may come to believe they are not smart or capable—and depression has a way of reinforcing those false beliefs by making someone have a low opinion of themselves.

In relationships, people with depression may not talk about their experience because they are afraid others won’t understand. They may worry that their spouse, family, and friends will stop loving them. They may fear the people they care about will blame them for the feelings they have.

They may also be worried that their loved ones will blame themselves if they are unable to help, which can make a person who is depressed feel guilty or like a burden.

Parents who are experiencing depression may worry about how their children could be affected. They may even fear that they will be seen as “unfit” parents if they admit to having feelings of depression.

The pressure to “justify” depression can be overwhelming, but remember the old saying that you “can’t judge a book by its cover.” The way someone else’s life appears to be may not show the whole truth.

People who are depressed may work very hard to try to hide how they really feel. On the outside, they may look and even act as though they feel OK and that everything is fine.

Whether you’re experiencing depression yourself or you care about someone who is, it can be helpful to reframe how you think about the condition. Start by focusing on the causes of depression (which are backed by facts) rather than focusing on reasons (which are subjective and relative).

The Importance of Focusing on “Causes” Not “Reasons”

Researchers are still learning about all the different mechanisms that drive depression.﻿﻿ There are many causes and in most cases, it’s a combination of factors that ultimately cause a person to become depressed.

2:12 Some Common Causes of Depression

The "chemistry" of depression is not well understood, but researchers do know that an imbalance of brain chemicals called neurotransmitters can happen in anyone, even in the absence of an obvious "trigger."﻿﻿

Some influences, such as brain structure, genetic predisposition, and environmental exposures, are not something a person can control. Risk factors that fall under the category of lifestyle choices are considered modifiable, but the extent to which an individual can do so will depend on their own ability and how much support they have.

Depression can make it much more challenging to address factors that might be contributing to depression, such as substance use or diet. As much as it is a mental illness, depression can also be physical. Symptoms like chronic pain and fatigue can make it difficult for people to take on lifestyle modifications, such as exercise, even if they want to and believe they could help.﻿﻿

To make these changes (and stick with them) people need to have the right tools and a good deal of support. To get treatment, a person with depression needs to feel safe talking about how they are feeling.

A person who believes they are depressed “for no reason” may not feel they “deserve” to ask for or get help. That’s why it’s important to focus less on the “reason” for depression and instead think about the causes.

Looking at the causes helps people (both those with depression and those who want to support them) understand that being depressed is a medical condition, not a choice.

Depression can be, needs to be, and deserves to be treated. However, there are many different ways to treat the condition. What works for one person may not work for another, and some people have to try many different options before finding something effective.

It’s also not unusual for people to need to try different treatments throughout their lives to manage depression, as the condition can change and evolve in response to changes in a person’s life (both physically and emotionally).

If you are depressed but don’t understand why, you may recognize that you need help and may want it, but may also be struggling with the feeling that you don’t “have the right” to ask for help.

Know this: Every person with depression deserves treatment.

Will Treatment Help?

It’s hard to predict which treatments will work best for someone with depression. How well a specific treatment works also depends on the type of depression a person is experiencing. It’s important to work closely with your doctor and/or a mental health care professional (such as a psychiatrist, especially if you take medications) as you are exploring different treatment options.

Antidepressant medications such as Prozac (fluoxetine) and Zoloft (sertraline), are among the most commonly prescribed. Psychotherapy is another option and is often used in combination with medication.

Research indicates that for many people, using therapy and antidepressants together can effectively treat depression. However, these interventions alone may not adequately address symptoms for every person with depression.﻿﻿

In these cases, other types of treatment such as electroconvulsive therapy (ECT) can be used. ECT involves the brief application of an electrical pulse to the scalp in order to produce a seizure. Research has shown that the brain’s response to such stimulation can be rapid and may be able to treat symptoms that were resistant to medication and therapy.﻿﻿

Newer depression treatments include various types of brain stimulation therapy such as vagus nerve stimulation (VNS) and transcranial magnetic stimulation (TMS). These treatments may be recommended for someone whose symptoms haven’t responded to medication or therapy.﻿﻿

While it can be exhausting, frustrating, time-consuming, and in some cases costly to try different methods of treating depression, it’s important to try to find the option that will be the most effective for you. Depression (and its treatment) is a complex process that’s not one-size-fits-all.

Understanding a Loved One’s Depression

If someone you care about is dealing with depression, you may not be sure how to support them. If your attempts to help are rejected or don’t seem to do any good, you may become frustrated and impatient.

If you feel tempted to tell someone who is depressed to “try harder” or “just snap out of it,” it may be a sign that you are overwhelmed or experiencing burnout. If this happens, it’s important that you pause and take time to reflect on your own feelings. You won’t be able to help someone else until you have taken care of your own emotional needs.

When you’re worried about a person you care about, the feelings of fear you have may come across as anger when you’re talking to them. Even if you aren't mad or speaking in anger, depression can make it harder for a person to really hear what you are saying. They may interpret your words as being dismissive, accusatory, disappointed, or any number of emotions that aren’t necessarily accurate.

When you’re speaking to your loved one with depression, keep this in mind if it seems like your conversations are full of miscommunication. Although you may want to remind them of all the “good things in life” or point out that “it could be worse,” platitudes such as these aren’t usually helpful for a person with depression to hear.

Comparing their pain to someone else’s (or your own) may be your way of trying to give your loved one some perspective, but it may come across as though you are minimizing their experience. If the person is already struggling to understand why they are depressed, comments like these can reinforce feelings of guilt. In response, a person may “close up.”

If someone you care about is depressed, especially if they are struggling with “having no reason” for it, the most important thing you can do for them is to be a compassionate and active listener.

This doesn’t mean you should put your emotional needs second or withhold your own feelings. Keeping the lines of communication open helps the person you care for feel safe to discuss what they’re going through and express the desire for help when they’re ready. If you are worried about them, maintaining a “lifeline” can reassure you of their safety and well-being.