8 Risk Factors for Major Depressive Disorder

Learn what increases the odds that you or a loved one will experience major depressive disorder.

a young white woman in distress sits with her arms wrapped around her head

Updated on June 10, 2022

Major depression (also called clinical depression, major depressive disorder, or MDD) doesn't discriminate between different types of people. Anyone can become depressed, but several factors can increase your personal risk of major depression. These include the following:

You're a woman. Women are about twice as likely as men to have depression during their lifetime. Experts believe this is due to a combination of factors including:

  • Hormonal changes related to puberty, pregnancy, and menopause
  • Social and cultural factors that affect women
  • Added stress from work, parenthood, and caregiving

You’re a young adult. Data from the Centers for Disease Control and Prevention (CDC) show that 21 percent of adults between 18 and 29 years old experienced symptoms of depression in 2019, compared to 18 percent of adults aged 45 to 64, 18 percent of adults 65 and over, and 17 percent of those aged 30 to 44. Rates of depression among teenagers are also growing, with experts citing academic and social pressures as contributing to this trend.

You have a family history of depression. Major depression can affect you even if you don't have a family history of it. But you're more likely to develop depression if you have a relative—especially a parent, sibling, or child—with depression. Current research shows that the risk for clinical depression is most likely a result of both genetics and other life factors, such as experiencing trauma early in life (see below).

You've had major depression in the past. About 50 percent of people who experience major depression become clinically depressed again. That's because depression is a disease that often returns. The right treatment for depression can reduce the chance of a relapse and keep repeat episodes of major depression as short as possible.

You've experienced a lot of stress. The stress of divorce, the death of a loved one, or other painful experience can raise your risk of clinical depression. The same is true for traumatic childhood events, which can trigger major depression in adults. If you've ever had depression or have a family history of depression, your risk of developing depression due to stress or grief may be even higher.

You use alcohol, drugs, or nicotine. People with depression often use drugs and alcohol to feel better. But did you know that substance use may actually raise your risk of depression? Experts think drug use may lower the brain's ability to deal with stress, making you more vulnerable to depression and making episodes of depression more severe.

You don't have strong social support. When it comes to your health—mental and physical—there's something to be said for having friends and loved ones around when you need them. Not having enough support is a risk factor for major depression. In turn, if your depression isn't treated, it can get in the way of good relationships.

You have a chronic illness or take certain medications. People with a chronic physical or mental condition such as cancer, stroke, or anxiety are more likely to also have depression. Some medications can also raise your risk of major depression.

Experts don't know exactly why some people get major depression and others don't, but they do know that some risk factors can make you more vulnerable to experiencing it. Depression can affect the way you feel, both physically and mentally. If you feel depressed or have key risk factors, talk to a healthcare provider. With the right treatment, you can take control of major depression.

If you or someone you love is experiencing thoughts of self-harm, call the National Suicide Prevention Lifeline at 1-800-273-8255 or call, text, or chat 988. You can also reach out to the Crisis Text Line by texting ‘HELLO’ to 741741. If you or someone you know is actively considering suicide, call 911 right away or go to the nearest emergency room.

Article sources open article sources

Mayo Clinic. Depression in Women: Understanding the Gender Gap. Page last reviewed January 29, 2019.
Centers for Disease Control and Prevention. NCHA Data Brief Number 379. Symptoms of Depression Among Adults: United States, 2019. September 2020.
A.W. Geiger and Leslie Davis. A growing number of American teenagers – particularly girls – are facing depression. Pew Research Center. July 12, 2019.
Choi KW, Stein MB, Nishimi KM, et al. An Exposure-Wide and Mendelian Randomization Approach to Identifying Modifiable Factors for the Prevention of Depression. Am J Psychiatry. 2020;177(10):944-954.
National Institutes of Health. Factors that affect depression risk. September 1, 2020.
Nuggerud-Galeas S, Sáez-Benito Suescun L, Berenguer Torrijo N, et al. Analysis of depressive episodes, their recurrence and pharmacologic treatment in primary care patients: A retrospective descriptive study. PLoS One. 2020;15(5):e0233454.
Mayo Clinic. Depression (major depressive disorder). February 3, 2018.

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Types of Depression: Don't Let the Blues Beat You

If you've experienced blue moods, you know the toll they can take on your personal and professional life. But did you know that depression can have a negative impact on your health? It's true: Depression affects not only your thinking but also your sleep, your appetite, your immune system, and other natural processes that help keep your mind and body in good working order.

In fact, depression has been linked to hypertension, stroke, heart disease, diabetes, obesity, and asthma. But whether depressive symptoms are a marker for or a cause of these conditions remains to be determined. What we do know is that the combination of depression and chronic disease greatly increases the risk of poor health outcomes.

Degrees of Depression

Depression is common. The latest figures suggest that 1 in 13 adults will experience at least one episode of major depression. Women seem to have a higher incidence of depression than men do, but men's symptoms tend to manifest as irritability, anger, and frustration and therefore may not always be recognized as signs of depression.

There are many different types of depression, including:

  • Dysphoria: Brief episodes of sadness or depression that last less than 2 weeks
  • Mild depression: Low-level depression that lasts at least 2 years (also called dysthymia)
  • Major depression: Intense, disabling depression that may occur in a single episode or recurring episodes
  • Seasonal affective disorder (SAD): Depression that occurs seasonally, specifically during winter, when there is less sunlight
  • Postpartum depression: Major depression that can develop in women after giving birth
  • Bipolar disorder: Cycles of severe depression alternating with an extremely elevated or irritable mood known as mania (also called manic depression)

Any number of events can set off an unpleasant emotional reaction that leads to a blue mood. But for some people, the sadness spirals into something deeper and may last for weeks or longer. This level of depression typically requires treatment by a professional healthcare provider.

However, if you experience a milder form of depression, you can take steps to defuse your negative feelings before they become debilitating and put your health at risk.

Start by taking a close look at three important areas of your life: your thought processes, your relationships, and your stress levels.

As you consider these areas of your life, assess how and why they influence your psyche on a daily basis, and begin to develop a plan to resolve any troubling issues.

1. Brighten Up Your Thinking

Pay more attention to your perceptions and reactions, and track them in a journal. Identify troublesome exchanges, and consider whether your emotional reactions -- to your boss, partner, family, or coworker, or to others -- were appropriate, or whether you may have overreacted. Keep in mind that emotions can twist how you see reality. Running through these events and evaluating them objectively can help you come up with healthier, more productive responses.

Example: Your boss snaps at you for missing a minor deadline.
Overreaction: You feel like a total failure or think to yourself, "I can't work with him. He's out to get me."
A more constructive reaction: Consider whether your boss may be having a stressful day himself, or resolve to make meeting your deadlines a higher priority in the future.

With practice, you'll be able to come up with more rational responses not only after the fact but also in the moment.

2. Build Supportive Relationships

How healthy are your relationships? Are you connected to a solid support group, or are you caught in friendships with people who take more than they give? Rate your mood after spending time with your close friends. If you consistently score low following outings with certain people, it's time to make some changes in those relationships. Negative social exchanges can affect your health even more than stressful life events or daily hassles.

If a friend has a habit of always pointing out mistakes you've made in the past or, knowing you're dissatisfied with your job, insists on talking about work, try telling her that you'd prefer to talk about what's positive in your life. If things don't change, limit the time you spend with her, and spend more time with friends who make you feel good about yourself.

Seek out positive people at work or in your community whom you admire and who will encourage and motivate you to take positive action and enjoy your life. Make time to chat with them at least once a week -- it could lift moderate depression as effectively as antidepressant medication or counseling.

Also, don't make the mistake of cutting out larger social engagements to accommodate a demanding schedule. Spending too much time alone puts you at risk of becoming overly self-focused and critical. Join a book club, sports team, or gardening club -- these are great ways to connect with people.

3. Simmer Down Stress

Some stress is good for you. It keeps you alert and active. But when it gets out of control, it can cause serious damage to your psyche and make you vulnerable to bouts of depression. So how can you keep yourself from getting too stressed out? Set aside at least 20 minutes every day to rest your mind. Turn off your phone, computer, and TV. Sit quietly and reflect on your favorite moments of the day. Or try picturing positive moments you'd like to have tomorrow.

Other ways to unwind: Practice yoga, go for a walk, read, pray, meditate, listen to a relaxation tape or music, or engage in any activity that clears your mind and releases tension. Try different techniques, like learning to meditate. See what works best for you, and then do it regularly.

Help When You Need It

Depression affects millions of Americans in varying degrees at some point in their lives. No matter what level, depression is a condition that requires management to keep episodes to a minimum. Before you get pulled back into another dark hole and struggle to climb out, do some self-reflection and make the changes that are necessary to help you maintain a positive frame of mind. These changes may give you the mental strength to manage your emotions before they escalate.

But if you feel down or depressed for more than 2 weeks, or your mood is interfering with everyday activities, you may need professional help to get back on track. The following two questions can help you determine if you'd benefit from a little extra help:

During the past month, have you often felt down, depressed, or hopeless?
During the past month, have you had little interest or experienced little pleasure in doing things?

If you answered yes to both of these questions, make an appointment with your doctor to find out whether you are suffering from clinical depression and need treatment.

If you answered yes to one of these questions, or feel uncertain about your mood, you may need to seek the advice of a medical professional.