All you need to know about reactive depression

Reactive depression is also known as situational depression or adjustment disorder. It's a type of depression linked to a life-changing event. Any significant change in your life can trigger reactive depression. 

It’s a fairly common condition: The SAHMSA (Substance Abuse and Mental Health Services Administration) Surveillance Study found 6.9% of American adults received an adjustment disorder diagnosis in the last year.¹

Depending on the situation, these events may or may not feel traumatic. Experts often refer to these events as stressors. There are no precise criteria as to what a stressor could be. 

If you are experiencing reactive depression, you may want to know why it's different from other types of depression. Additionally, it's also essential to address the symptoms so that you can find ways of coping. Let’s learn more about reactive depression. 

What is reactive depression?

There are several classification systems for depression. For example, mental health professionals can categorize it based on how severe it is or classify depression based on the case. Depression may be either reactive or endogenous. 

A clear external event triggers reactive depression. In contrast, endogenous depression (also known as melancholic depression) occurs without a clear triggering event. The word endogenous refers to something that originates inside the body. 

For example, there could be a genetic component influencing your depression. On the other hand, reactive depression has an external cause in the form of some type of stressor. A stressor is any event or circumstance that causes significant stress or change in your life.

If you notice your mood has been low following a recent event or change, you might be experiencing reactive depression. Since the symptoms of reactive depression overlap with other types of depression, it's a good idea to check in with your doctor to determine what is happening. 

Are reactive depression, situational depression, and adjustment disorder the same thing?

Sometimes, healthcare professionals use the terms reactive depression and situational depression interchangeably. These two terms mean the same thing.

Another term you may hear is adjustment disorder. Reactive depression is a type of adjustment disorder. Specifically, it’s classed as adjustment disorder with depressed mood. Adjustment disorder can also cause anxiety or behavioral disturbances.

Reactive depression, situational depression, and adjustment disorder with depressed mood all refer to the same type of depression. 

However, it can be somewhat confusing when one kind of depression has so many different names. To keep it simple, we will only refer to it as reactive depression. 

Is reactive depression similar to acute stress disorder and post-traumatic stress disorder?

Acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) are two disorders that sound similar to reactive depression. Like reactive depression, these stem from an external stressor or traumatic event. 

However, ASD and PTSD have different symptoms than reactive depression. These involve overly reactive and anxious symptoms, while reactive depression causes people to feel hopeless and down.

It’s possible for the stressful event that triggers reactive depression to be a traumatic experience involving actual or threatened death or sexual violence. This is the same type of event that can trigger PTSD. However, a wider range of stressors can lead to reactive depression, such as the loss of a job, the death of a loved one, or a personal illness.

Signs and symptoms of reactive depression

The symptoms of reactive depression have quite a bit of overlap with major depressive disorder (MDD). Because of this, it may be challenging to know whether you have reactive depression or MDD. That's why it's essential to seek evaluation by a psychologist, physician, or another healthcare professional.

The general symptoms of depression include:

• Feelings of sadness or emptiness

• Feeling hopeless

• Feeling irritable or anxious 

• Feelings of guilt 

• Favorite activities or hobbies no longer interest you 

• Overeating or loss of appetite

• Difficulty sleeping (insomnia)

• Oversleeping (hypersomnia) 

• Fatigue 

• Headaches

• Digestive disturbances 

• Body aches or pains 

• Thoughts of suicide and death

If you are experiencing these symptoms, you likely have some type of depression. But how can you know whether it's reactive depression? Assess the circumstances surrounding your depression, and see if you can determine a stressor.

The DSM-5 classes reactive depression as adjustment disorder with depressed mood. The signs of this condition are:

• Significant distress that is out of proportion to the severity or intensity of the external stressor

• Difficulty coping at work or with social aspects of life 

• Low mood 

• Tearfulness

• Feelings of hopelessness 

• Feeling anxious, nervous, worried, or jittery 

• Separation anxiety (struggling to cope when you are away from others)

• Displaying mixed emotions 

It's also important to note that the DSM-5 states that the symptoms you're experiencing can't meet the criteria for another preexisting mental disorder. Therefore, you cannot be diagnosed with reactive depression if your symptoms are related to a different mental health condition that you already have.

Another fact that the DSM-5 points out is that reactive depression does not represent normal bereavement. So while death can trigger reactive depression, the emotional state brought about differs from grief. 

Lastly, symptoms of anxiety are similar to those of reactive depression. The DSM-5 states that a combination of anxiety and depression is common. 

Causes and triggers of reactive depression 

The trigger for reactive depression is an external stressor. An external stressor is an event or circumstance you struggle to adjust to. In some people, this can lead to depression. 

Some examples of potential stressors include:

• Interpersonal conflict 

• Death of a loved one 

• Unemployment 

• Financial difficulties 

• Illness of a loved one or yourself 

Overall, adjusting to any major change in your life can be challenging. Reactive depression can be triggered when you have difficulty adjusting to a life-changing event. 

Prevalence and incidence

The prevalence of reactive depression in the general population is unknown, and studies we’ve cited have different figures ranging from 2–6.9%. However, some uncertainty remains since this disorder is underreported. 

It appears that reactive depression is most prevalent in unemployed or bereaved people. As unemployment and bereavement are significant life changes, this makes sense.

A 2019 study reported that the rate of reactive depression for unemployed people was 27%, and the rate for bereaved people (those dealing with the death of someone close to them) was 18%. Hospitalized patients (those dealing with a significant illness) had a rate of 18.5%.²

Risk factors

Unfortunately, there is a lack of research on the risk factors for reactive depression. Anyone undergoing a significant life change may be at risk for developing reactive depression.

If you have experienced depression in the past, you could be more prone to reactive depression. Additionally, a family history of depression could put you at a higher risk. 

However, there is no clear way of knowing who will develop reactive depression. At this stage, we can only speculate who might be more at risk. 

Understanding reactive depression 

If you have reactive depression, it's essential to understand that your depression comes from an external stressor. Understanding what triggered your depression could help with your progress in therapy because it will better enable you to process what happened.

Some people go to therapy for help with their reactive depression. A therapist will ask you to discuss the situation around your depression. They will help you understand why a particular event affected you and explore healthy ways of coping with your emotions. 

How is reactive depression different from other types of depression?

While most of the symptoms of reactive depression are similar to other types of depression, there are some differences.

People with an adjustment disorder may experience depression, anxiety, or a combination. While you are experiencing a low mood and a feeling of hopelessness, you may also experience nervousness or feel worried. 

Another hallmark of reactive depression is that you experience significant distress. This distress is out of proportion to the severity or intensity of the external stressor. If you have reactive depression, you react more strongly to a stressful event than others experiencing the same kind of event.

Lastly, the causes of reactive depression are different from the causes of other types of depression. Reactive depression occurs in response to a particular event. In contrast, other types of depression derive from many factors, such as genetics, changes in body and brain function, and environmental factors.

Reactive depression vs. grief

Reactive depression can be triggered by grief since the death of a loved one is a life-changing event. However, grief is different from reactive depression. 

Grief, also known as bereavement, is a period of mourning following the death of a close friend or family member. There is no time limit as to how long grief lasts.

Feelings associated with grief are: 

• Anger

• Guilt 

• Sadness

• Anxiety 

• Despair 

Other signs of grief include:

• Difficulty sleeping

• Loss of appetite or increased appetite 

• Physical problems such as illness 

• Emotional reactions

• Social reactions 

Grieving is a normal response to the death of a loved one. If you are experiencing grief, it's important to acknowledge that it's part of the process. However, when your reaction to the death of a loved one is out of proportion to what it's expected to be, you may have reactive depression. 

It can be difficult to know whether your grief is proportionate to what most people experience in a similar situation. If you’re struggling, it’s a good idea to talk with a mental health professional to get support and an evaluation.

How can you tell the difference between clinical and reactive depression?

Reactive depression is a type of clinical depression. If you are trying to determine the cause of your depressive symptoms, it's best to speak to your doctor. Diagnosing depression can be tricky, so it's good to seek expert advice rather than attempting to diagnose yourself.

Diagnosing reactive depression 

The only way to diagnose reactive depression is to get an assessment completed by your doctor. Your doctor may use two different assessment methods. One is the DSM-5, which medical professionals often use for diagnosing all kinds of mental health issues. Sometimes, they use the International Statistical Classification of Diseases and Related Health Problems (ICD-11) instead. 

Both the DSM-5 and ICD-11 include a list of specific symptoms and timelines. Your doctor will compare what you’re experiencing to the list and determine whether you meet the criteria for adjustment disorder. If you do not, your doctor will consider other possibilities. 

The lowdown 

If you have reactive depression, it’s likely that it will eventually pass. However, it's still important to seek help, especially if you are struggling to cope. 

There is a range of therapies available to alleviate reactive depression. Simply talking to someone about what you’re experiencing is often helpful, and it can make you feel less alone. 

People also ask: 

What does reactive depression mean?

Reactive depression is the depression you experience while struggling to adjust to a life-changing event. These are typically significant events with an adverse outcome, such as the loss of a family member or divorce. 

Even major changes that don't have negative consequences, such as starting a new career or school or having a baby, can trigger reactive depression.  

What is the difference between reactive and endogenous depression?

Reactive depression comes from an external event that may impact your thoughts. In contrast, endogenous depression is from something biological, such as genetics.