It is difficult to answer this question in general terms because each person’s life circumstance is unique. Having said that, in my observation as a therapist, depression is often (but not always) a response to pain; more specifically, prolonged emotional pain.

There are many ways in which pain can enter our life. Sometimes it enters our life suddenly. For example, a loved one dies, our romantic partner decides they no longer want to be with us, or some other drastic change occurs. And just like that, the life as we know it no longer exists; anxiety and grief come flooding in.

Sometimes pain lingers from a previous chapter in our life. For example, many people experience trauma in childhood or adolescence; they grow up and make a life for themselves, but the pain of their past is carried forward. Although they may have become numb to it, It’s still very much “alive” within them.

And sometimes pain gradually accumulates over time as one goes about their day to day life. This is particularly true for people who struggle with low self esteem. Many people don’t like themselves and have to wake up each day living in this reality. A lifetime of shame and disappoint can bring about a tremendous amount of pain, even if no major “trauma” has occurred.

Regardless of how pain enters one’s life, when it persists, it takes a physiological toll on the mind and body. It is helpful to think of this pain as a “weight” that one carries. And when the weight becomes too heavy (this point is different for each person) something inside of them begins to “shut down” in order to conserve their depleting energy.

They sleep more and socialize less; they withdraw from the world and avoid doing activities that have the potential to bring them joy because the energy cost of doing them feels too great. It’s often at this point that one starts to consider the possibility that they may be “depressed”.