Depression often comes and goes because it’s influenced by a combination of biological, psychological, and environmental factors that can change over time.
It’s not always a constant state; it can fluctuate depending on what’s happening internally and externally.
I have been dealing with chronic depression and can say that I have periods where my mood gets worse, which is why we must continue to monitor our triggers and mental state.
- Brain chemistry changes
Depression is linked to imbalances in neurotransmitters like serotonin, dopamine, and norepinephrine.
These chemical levels can fluctuate due to:
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- Stress.
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- Sleep patterns.
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- Hormonal shifts (like PMS, menopause, or thyroid issues).
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- Substance use.
Even things like seasons can play a role (e.g., seasonal affective disorder or SAD), where lower sunlight in winter affects melatonin and serotonin, triggering symptoms in certain months.
- Genetics and vulnerability
Some people have a genetic predisposition to depression, but that doesn’t mean it’s always active.
A stressful life event might “trigger” an episode, but once things settle, symptoms might lift until the next trigger.
This pattern is common in recurrent depression, where episodes can return even after long periods of remission.
- Coping mechanisms and resilience
Symptoms may fade when people are doing well by getting enough sleep, staying active, and having a support system.
But when life gets overwhelming and coping strategies break down (burnout, grief, relationship issues), depression can resurface.
I notice that my mood deteriorates whenever I don’t sleep well or quit exercising for a while.
Depression often has a situational component.
It might fade when a person’s environment improves (like finding a new job or ending a toxic relationship), only to return if another stressful situation comes up.
- Chronic illness pattern
Depression can act like a chronic illness in some people, coming in waves.
This “relapsing-remitting” nature is well documented. According to longitudinal studies, about 50–85% of people who’ve had one major depressive episode will experience another in their lifetime.
Patterns like negative thinking or rumination can remain even when someone feels “better”.
A small trigger, a critical comment, a bad day, or even fatigue, can reignite old neural patterns tied to depressive thinking.
- Incomplete recovery
Sometimes symptoms go into “remission,” but not full recovery.
People may still feel fatigued or have trouble concentrating, and that makes them more vulnerable to relapse. That’s especially true if they stop therapy or medication too early.
Although not as bad as at my worst, I still have less energy and motivation than I did before becoming depressed.
- Unrecognized patterns (like bipolar II or cyclothymia)
Sometimes what looks like depression “coming and going” might be part of a mood disorder spectrum, such as:
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- Bipolar II disorder
Characterized by episodes of depression alternating with hypomania (a milder, often unrecognized elevated state).
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- Cyclothymia
A less serious form of bipolar disorder with ups and downs that don’t meet full criteria for major depression or hypomania.
- Gut-brain axis imbalances
Emerging research shows that the gut microbiome, the trillions of bacteria in the digestive system, can influence mood via the gut-brain axis.
Disruptions in gut health (like from antibiotics, poor diet, or inflammation) can contribute to depressive symptoms, and those imbalances can fluctuate.
For example, a low-fiber diet might feed pro-inflammatory bacteria, potentially triggering low mood or fatigue.
- Inflammation and immune activation
Chronic, low-grade inflammation is linked to depression.
Inflammatory cytokines such as IL-6, TNF-alpha, and CRP can affect neurotransmitter metabolism and neural plasticity.
Some medications like corticosteroids, hormonal contraceptives, beta-blockers, or even acne drugs like isotretinoin can induce depressive symptoms in some people.
Discontinuing psychiatric meds too quickly (notably SSRIs or SNRIs) can also cause a withdrawal syndrome that mimics or triggers a return of depression.
- Cultural or seasonal expectations
In some people, symptoms spike around anniversaries, holidays, or specific times of year (not just due to SAD, but because of emotional memory and trauma triggers).
For instance, a person might feel fine most of the year but get depressed every year around the time a loved one died, even if they’re not fully aware of the link.
I notice that my psychological state tends to get worse during the winter and when there are long periods without much sun.
Some individuals “hold it together” emotionally for long stretches (at work or for family) and crash later when their emotional bandwidth runs out.
This can create an illusion of depression coming and going.
Your brain is always changing based on what you do, think, and experience.
Positive changes (like therapy, new habits, and exercise) can improve mood. But if those changes aren’t sustained or if life gets harder, your brain can revert to old depressive pathways.
Depression may resurface when healthy behaviors drop off, even if everything else seems stable.
Major life changes, even positive ones, can destabilize mood.
Starting a new job, becoming a parent, moving to a new country, or retiring can bring identity loss, uncertainty, or pressure.
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- Depression might lift once someone settles into a new role or comes to terms with the transition.
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- But it can resurface during new phases, when life feels unfamiliar again.
Not all depressive episodes are purely psychological or biological.
Some stem from deep questions of meaning, purpose, or disconnection from one’s values, something that existential psychologists call the “dark night of the soul.”
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- These episodes might be resolved without medication through therapy, reflection, or finding renewed purpose.
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- Nevertheless, they can recur during spiritually disorienting times, such as after trauma, loss, or major turmoil.
I went through a period of existential crisis where I was pondering a lot about my mortality, which aggravated my mood issues once again.
For some, depression follows patterns in close relationships, particularly if they have anxious, avoidant, or disorganized attachment styles.
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- A person might feel fine when things are stable, but become depressed during conflict, breakups, or emotional withdrawal from a partner.
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- These ups and downs can be mistaken for purely internal mood shifts when they’re actually relational triggers.
- Sensory overload or environmental fatigue
Highly sensitive people (HSPs) or neurodivergent individuals, such as those with ADHD or autism, may go through periods of overstimulation from noise, crowds, screens, or demands.
When exhausted, they may experience:
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- Shutdowns, emotional blunting, or depressive symptoms.
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- Once the environment calms down, they may feel better once again.
This “come-and-go” pattern is common in those with low sensory thresholds.
- Energy and circadian rhythm dysregulation
Not just sleep quality, but how the body regulates energy and time plays a huge role.
Disruptions in circadian rhythm, ranging from jet lag, shift work, or inconsistent routines, can lead to depressive symptoms that seem to appear and disappear.
Even people with delayed sleep phase syndrome (DSPS) or night owl tendencies may find their mood worsens simply from living out of sync with society’s schedule.
I found that sleep disturbances and not adhering to my sleep schedule hurt my psychological state.
Many artists, writers, and profound thinkers experience cyclical depression tied to creative blocks, intense introspection, or emotional exhaustion.
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- When they’re in “flow,” they feel fine or even euphoric. But unfortunately, depressive episodes can return between projects or during emotional lulls.
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- This is sometimes mistaken for bipolar spectrum, but it’s more about emotional processing cycles.
While big traumas get attention, small, repeated stressors (like constant criticism, racism, or invalidation) can cause low-grade depression that flares up intermittently.
These “paper cut” wounds build over time and may lead to emotional shutdown or despair when cumulative stress gets too high.
Final note
Depression isn’t just about “sadness” or serotonin; it’s often the brain’s response to a mismatch between internal needs and external demands.
The fact that it can come and go reflects that we are constantly evolving psychologically, socially, and biologically.
That’s why managing depression is often about long-term maintenance, not just short-term relief.
The good news is that understanding its patterns can help to build resilience, spot early warning signs, and seek help before it develops.
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