One of the reasons depression is getting worse is that even though people are seeing more psychiatrists, not all of the depression that people experience is an illness. Somewhere along the way, as a society, we started assuming that if you are depressed, then that also means that you are ill.
An illness is a malfunction in the regular function of your body. For example, our blood pressure is supposed to stay within a particular range. But if we develop hypertension, our blood pressure rises above what it is supposed to be.
Sometimes, our brain malfunctions and we end up with clinical depression. If your life is going really well, and you have a good job, are in a relationship, and you have people in your life who care about you, and at the same time you wake up every day and you feel sad and empty, that is more consistent with clinical depression. We look at this person’s life and we think “this person should be happy”. But if they are sad even though they should be happy, that implies that there is a malfunction.
However, the tricky thing is that not everyone who is depressed should be happy. In fact, a lot of people who are depressed should be depressed. That means that it is normal or “congruent” with their situation. If you are stuck in life, you don’t have a job, no fulfilling relationships, socially isolated, then it makes sense for you to feel depressed in that situation.
However, there is a caveat that sometimes clinical depression can come out of unfavorable circumstances. For example, if you lose your job, then you can get clinical depression that was triggered by that bad circumstance. But the key idea is that if the bad circumstance is fixed, then someone with congruent depression will start to feel better and someone with clinical depression will have episodes of depression that are independent of their circumstances i.e. it becomes episodic.