The Reality Of Birthday Depression: How To Cope

Medically reviewed by Majesty Purvis, LCMHC
Updated May 16, 2024by BetterHelp Editorial Team

Experiencing depression on or around your birthday is a more common occurrence than one may expect. This experience can be common, and for some, it's a temporary feeling that fades with time. However, it can be a vivid, intensely unpleasant event for others. 

In some cases, birthday depression is "swept under the rug" or considered an invalid emotional experience by peers and family members. This invalidation might occur for many reasons, including the social expectation that it is a pleasant event, regardless of one's feelings. However, your feelings are valid and experienced by many people, and you're not alone. 

Pay attention if you're experiencing the birthday blues, as it may indicate a more profound concern like chronic depression or anxiety. For some, birthdays are a trigger for past trauma, and for others living with chronic depression, these days can seriously impact and incite symptom relapse.

Birthdays can bring challenging emotions

What causes the "birthday blues?" 

There are a few potential causes of birthday-related sadness, including the following. 

Clinical depression 

Although the term "birthday depression" uses the word "depression," it isn't an existing condition in the diagnostic manual used by professionals (DSM-5). However, depression can be a cause for experiencing more severe symptoms during special events like birthdays. 

With over 280 million people worldwide living with depression, it is a common and treatable mental illness. You might be experiencing depression if you live with many of the following symptoms for most days spanning more than two weeks: 

  • Feelings of profound sadness that don't disappear 
  • Difficulty smiling, laughing, or enjoying your time with others
  • No longer enjoying previously-enjoyed activities
  • Withdrawal from social situations 
  • Difficulty caring for your hygiene 
  • Sleep schedule changes
  • Low energy
  • Appetite changes
  • Feeling numb, empty, or apathetic
  • Thoughts or urges to end your life*

If you are experiencing suicidal thoughts or urges, contact the National Suicide Prevention Lifeline at 988. Support is available 24/7.

Anxiety disorders

Anxiety disorders may increase feelings of sadness during a special event. Depending on the circumstances and the level of anxiety present, a birthday celebration can be exhausting and lead to sadness. Anxiety disorders in the DSM-5 include the following: 

  • Panic disorder
  • Generalized anxiety disorder (GAD)
  • Specific phobias
  • Social anxiety disorder
  • Separation anxiety disorder
  • Selective mutism
  • Agoraphobia
  • Substance or medication-induced anxiety disorder
  • Anxiety disorder due to another medical condition
  • Other specified anxiety disorder

An introverted personality

Introverts are sometimes labeled as anti-social. However, many introverts are social people with less capacity than extroverts for repeated or high-energy interactions. Introverts may feel uncomfortable in a crowded room if they can't connect with anyone there, and they may feel lonely, even when surrounded by people. 

If an introvert's birthday summons an uncomfortable level of socializing (for instance, a surprise party), it can leave them feeling burned out. In addition, the anticipation of the birthday might feel stressful and anxiety-inducing. For many introverts, an intimate or low-key party may be more enjoyable. 


Whether you're experiencing a mental illness or a physical illness, any state of being that presents a challenge or barrier to celebrating your birthday might cause you to experience sadness. It can be frustrating when you want to participate as usual, but an illness limits your ability.  

Discomfort about aging and gerascophobia

For various reasons, some people don't want to accept the physical and mental changes accompanying aging. However, beyond mild discomfort or aversion lies a condition known as gerascophobia, a specific phobia of growing older. This mental illness affects adults and children and can cause severe depression and anxiety during your birthday and potentially days surrounding it.  

Expectations and pressure around "milestones"

Many societies recognize “milestone birthdays” for specific achievements. From taking your first steps to reaching adulthood to hitting retirement, pressure to achieve these benchmarks might bring significant feelings of depression and anxiety. 

Feelings of failure or an existential crisis

Along with societal expectations, your expectations might be a source of depression around your birthday. For example, plans to own a home or cross items off a "bucket list" by a certain age might occur, pressuring you to feel you've met your goals by the time your birthday arrives.

Reviewing your life's progress to find that you haven't achieved everything you planned up to that point may be disappointing, and if you are unkind to yourself, it might lead to intensely negative feelings. In addition, a birthday can increase feelings of hopelessness or despair if you struggle with finding your life's purpose or meaning, or struggle with worry about your own mortality. 

Social dynamics 

Depending on the nature of your relationships, gatherings involving friends, family, or both can be a source of stress. If you're worried about how your family and friends will behave when they're together or how they'll treat you, you might feel sad when your birthday comes around. 

Feelings of isolation

It can be challenging to make friends as an adult. Perhaps you've lost close friends or family as time has passed and haven't been socially inclined since. Whatever the reason, birthdays can be difficult to celebrate without friends. The same feelings can arise when you don't get attention or recognition from your loved ones on your birthday. If the day passes unnoticed, you might feel lonely and unappreciated. In addition, if you planned a large party and no one showed up, you might feel that others don't consider you.   

Faulty nostalgia

You might recall happy, carefree times when you reflect on your childhood birthdays. However, nostalgia and memory can be unreliable, and people may sometimes long for an event or feelings that didn't, or don't, exist the way they remember. Nostalgia can increase feelings of sadness if your current situation fails to bring happiness to your memories.

Coping with birthday depression

The best ways to cope with birthday depression may vary between individuals, and what works for you may not work for someone else. Often, the goal is to cultivate a positive experience for yourself in your own way without denying or ignoring your feelings. A few ways to do so may include the following: 

  • Speak to a therapist about your feelings about your birthday
  • Keep your daily routine on your birthday if you don't want to celebrate
  • Change up your routine if you want to make the day unique
  • Practice self-kindness and compassion
  • Partake in activities that bring you joy
  • Congratulate yourself on your accomplishments, and ponder potential future accomplishments
  • Treat yourself
  • Arrange a small, informal social gathering to celebrate
  • Don't celebrate at all if you don't want to
  • Foster healthier relationships in your life if you feel that your family and friends are acting unhealthy on your birthday or not showing you love
Getty/Vadym Pastukh
Birthdays can bring challenging emotions

Mental health counseling options 

Birthday sadness may be indicative of a more encompassing concern. Many people living with generalized anxiety or major depressive disorder find that significant events like a birthday can incite a spike in their condition and a decline in their mental health. If you're not used to experiencing birthday sadness, explore why you think it might be a factor this year. Writing down your feelings or confiding in a trusted loved one can help. If you find the sadness lingers or deepens into more intense feelings, speaking to a therapist might also be beneficial.  

Some people feel trepidation about seeing a therapist. Traveling to and from an office, scheduling time for regular appointments, and discomfort over encountering others in a therapist's office can be deterrents to seeking help. If you're feeling this way, you might benefit from online counseling. If you think you may have a mental health disorder, a therapist cannot provide a formal diagnosis, but a psychiatrist or primary care physician can.

With time, research surrounding therapy efficacy indicates that the most effective alternative to in-person therapy is online therapy. With the rise in popularity of online therapy comes many platforms like BetterHelp that connect clients with mental health professionals with a wide range of backgrounds. Online therapy often offers convenient, affordable therapy tailored to your needs so you can learn practical, real-world strategies for coping with feelings of depression and anxiety, among many others. 


Many factors contribute to birthday depression and why people feel sad around this time. However, you're not alone in feeling this way; there are ways to cope. While some people can't understand why someone would feel depressed on their birthday, you don't have to justify your feelings. If you think you may be experiencing clinical depression or anxiety, consider reaching out to a therapist for further guidance as you navigate your feelings on your birthday.
Depression is treatable, and you're not alone
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