Background Negative life experiences are well-established risk factors for mental health problems, yet evidence from low- and middle-income countries remains limited. Many studies also overlook area-level factors that may influence these relationships. This study aimed to examine the association between negative life events and depression among individuals in Indonesia, accounting for both individual and area-level characteristics. Methods This cross-sectional study used data from 31,446 individuals aged 15 years and older who participated in the Indonesia Family Life Survey Wave 5 (IFLS-5), conducted in 2014–2015. Depression was assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10), a validated instrument measuring depressive symptoms during the past week. Negative life events, including chronic illness (self or family member), natural disasters or accidents, and deaths of family members within the past year, were evaluated. Multilevel logistic regressions accounted for the hierarchical data structure and adjusted for demographic, socioeconomic, behavioural, and district-level characteristics. Results The prevalence of depression was 23%. Experiencing one negative life event increased the odds of depression (adjusted odds ratio [AOR] = 1.22, 95% confidence interval [CI]: 1.15–1.30), while two or more events further elevated the odds (AOR = 1.55, 95% CI: 1.32–1.83), adjusted for covariates. Individually, chronic illness (AOR = 1.25, 95% CI: 1.17–1.33), natural disasters or accidents (AOR = 1.41, 95% CI: 1.15–1.73), and deaths of family members (AOR = 1.14, 95% CI: 1.03–1.26) were significantly associated with depression. Conclusion Multiple and specific negative life events substantially increase the risk of depression among Indonesians. These findings highlight the importance of integrating culturally sensitive mental health interventions within community and healthcare settings. Background The global burden of depression is profound, affecting approximately 280 million people, or about 3.8% of the world’s population in 2019 [1]. Recognised as a leading cause of disability, depression significantly diminishes the quality of life and imposes a substantial economic burden through lost productivity and healthcare costs [2]. Depression caused 46.86 million (95% uncertainty interval [UI] 32.93–63.80) disability-adjusted life years (DALYs) worldwide in 2019, which equates to an age-standardised DALY rate of 577.75 (405.79–788.88) per 100,000 [3]. The COVID-19 pandemic has further intensified the global mental health crisis, with studies indicating that the prevalence of pandemic-related depression ranges from 14.3% to 24.3% [4]. Characterised by low mood and a range of emotional, cognitive, physical, and behavioural symptoms [5], depression is associated with chronic illnesses [6], increased risk of suicidal ideation [7,8], and higher mortality rates [9,10]. Furthermore, depression can significantly decrease quality of life and lead to disability [11,12]. Understanding the factors contributing to depression in specific populations is crucial for developing effective preventive interventions. Studies consistently link negative life events to increased risk of mental health problems, including depression [13–16]. These events can encompass experiences of the death of someone close, serious health events or illness, or challenging socioeconomic circumstances, all of which can have lasting negative consequences [17]. Furthermore, critical life events perceived as unwanted, uncontrollable, or life-threatening can significantly impact mental well-being and self-rated health, increasing the risk of depression, anxiety, and even post-traumatic stress disorder [18]. Several studies support the connection [19–22]. A South African study linked serious illness/death in family members to depression [19], aligning with research highlighting specific negative events’ cumulative impact on older adults’ depression [20]. A proposed model suggests that reducing exposure to negative life events could alleviate depression and vice versa [21]. Another study adds a cognitive dimension, finding that negative life events interact with cognition to influence depression in young adults [22]. These studies emphasise the importance of considering negative life events when understanding and addressing depression. Some limitations are evident in the emerging literature. Most studies have been conducted in high-income countries, including the UK [13], the Netherlands [23], Hong Kong [24] and the US [25]. Low and middle-income countries (LMICs) face a rising burden of mental illness, with depression projected as the third-largest source of disease burden by 2030 [26–28]. Studies in LMICs, including China and Nigeria, are limited and have focused on specific populations, such as older adults [29] or women living in slum areas [17]. Studies in LMICs are essential to understanding how cultural, economic, and social contexts influence the relationship between negative life events and depression. The unique stressors faced by populations in LMICs, such as poverty, political instability, and limited access to mental health resources, may alter the dynamics of this relationship. Furthermore, none of the studies have adequately incorporated area-level variables that may influence the relationship between negative life events and depression. Factors such as access to healthcare, area deprivation, and local cultural norms can significantly impact how individuals experience and cope with negative life events. Research indicates that individuals with better access to healthcare resources are more likely to seek help and receive appropriate interventions [30], which can buffer against the psychological consequences of negative life events. To address these gaps, we explore the associations using large household and area-level datasets from Indonesia. Indonesia, a middle-income country [31] with a large and diverse population, ranks among the top two nations in the Southeast region with the largest mental health burden. The GBD study shows a rise in depression prevalence in the country from 19 million (1990) to 27 million (2019), with DALYs due to depression also increasing from 303/100,000 population to 369/100,000 population [1]. Researching negative life events in Indonesia is particularly valuable due to the country’s frequent exposure to a wide range of adverse events, including natural disasters. As an archipelagic nation in the Pacific Ring of Fire, it is particularly susceptible to various natural calamities, including earthquakes, tsunamis, and volcanic eruptions [32]. These events can lead to trauma, displacement, loss, and increased psychological distress among affected individuals, contributing to mental health issues. Studies show increased depression and PTSD after disasters globally [33–35]. Studies in Indonesia confirm this. A study in Aceh and Nias provinces following a huge tsunami disaster in 2004 showed that a significant number of Aceh and Nias residents experienced psychological symptoms with internally displaced persons (IDPs), experiencing more severe effects than non-IDPs [36]. Economic losses resulting directly from the disaster amplified the risk of depression following the Jogjakarta Earthquake in 2016 [37]. Furthermore, Indonesia’s unique cultural and religious landscape [38] might provide insight into the adverse impact of negative life events on mental health, as these cultural and spiritual elements may act as protective factors, fostering resilience and coping mechanisms. Depression manifests differently across cultures [39]. Studies suggest cultures emphasising interdependence [40] and religiosity [38] may lower depression risk. Cultural norms also influence how depression is expressed and diagnosed [41,42]. These factors highlight the need for culturally sensitive approaches to understanding and addressing depression in Indonesia. While numerous studies have explored negative life events and depression globally [19,20,43,44], research in Indonesia remains limited. Addressing these gaps, this study aims to examine the association between negative life events and depression among individuals in Indonesia, accounting for both individual and area-level factors. The findings of this study will provide evidence on how adverse experiences influence mental health and inform the development of preventive interventions. © 2026 Irmansyah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.