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Depression: How To Overcome It

What Causes Depression?

Wednesday, March 21, 2012 - 15:41

Contributing Author: Guy Slowik FRCS

The precise cause of depression is not known, but evidence points to several factors, including:

Heredity

Depression does "run in families. " People with a close relative who has had major depression or bipolar disorder are twice as likely to develop depression themselves. About one-third to one-half of depressions are thought to be largely due to genetic factors. Those most likely to have a genetic form of depression have recurrent episodes, as do one or more close relatives.

Biochemical Makeup

Every human being has a unique biochemical makeup. Whether or not a person will experience depression (or other neurological disorders) depends largely on the function and chemical makeup of select neural systems in the brain.

A person's biochemistry is an intricate balancing act. Think of a choreographed ballet with a troupe of dancers performing at once. If one or more of the dancers are out of step, the whole production is thrown off balance. So it is with an individual's biochemistry.

The brain is the "master " control center that governs our lives in every conceivable way. Just as messages from the brain (in the form of electrical impulses) control our movements, other messages control our emotions.

  • Neurons, or nerve cells, are the most basic units in the brain. Neurons are separated by gaps called synapses.
  • Chemical substances called neurotransmitters carry messages or signals across these gaps to various nerve cells.
  • If there is a deficiency or an imbalance in certain neurotransmitters, a variety of disorders can result.
  • The neurotransmitters serotonindopamine, and norepinephrineare just a few of the chemical messengers believed to be responsible for moods and emotions. A disturbance in these chemical systems has a profound negative effect on mood and emotions.

Psychological Makeup

It is said that a person's basic personality traits are often defined in early childhood. One defining factor is the social environment to which we are exposed. What happens to us in childhood can have a deep-rooted effect on our attitudes and behaviors in adulthood. For instance:

  • Long-standing neglect or physical or mental abuse in childhood will affect one's view of the world later on, and appear to be risk factors for developing depression and other disorders.
  • Conditions of social deprivation, such as overcrowding and the lack of a confiding relationship with a trustworthy person, can affect the quality of one's relationships throughout life.

Stressful Life Events

A person's reactions to external factors can affect the normal level and activity of the chemical messengers in the brain, thus affecting mood and emotions. A stressful life event can plunge a person into clinical depression, especially if a person is at risk for depression due to other factors. Stressful life events include:

  • Prolonged medical illness
  • Illness or death of a loved one
  • Divorce
  • Ending a close relationship
  • Loss of a job
  • Moving to a new home
  • Financial or legal problems

Fluctuating Hormone Levels

In women, fluctuating hormone levels can contribute to depression. Conditions linked to hormones in women are:

  • Premenstrual syndrome. Approximately 3% to 8% of women in their reproductive years are affected with premenstrual syndrome (PMS) during the week or so before their menstrual period. PMS is characterized by depressed mood, mood swings, irritability, and tension or anxiety. It lessens with the onset of the menstrual period each month.
  • Depression after pregnancy. This temporary form of depression is strongly linked to hormonal fluctuations following pregnancy, but social factors may play a role in some cases. For instance, a professional woman who is suddenly faced with being home every day, essentially alone with a baby, may feel isolated and depressed.
  • Depression in menopause. Menopausal depression was once attributed to middle-aged women feeling sad over the loss of their childbearing capabilities (the loss of their "youth" or "femininity"), and the loss of their grown children (the "empty nest"). There is no evidence that this is true. In fact, evidence suggests that for some women, menopause and the "empty nest" may signify a new freedom in their lives to pursue long-delayed interests and devote more time to their own needs.

For further information on premenstrual syndrome, see Premenstrual Syndorme.

For further information about depression after pregnancy, see Depression After Pregnancy.

However, hormonal fluctuations in menopause are real, and some women suffer mood swings, fatigue, and depression. Hormone replacement therapy (HRT) can lift mood and fatigue among women who are medically able and who choose to take HRT. However, the risks of HRT must also be considered.

Other Factors

Other factors that can lead to depression include:

  • Alcohol or drug abuse
  • Use of certain medications, such as steroids and some blood pressure medications
  • Underlying general medical conditions that can cause depressive symptoms, such as hypothyroidism (underactive thyroid gland), chronic fatigue syndrome, and others.
  • "Burnout," a depletion of mental and physical energy usually stemming from prolonged overwork and/or an overload of demands and obligations placed upon an individual

For further information about hypothyroidism see, Hypothyroidism.

Nice To Know:

Psychological theories about the root causes of depression include:

  • Guilt. One theory suggests that depression, like bereavement, is a response to loss. This may include loss of a person, job, or role. In bereavement, intense feelings towards a loved one are often mixed. The adult in us will tell us not to speak ill of the deceased, but the child inside us feels sadness but also anger at having been abandoned. Freudian theory maintains that because this second reaction is socially unacceptable, we unknowingly hide it from ourselves and direct the anger inwards as guilt. This suppressed guilt is thought by some to lead to depression.
  • Pessimism. Another theory suggests that some people have a habitually pessimistic view of themselves, the world, and the future. Such people tend to form false conclusions about their experiences. For example, a man greets a woman friend across a busy street. When she does not respond, he concludes that she no longer wishes to know him because he is not likeable. He fails to consider other reasons behind the incident - maybe she didn't even notice him with the crowded sidewalk and the noisy traffic. Repeated experiences of this sort, when interpreted in this negative way, can foster or maintain depression.

 

Depression: How To Overcome It