I remember as a young adult, I was in a room with people who did not really have a background in mental health. I was supposed to be the “expert in the room” with my Bachelor degree in Psychology. The conversation of the day was what caused a person’s depression. Everyone seemed to feel like assigning blame would help “solve the problem”.
While we understand a great deal about depression, we cannot pinpoint a particular cause, nor can we say for certain things that can be avoided so that one can avoid depression. Even more important, if we get too caught up in the idea of cause and blame, that can negatively impact the ability to accept and treat depression. I happen to love musicals, and in the musical “Into the Woods”, there is a part where many of the characters go into a rousing chorus of trying to assign blame instead of working to fix the problem, and sometimes I feel like this can happen when we look to assign cause to many of the things that we face in the world of mental health. Therefore, when looking at the causes, triggers, and risk factors of depression, allow me to take a different approach, and look at these factors with a lens of understanding and assistance.
Let’s start by saying there is no single cause of depression. We cannot give you a blood test or take a urine sample and say yep, this is depression. However, there are components that make up depression, and things that can happen to a person that make depression more likely.
Biological:
Your genetics play a big role in the possibility of depression. The chemical makeup in your brain can lead to depression. The brain has neurotransmitters such as serotonin, dopamine, and norepinephrine, which are used in mood regulation. If there are changes or imbalances in these, that can be correlated with depression. Depression also runs in families. This is why your family history is taken when you go in for any mental health appointment. The genetic components are not fully understood at this point. While they are correlated, it cannot be pointed to as a cause. Hormonal changes can also affect our mental health. Pregnancy, menopause, or other conditions that cause fluctuating hormones can trigger depression or make it worse. Also, many medical conditions, especially chronic illnesses, can have depression show up as a side effect.
Environmental:
If we are surrounded by stressful situations, lack of basic necessities, or do not have the support systems we need in place, depression can be a likely result. People who have been exposed to traumatic circumstances, especially in childhood, are also more likely to experience depression. Being exposed to violence can also trigger depression. However, again it is important to point out that none of these things can be pointed to as a definitive cause of depression. I feel like this is where it is most essential to make this point. Some people seem to weather the storms of these challenges without any depression, while others find it difficult to get out of bed each day. Often, this comes with judgment and misunderstanding from friends and family. That seems to add to the depression in many cases. When we look at people and see that some people can handle things in their environment and not have depression, while others do have depression, and make judgmental comments, this leaves the person with depression feeling like they have some sort of flaw, rather than understanding that there are so many factors that contribute to the cause of depression.
Psychological:
Certain psychological traits can also lead to depression. These can be co-occuring mental health disorders, such as anxiety, that will increase the likelihood of depression. Having issues with substance abuse also increases the likelihood of depression. Having low self-esteem, negative outlook on life, or other psychological learned behaviors can also add to the depression levels that people experience. Being overly critical, expecting perfection, or self-blaming can also lead to depression.
Other Factors:
Medication side effects, lack of exercise, poor diet, lack of sleep, death or loss, and many other things can also lead to depression. There may be specific factors in your life that have led you to depression that I cannot possibly name in this article. One important fact is that you did not cause this depression. Even if your family is genetically predisposed, you did not cause depression in your child. Just because you and your family have had economic hardships, you did not make your family depressed. Mental Health is full of many potential causes, correlations, and connections. Trying to find something to blame usually does nothing more than waste the time we could be using to help.
So just what is depression? All of us feel sad. There is nothing wrong with being sad or upset. In fact, if a lot of the things I just listed happened to you and you did not feel sad, there might be something else wrong. The differences between sadness and depression are important. One difference is time. If you have a loved one die, you will likely experience a deep sadness. This sadness will be for a significant period of time. However, if that time period continues on for months and years, that may indicate more than sadness, and start to lean into depression. Another indicator is if the level of sadness and other symptoms starts to affect your everyday life. If you become unable to function at work or school, or you stop finding joy in the things you once loved, the likelihood of depression is greater. If you start to see troubles with thinking and concentration, feelings of worthlessness, anger, anxiety, reduced weight or weight gain, trouble sleeping or sleeping too much, these are also symptoms of depression.
This is all quite, well, depressing. What exactly can we do if we think we are suffering from depression, or we think our loved one may be suffering from depression? The first thing I suggest is seeking help. Trying to manage depression alone is like trying to manage any health condition without proper treatment. It may go away on its own, but it may also get worse. There are tools and treatment, and you will be far better off by seeking assistance. The next suggestion I would make is looking into the things that may work best for you. We all function differently, and just like no one pair of shoes is alike for a person who needs specific soles for better foot function, no one mental health treatment plan is alike. There are many different medications, therapies, and practices that can help. Learning about what may fit you best will help you gain the hope and support you need. Finally, reach out to your support systems. If you have trusted family or friends, talk to them about what you are going through. It is estimated that over 280 million people in the world have depression. If you are one of them, you are not alone. Likely the people in your life know what you are going through and want to help. If they do not, or if you feel like you have nowhere to turn, finding a therapist or calling the 988 crisis hotline is also a good option.
When you do meet with a therapist, please be as open as possible. The more a therapist knows and understands about your situation, the more they can do to help. As you have seen in this article, depression has many factors. A therapist is like a puzzle maker. As you give us all the pieces, we try and put it all together to see the big picture. Once we start to see the picture clearly, we will be better at helping you see it, and then together we can work on discovering solutions that work for your own situation. If you are on medications or have chronic health conditions, exploring those to see if they are contributing to the depression becomes extremely important. If you do not share about them, and we skip over them, we may be missing a very essential piece to the puzzle of your well-being.
One final point. Sometimes depression gets better for a while, and then comes back. This can be quite demoralizing. Please understand this does not mean you did anything wrong, or that treatment did not work. Just as a cold can come back, our mental health can have ups and downs. This is why you may hear a care-giver say mental health management rather than mental healthcare. Learning how to manage our feelings and reactions means accepting that sometimes we are up, and sometimes we are down. Of course we prefer the up days, but we can learn to weather the storms so that we can be prepared with our umbrellas when they come, and also enjoy the sunshine when it arrives.