The emotion of sadness is normal in response to everyday stressful or upsetting events like losing a loved one or running into financial difficulty. These feelings are usually only temporarily and should resolve once the grieving period is over or once the disturbing event has been resolved. When the feeling of sadness remains for longer than is reasonable or it starts to interfere with an individual’s daily activities or personal relationships it may signal the onset of depression.
The causes of depression
Modern day imaging technologies like Magnetic Resonance Imaging (MRI) have demonstrated significant differences in the anatomy of depressions patients’ brains compared to those of people who do not suffer from depression. The specific parts of the brain displaying these “abnormalities” include the mood, higher thought, sleep, appetite and behavioural centres in the brain. Unfortunately these imaging modalities do not give information on the cause of these abnormalities.
One of the challenges with diagnosing and treating depression effectively is that it is caused by a combination of factors instead of just one easily identifiable factor. It has long been accepted that depression is caused by a combination of genetic, biological, environmental and psychological factors. The one common factor is that it is always linked to the brain.
The genetic factor is proven by the fact that depression tends to run in families and if an individual has a close relative who suffers from depression it naturally increases that individual’s risk of also developing depression.
Certain genes are being studied by scientists as it is suspected that these genes combined with other factors can increase a person’s risk of developing depression. Genes are suspected to be responsible for the regulation of neurotransmitters and if scientists can identify these genes they can accurately predict which patients will respond to specific anti-depressant drugs and which won’t.
It is however possible for people with no family history to also develop depression.
The biological aspect of depression is very closely related to the genetic one, since an individual’s genes will influence the biological working of his or her body.
Scientists believe that depression may also be caused by an imbalance in the important neurotransmitters of the brain. This theory is difficult to prove but the effective use of serotonin re-uptake inhibitors in some patients support this theory. The important neurotransmitters that play a part in the onset and development of depression are serotonin, acetylcholine, catecholamine and corticotrophin-releasing factor (CRF).
Scientists believe it is as a result of the hormonal changes women are exposed to during their monthly cycle that may also influence the neurotransmitters in the brain. One example is of a recent study which exposed the link between serotonin and oestrogen. As the oestrogen levels drop after ovulation the serotonin levels in a woman’s brain also drops causing her to feel anxious or depressed. In the same way the rapid hormonal changes after giving birth is believed to be one of the mayor factors leading to postpartum depression. Unfortunately menopausal women are not spared as they too are exposed to changing hormonal patterns during this stage of their lives.
Environmental factors that may trigger depression include the loss of a loved one, divorce, losing a job or failing at an important task. Short term sadness is a normal response to these triggers and should not be confused with depression that is a more severe, debilitating mental illness.
People differ in how they deal with everyday troubles and this can be traced back to the psychological make-up of each individual. When faced with a stressful situation people can revert to coping mechanisms, some of which they may have learned from childhood. Where one individual may rely on alcohol to ease their psychological pain another may rely on comfort eating or cigarettes.
Unfortunately these coping mechanisms can either trigger the onset of depression or worsen already existing depression. Alcohol and drug abuse are often seen in men, more than in women, but both these coping mechanisms can cause and worsen depression. Another example is an individual who suffers from insomnia, also a psychological response, which can lead to depression.
Some psychological disorders like anxiety, post-traumatic stress disorder, obsessive compulsive disorder, panic disorder, social phobia and generalized anxiety disorder (GAD) can co-exist with depression. It is also possible for depression to develop as a result of these disorders.
Diseases like cancer, heart disease, stroke, diabetes and Parkinson’s disease can cause depression. The depression symptoms can be worsened by the presence of the disease and the disease symptoms can be worsened by the presence of depression. In these instances treating the depression can alleviate the symptoms associated with the disease.
Risk factors for depression
Depression is a severe mental illness which can afflict anyone, even children, at any stage of their life. There are however prevalent risk factors associated with depression. These risk factors include:
People who are aged 49 – 54.
Being of the female gender
Living in poverty
Alcohol or drug abuse
Age associated with depression
The median age at which depression occurs for the first time may be 32, but the highest depression rates are seen among people aged 49 to 54. One of the reasons may be due to hormonal fluctuations in women caused by menopause. Another important reason may be due to the development of serious illnesses associated with this age group. Diseases that may develop during at this life stage include heart disease and cancer. Financial tension related to specifically retirement goals may be another factor that can influence the onset of depression.
Gender associated with depression
The relationship between the hormonal changes in a woman’s body and the occurrence of depression has already been discussed.
Apart from these hormonal changes women are exposed to more sociocultural stressors as they have to fulfil multiple roles like earning an income, raising children, and running a household. It is also estimated that many women have suffered from a history of sexual abuse further increasing their risk for developing depression.
Poverty associated with depression
People who live in poverty struggle to make ends meet causing them to be in a continuous stressful state, feeling overwhelmed and incapable of taking control over their own lives. Loss of control, like that seen in poverty and at the onset of a serious illness, is a major contributing factor in the development of depression.
Alcohol or drug abuse
Although alcohol abuse is seen in women and men alike, it tends to be more prevalent amongst members of the male gender. Men tend to be less emotionally open and willing to discuss their problems rather turning to alcohol or drug abuse. The sedative effect that these substances have can make it harder for an individual to accept responsibility for their own lives or the lives of their families. In turn this may lead to feelings of inadequacy and consequently depression.
Diseases like cancer, heart disease, stroke, diabetes and Parkinson’s disease can cause an individual to feel like they have lost control over their own lives. When an individual becomes dependant on home care or the care of family members feeling like they are a burden to others combined with the financial burden of a serious disease can worsen their depression.