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    What Causes Depression?

    What Causes Depression?

    Before we begin treatment it is good to understand depression. So many times horrible looking things have simple solutions. Not to forget the age old saying that prevention is better than cure. Therefore, for both prevention and cure it is crucial to understand depression.

    Depression is complex disease or we can call it a group of conditions clubbed together as depression.  Why we are calling it complex? Because of diversity. The risk and causative factors are diverse, symptoms are even more diverse. No wonder, no single treatment is good enough. We can with confidence say that EVERY CASE OF DEPRESSION IS DIFFERENT.  So to believe that same set of few medicines will treat all those suffering is too simplistic and is bound to fail.

    Coming back to – What causes depression

    – Is it genetic?

    – Is it due to learning effect?

    – Is it due to circumstances?

    – Is it due to brain chemistry?

    – Is it due to personality of the person?

    – Is it primary or related to other important aspect such as anxiety

    So when we say every case is different, the cause of depression in every person is different and unique combination

    1. Genetics – Genetics indeed play a role. No two people are born alike. Here it must be noted that it is not very straightforward ankylosing spondylitis linked to HLA B 27. No single gene is responsible. Children of people with depression may not have depression and children of people with no depression can have depression. It is the unique combination of genes that a person carry that makes him or her somewhat prone to depression. But do not jump to any conclusion. Life has lot more than genes.

    2. Learning – This is very interesting and probably ignored. A lot of that we have emotions, thoughts, behavior are learned. We pick up patterns in family and outside, from parents, other family members, other significant and even not so significant people. We learn by observation to apply and with application we learn more.

    3. Circumstances – This is much talked about and no doubt has significant role. Anything that is away from expected can cause frustration, stress and depression. Range is enormous – Physical, emotional or sexual abuse, violence or conflict is seen as big by most people. Death is another big. Further any problem in academics, job, relationship, health, finance, religion, social interaction even day to day life. It could be about self or family, community, nation or even entire humanity. Cases are seen where people get depressed about how world is becoming less human. Remember it is the complex mix of circumstances.  On top of it a lot depends on how one perceives. Same thing depressing for one is not for other. One occasion it may be depressing but not on other occasion.

    4. Brain chemistry –  A very common term used in almost all psychiatric issues including depression is chemical imbalance in brain. It has been observed that certain brain chemical transmitters do get disturbed.  Many treatments attempts to re-balance this imbalance. But it is not that simple and straight. These chemicals are under a complex system of brain and no single factor or medicine can increase or decrease them.

    5. Personality –  Do we get designed for depression? Over anxious, over sensitive, self critical, perfectionist even over aggressive can make a person prone to depression. But the question is that making of these types of personality is itself under influence of so many other factors. Good point is that all these personality types are not fixed and can be changed.

    6. Emotions  –  Another factor which is less understood probably least understood. And this factor plays biggest role. It is less understood because most emotions are subjective even for doctor and therapist. And we all know how difficult it is to understand own emotions. Emotions can be subtle or complex. It can be too contradictory to understand. A lot depends on how an individual feels joy or sadness, anger, worry, fear, feeling of belonging or isolation. Most basic is – do you feel wanted and loved? There is two way interaction between emotions and chemical neurotransmitters in brain. They both can influence each other. Emotions interacts with life circumstances and also interact with each other. Depression can occur along with anxiety or due to anxiety.

    7. Nutrition – Oh how much we know but how little we do. We all know importance of good healthy balanced diet. We know what deficiencies can do and how easy it is to avoid them. But alas! how often we suffer from over eating as well as nutritional deficiencies be it Vit B Vit D and Calcium Iron Selenium Manganese.

    8. Lifestyle  –  A two way cause and effect. Depression can affect our lifestyle and also our lifestyle affects mental health.  How is our work life balance, do we sleep sufficient, do we have sufficient physical activity, how is our time management, how organized we are, do we enjoy our holidays and go on vacation etc. A big factor here is modern lifestyle which is indoors and away from nature. Not to forget the gadgets and time spent on social networking. It is not only about the radiation but also about fake life that one goes into, compares and feel sad.

    9. Medical condition  –  Medical illness can affect in two ways. Some ailments directly linked to depression like hypothyroidism, diabetes, SLE etc. Other ailments can cause depression due to long suffering with no solution in sight like cancer, HIV, heart disease, chronic pain etc. Some other mental ailments too are linked to depression like phobia, panic, PTSD etc.

    10. Medication or Substance abuse – Some medicines are known to cause depression. They do so by altering the status of neurotransmitters in brain. Those people with other factors of depression present must be extra cautious with such medicines and must always tell doctor beforehand so that such medicines can be replaced by other suitable medicines. Also included here is the role of alcohol and substance abuse that again interact two way. People with depression are prone to alcohol and substance abuse as also those on these substances are prone to depression.

    To conclude depression has as many faces as there are people on earth.  It is complex, unique and very subjective.  We can make humanity free from depression if we follow a well guide program that includes:

    – good understanding of depression

    – freedom from social stigma

    – not to dismiss it as just habit

    – freedom from guilt and self blame for depression

    – support of near and dear ones and society at large

    – holistic treatment with follow up as long as required


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