Understanding Depression

The World Health Organisation has now ranked depression as the leading cause of ill health. This places it ahead of medical illnesses such as heart disease and cancer. This is a worldwide phenomenon and is cause for concern. Not only does depression prevent people from living healthy, fulfilling lives, but it also affects families. Additionally, depression brings a huge economic cost to the health system and workplace productivity.

Despite these alarming statistics, depression remains a poorly understood illness. The rapid rise in depression cannot be explained in medical terms. It seems more likely that it is associated with significant social change that has taken place over the last 5-10 years.

The stigma associated with depression has prevented many people from seeking treatment that would enable them to reclaim their lives, and the reality is that everyone can be vulnerable to depression at different times in life.

Not only is depression treatable, but it is also preventable. So, understanding what causes depression is important.

What are the symptoms of depression? Depression is marked by a disturbance in mood that is associated with negative thoughts and emotions and social withdrawal. Other common symptoms are anxiety, disturbed sleep, changes in appetite, sudden weight loss or gain, lethargy, difficulty thinking clearly and memory problems.

What Causes Depression? There is no single cause for depression. It’s more useful to think of depression as being linked to a range of factors.

Biological factors Having parents who suffered from depression increases the risk of depression. This is not due to genetic factors so much as the impact on the early family environment when one or more parents have depression.

Depression is associated with a pattern of coping called avoidance. This results in problems not being addressed directly and this, in turn, can result in poor decisions that have a domino effect, leading to a person experiencing failure, which can then lead to a sense of learned helplessness. This is the hallmark of depressive thinking.

The theory that depression is caused by a chemical imbalance in the brain is not supported. It is more likely that depression causes a chemical imbalance. Our brain needs a neurotransmitter called serotonin, to think. About 70% of serotonin is stored in the gut. If appetite and digestion are disturbed, the brain may not receive sufficient serotonin. This could explain why people with depression experience foggy thinking and have difficulty making decisions.

Psychological factors Depression is associated with rigid patterns of thinking, involving a preference for black and white answers to problems that are more in the “grey” zone. These thinking patterns distort how the person sees their world. For example, depressed people often place a lot of blame on themselves for problems that are due to many factors. This increases the sense of helplessness.

Social factors Social factors play a huge role in vulnerability to depression. Depression is essentially associated with loss. There are many types of loss that humans experience over the course of a lifetime – loss of parents, siblings, friends; loss of jobs and businesses, loss of health, marital breakdown, loss of home – the list goes on. All of these have to do with our fundamental needs for safety and connection. Having healthy relationships is one of the most important factors for maintaining connection and preventing depression.

We cannot control whether we will experience loss, however, we can influence the social connections we have. This requires investing in relationships and spending time connecting with people, not just via social media, but in shared interests and activities.

In the next issue, I’ll discuss how depression can be prevented and treated.