Insider’s Guide to Depression, Part 2

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Published Date : February 17, 2022

What causes depression?

In a nutshell, there are many factors that may cause depression. Some specific contributing factors are genetics, medication, hormone changes, medical conditions, stress or grief to name a handful. Researchers have learned there are neurological changes, which cause it, too. For a long time, mental health professionals haven’t known for sure what exactly causes depression. The research is getting us closer. I like to think of it as the perfect storm of genetics and other factors. One thing we know, it isn’t just in your head and something a person can just “get over.”  The neurological changes in the brain are real. Let me break down what some of the research is telling us about the causes. 

Unpleasant Life/Stressful Life Events

Have you experienced the death of a loved one lately? In the Australian and New Zealand Journal of Psychiatry1, researchers studied unpleasant life events as a possible cause. They reviewed past studies on the connection with life events and depression. These researchers looked at studies, which didn’t think there was a connection as well as those that did. Overall, they concluded unpleasant life events do cause it. They found loss as one of the predominant unpleasant life events to cause depression. To clarify, grief is different from depression. However, sometimes the death of a loved one can be the catalyst for a depressive episode.

Stress

I wanted to differentiate stress from stressful life events.  Researchers have studied stress in general and learned it can cause it, too. In one study2, researchers discovered stress can cause brain disturbances, which may lead to depression. They learned there is large amount of evidence showing the hormonal changes in a person with depression is not just because they are depressed but a byproduct of stress generated depression. They concluded prevention should be focused on stress reduction.

Medication

The medication you are taking could possibly be a cause.  In the South African Medical Journal researchers reviewed the existing research literature to learn the connection between physical illness, medication and depression. They learned there is a connection with certain medications. There was attention to antihypertensive and cardiac medication, oral contraceptives, levodopa (medication to treat Parkinson’s Disease) and major tranquilizers. If you suspect your medication may be the cause of your depression, talk to your doctor.

Neurological Dysfunction

There is some promising research studying the neurological connection with depression. Researchers have learned there is hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis in depressed patients4. This affects other processes in the brain. The research is looking at other areas in the brain that regulate motivation, eating, sleeping, energy etc.  They found these areas are abnormal in depressed patients. These findings will help mental health professionals improve the treatment and prevention of depression.

Insomnia

Chronic insomnia is a risk factor, but does it cause it? There is still some question if it is a cause or just a risk factor. Researchers have seen people with depression have shorter periods of REM sleep5. In most cases, when the depression is treated, the insomnia disappears. However, if it persists, a person is at risk for relapse of depression.

Family History (Genetics) & Environment

Your genes play a role. However, researchers can’t state confidently whether a person’s depression is due to his or her genes or not. What they can say for sure is your genes most likely play a part. It is the nurture versus nature debate. Researchers have found the way you respond to your environment growing up matters.  It isn’t things like  your parent’s parenting style, if you were raised in poverty or what kind of neighborhood you lived in growing up. It is how you interacted with these influences across your development.

Child Abuse and Neglect

Remember I told you researchers have found neurological dysfunction is a cause of depression? Did you wonder what caused this dysfunction? One cause is childhood abuse. Researchers found childhood abuse changes the HPA stress responses7. The same brain dysfunction mentioned in the neurological research above is seen in survivors of childhood abuse.  In 2000, researchers reviewed all the English language articles related to childhood sexual abuse after 1989 to 20008. They decided childhood sexual abuse is a significant risk factor for mental health problems, especially substance abuse and depression.

What now?

I understand most people want a hard and fast reason for being depressed. I wish it was that simple.  As you read, there are so many factors, which can cause a person to be depressed. The important takeaway is that depression IS treatable. As a counselor, I find it helpful to collect as much past and current information about the clients I treat for depression, such as family history, work stress, etc.  This allows me to develop the best plan for treatment. In many cases, I recommend my clients to have a full physical with specific lab work to rule out possible medication issues, hormonal changes, vitamin deficiencies, etc.  If you are dealing with depression or know someone who is depressed, recognize the signs and symptoms then seek treatment. Contact us about how we can help you treat your depression or someone you know.  Anthony and I are both licensed mental health counselors in the State of Florida. We also provide online counseling. If you are interested in our services, click on the “I’m ready to start living well” button.

 References: 

 1Robert Finlay-Jones, 1981, Showing that Life Events are a Cause of Depression—A Review, Australian and New Zealand Journal of Psychiatry Vol. 15, Iss. 3

2H.M. van Praag, Can stress cause depression?, Progress in Neuro-Psychopharmocology and Biological Psychiatry, Vol. 28, Iss. 5, August 2004.

3 Gangat AE, Simpson MA, Naidoo LR. Medication as a potential cause of depression. S Afr Med J. 1986 Aug;70(4) 224-226. PMID: 2874615.

4 Nestler, Eric J et al., Neurobiology of depression, Neuron, Vol 34, Iss. 1 13-25. March 2002. 

5 Lustberg, L., Reynolds, C.F., June 2000,Depression and insomnia: questions of cause and effect. Vol. 4, Iss. 3. 253-262

6 Sullivan, P.F., Neale, M.C., Kendler, K.S. 2000, Genetic Epidemiology of Major Depression: Review and Meta-Analysis, American Journal of Psychiatry, Vol. 157, 1552-162

7 Mcgowan, P. O., et al., 2009, Epigenetic regulation of the glucocorticoid receptor in human brain associates with childhood abuse, Nature Neuroscience, Vol. 12 342-348

8 Putnam, F. W. 2003, Ten-year research update review: Child sexual abuse. Journal of the American Academy of Child & Adolescent Psychiatry, Vol. 42, Iss. 3 269-278

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