What Causes Depression?

What Causes DepressionWhat Causes Depression? It really depends on who you ask.  If you ask a physician, whose training is in biology, physiology, and neurology, you will likely get an answer that talks about genetic and biochemical causes. If you ask me – my training is in psychology, theology, and family systems theory – I will tell you that what causes depression is both environmental and psychological factors.

The truth is there is no single known cause of depression. There is not even one single kind of depression. Depression most likely results from a combination of genetic, biochemical, environmental, and psychological factors. Or, to state it another way, depression has bio-psycho-social and spiritual components.

Counselors focus on self-talk.  Negative, distorted thinking leads to feelings of depression.

Some types of depression tend to run in families, suggesting a genetic link. However, depression can occur in people where there is no family history of the disorder  It may be best to think of depression in terms of risk factors: a family history is a significant risk factor but it is only one thing to consider.

Research indicates that on some level, depression is a disorder of the brain. Brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people who have a clinical diagnosis of depression look different from those without depression. The parts of the brain responsible for regulating mood, thinking, sleep, appetite and behavior appear to function abnormally. Additionally, important neurotransmitters–chemicals that neurons in the brain use to communicate–appear to be out of balance.  That is why some people refer to clinical depression as a “chemical imbalance“. The big question is which came first; did a chemical imbalance cause the depression or did the depression create an imbalance of neurotransmitters?

Think of depression as a circular pattern: a lack of neurotransmitters can lead to negative self talk.  Or, negative self talk can lead to a suppression of needed neurotransmitters.

It is probably not important to know which came first: the cycle needs to be interrupted or it will continue to spiral downward.

A Simple Rule for Depression and Medication.

I follow a simple rule of thumb when dealing with a Major Depressive Episode (clinical depression):

  • For mild depression (only the person who is depressed may know they are having problems) I don’t mention medication.
  • For severe depression (anyone and everyone can tell this is a clinically significant depression) I may choose not to work with someone unless they are on anti-depressant medication.
  • For everything else (which covers most people seeking counseling for depression) I simply ask my client to have a long conversation with their  primary care doctor about the pro’s and con’s of medication and then choose.  I will respect whichever path they choose and support them in their choice.