Causes of depression

Key points
- You may have heard people talk about chemical imbalances in the brain that occur in depression, suggesting that depression is a medical illness, without psychological causes.
- Major Depression (depressive illness) is a serious condition that result in extreme fatigue, sleep problems and eventually an inability to function.
- Studies of families, in which members of each generation develop bipolar disorder, found that those with bipolar disorder have a somewhat different genetic makeup than those who are not diagnosed.
- Some types of depression do seem to run in families, suggesting a biological vulnerability.
You may have heard people talk about chemical imbalances in the brain that occur in depression, suggesting that depression is a medical illness, without psychological causes. However, all psychological problems have some physical manifestations, and all physical illnesses have psychological components as well. In fact, the chemical imbalances that occur during depression usually disappear when you complete psychotherapy for depression, without taking any medications to correct the imbalance. This suggests that the imbalance is the body's physical response to psychological depression, rather than the other way around.
Some types of depression do seem to run in families, suggesting a biological vulnerability. This seems to be the case with bipolar depression and, to a lesser degree, severe major depression.
Depression
Major Depression (depressive illness) is a serious condition that result in extreme fatigue, sleep problems and eventually an inability to function. The exact cause is unknown, but it is thought to be a malfunction of brain neurotransmitters, which are chemicals that modulate moods. Major Depression is usually treated with a combination of psychotherapy and antidepressants which moderate or correct chemical imbalances in the brain. The group of antidepressants most frequently prescribed is the selective serotonin reuptake inhibitors (SSRIs) which regulate the neurotransmitter serotonin.
Examples:
Amitriptyline HCL
WELLBUTRIN
Wellbutrin SR
Fluoxetine
Celexa
Lexapro
Paxil
Prozac
Remeron
Zoloft
Effexor XR
Studies of families, in which members of each generation develop bipolar disorder, found that those with bipolar disorder have a somewhat different genetic makeup than those who are not diagnosed.
However, the reverse is not true. Not everybody with the genetic makeup that causes this vulnerability to bipolar disorder develops the disorder. Additional factors, such as stress and other psychological factors, are involved in its onset as well. Likewise, major depression also seems to occur, generation after generation, in some families, but not with a frequency that suggests clear biological causes. Additionally, it also occurs in people who have no family history of depression. So, while there may be some biological factors that contribute to depression, it is clearly a psychological disorder.
A variety of psychological factors appear to play a role in vulnerability to these severe forms of depression. Most likely, psychological factors are completely responsible for other forms of mild and moderate depression, especially reactive depression. Reactive depression is usually diagnosed as an adjustment disorder during treatment.
Written and revised by
Gerald Hurowitz, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.
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