Causes and Treatment of Depression

There are multiple factors that may influence the development of clinical depression, but they fall into the two broad categories:  either genetic or environmental factors.

Depression has been shown to run in families. Depression may result from a chemical imbalance in the brain of either serotonin, norepinephrine or dopamine. People who have low self-esteem, who consistently view themselves and the world with pessimism or who are readily overwhelmed by stress, are prone to depression.

Stressful life changes, such as marriage, divorce, birth, death, struggles with finances, family or friends, can trigger depression, especially in someone already genetically predisposed. Continuous exposure to violence, neglect, abuse, or poverty may make people who are already susceptible to depression more vulnerable to the illness.  However, it is important to note that depression can still occur under "ideal" living circumstances, without any apparent predisposing factors.  Depression can also be a side effect of certain medications (e.g. birth control pills).  Depression can also be the result of substance abuse, particularly alcohol. 

Medical illnesses such as stroke, heart attack and cancer can both cause depression and be worsened by it:  depression can prolong the patient's recovery period.  Very often, a combination of genetic, environmental and psychological factors is involved in the onset of depression. Sometimes, though, depression can be triggered by mild stress or none at all.

Common depression triggers for women:

Depression has been called the most significant mental health risk for women, throughout the life cycle.  Studies show that the higher incidence of depression in females begins in adolescence, when roles and expectations change dramatically.  Stresses of early adulthood, such as forming an identity, confronting sexuality, separating from parents and making life decisions for the first time, along with other physical, intellectual and hormonal changes, can precipitate a depressive episode.  Becoming a mother at a young age can also cause unexpected stresses and demands and lead to depression.

Women in their 30's and early 40's have the highest incidence of depression.  They may be adjusting to new family dynamics and solidifying a career path while trying to balance the competing demands of work and family , struggling with financial responsibilities and childrearing.  In addition, many women in their mid-to-late 40's are beginning to experience the hormonal fluctuations of  peri-menopause.  Sometimes, the inability to have children may cause fluctuations in mood which may lead to or contribute to depression.

After 50, women face new challenges that may affect their emotional health.  For instance, they may experience the first signs of aging, including menopause.  While menopause itself is not a risk factor for women in general, it may precipitate a depressive episode in women with preexisting depression, those who have had premenstrual dyphoric disorder (PMDD), those with a family history of depression, or those who experienced post-partum depression.  Other women at risk may be those forced to begin new careers or relationships after a divorce or the death of a loved one. While some women experience sadness over "empty nest syndrome", studies have shown that this is not a cause of depression for the majority of women in this age group.

For more information about depression or other mental health issues, click here.

Created: 11/19/2003  -  Donnica Moore, M.D.