Causes of depression
introduction
Depression is one of the most common mental illnesses worldwide. Up to 16% of the world's population suffers from it. Currently up to 3.1 million people in Germany alone suffer from depression that requires treatment; that is up to 10% of all family doctor patients. But only less than 50% ultimately also consult a doctor. But what are the causes of such an important and common disease?
causes
Depression usually arises from the interaction of many different factors; it is, so to speak, multifactorial. The role that genetic (hereditary) and environmental factors play in this often varies from person to person. There are people who can easily survive high emotional stresses and crises after a short period of time, and there are people who fall into a deep hole after losing their job or breaking up; who withdraw more and more, who isolate themselves from the world and ultimately think about suicide.
These affected people are often - compared to "healthy people" - more sensitive to emotional stress, i.e. they often have a lower tolerance to endure and deal with harrowing life events. This vulnerability (= increased sensitivity) plays an important role in the development and maintenance of depression.
In summary, it can be said that the basis for the development of depression is ultimately based on genetic factors and a formative life event, such as the death of a close person.
Which Types of depression there is, read here.
Genetic predisposition
Either Twin studies as well as family studies show that genetic factors are important in depression. A hereditary predisposition contributes a large part to the development of depression. Studies have shown that at least 1 parent was depressed in over 50% of those affected. In other words, if one parent is sick, the risk of developing depression is up to 15%. With some twins, the risk of both developing depression is up to 65%. This shows that hereditary factors play an important role in the development of depression.
However, a hereditary disposition alone does not mean that one inevitably has to suffer from depression. Ultimately, environmental factors - whether harrowing events occur or not, or how well someone learns to deal with difficult situations, for example - play an important role.
Metabolic disorders
Many studies show that depression in particular is often characterized by changes in the neurotransmitter balance. Neurotransmitters are messenger substances that trigger certain reactions such as pain or fear in the body.
Read more on the topic: Neurotransmitters and The Role of Serotonin / Neurotransmitters in Depression
In the case of depression, we recommend Neurotransmitters like serotonin, norepinephrine, and dopamine out of whack. Changes can also take place at their receptors (docking points where messenger substances can act). For example, they can become less sensitive to their messenger substances, which in turn leads to a weakened effect of the neurotransmitters. It is believed that the decreased serotonin and noradrenaline concentrations lead to a depressed mood and listlessness. Today, this deficiency can be compensated and stabilized with special drugs ("antidepressants").
Read more on the topic:
- You can recognize a magnesium deficiency by these symptoms
- Iron Deficiency and Depression - What Is the Connection?
Personality factors
Also the personality every person can decide whether or not to get depression. So studies have shown that exceedingly decent, compulsive, performance-oriented people (so-called type melancholicus) with low self-esteem are more likely to develop depression than, for example, people with very self-confident and strong personality traits. Even people with a low tolerance for frustration (i.e. people who are difficult to deal with disappointment) develop depression more often and more quickly.
Development factors
Next genetics and personality Our upbringing also plays an important role in the development of depression.
For example, did children experience their parents as very much in their upbringing clinging and fearful-caring; so these children have probably never learned to make their own decisions, to separate from their parents and to be confident. You have it often not learned to deal with stress or to make your own decisions.
If these children then find themselves in situations in adulthood in which they have to act independently and take responsibility, they often feel overwhelmed. They decompensate and often see no way out. Psychodynamically it then comes to one Regression (a going back), which is in Listlessness, fatigue and social withdrawal.
It often happens in parallel to this Feelings of guilt and Self-accusations. You feel like a failure, whereby negative thoughts continue to be amplified and ultimately closed Suicidality (Suicide).
The theory of "learned helplessness“Plays an important role here. It says that people believe in different things powerless to be; never being able to change anything. For example, if people fail at an interview, they think it's up to them because they have one failure are. Then you start this Generalize thoughtsi.e. To extend it to other areas of life as well, one gets into a thought pattern of learned helplessness.
For example, these people think, “I can't even get a job and I can't quit smoking. No matter what I start, I can't do anything. So I'm a failure. ”Such thoughts lead to drastic consequences for ours Self-esteem and our life. Those affected often withdraw and become passive. This in turn means that they actually do not change anything in their situation and the Future pessimistic looks like.
Also one disturbed mother-child relationship, the early loss of a parent or a lack of self-esteem since early childhood can result in a particular vulnerability to stress factors and disappointments and ultimately lead to depression.
Also insufficiently processed stress trauma from the past (such as rape or war experience) can come back to life in current conflicts (separation from partner) and promote the outbreak of depression.
Reactive factors
Often times, depression only occurs when it becomes certain negative, stressful or critical life events comes. These can range from moving or entering retirement age (moving depression) to the separation of partners or the death of loved ones. Chronic conflicts (such as a conflict-ridden partnership or permanent excessive demands at work) can also lead to depression in the long term.
Other studies have shown that straight stressful life events like weddings or parades, lead to an increased payout of Cortisol (Stress hormone) lead. This in turn affects our metabolism, brings it out of balance and can ultimately lead to depression.
Somatic (physical) factors
Current or chronic illnesses (such as cancer, cardiovascular and metabolic diseases or chronic pain) as well as various medications can cause depression.
For example, drugs used to treat high blood pressure (beta blockers), autoimmune diseases (cortisone), chronic pain (especially Novalgin and opioids), as well as severe acne (isoretinoin), hepatitis C (interferon alpha) or even a Malaria (Lavam®) used to trigger depression.
Furthermore, deprivation of light (autumn and winter depression) also promotes depression. Especially in the autumn and winter months, when there is little sun exposure, many people feel very tired and listless and often withdraw. The background: light controls the interaction of the body's own hormones such as serotonin and melatonin. Sunlight leads to an increased release of the "happiness hormone" serotonin; which results in activity and a positive mood. In contrast, darkness causes the release of melatonin, the so-called sleep hormone, which makes people tired and lacking in drive.
For this reason, sunlight and artificial light that is very similar to sunlight can help with depression. This type of therapy is called light therapy.
Other possible risk factors:
- the female gender
- life in a big city
- Alcohol or drug abuse
- Unemployment and a low level of education
- Being single
- few social contacts
- Migration (uprooting depression) - when migrants cannot find a social connection in the new country and feel isolated and lonely
Read more on this topic: Depression from the Pill? - Is there something to it? and Serotonin Deficiency - Symptoms and Therapy.
Causes of Pregnancy Depression
So far there are no clearly identifiable causes that trigger pregnancy depression. It is therefore impossible to predict which women will be affected by depression during pregnancy and which will not. About 10% of pregnant women suffer from depression during pregnancy. In most cases, the triggers for the depressive symptoms are fears or the experience of being overwhelmed. Expectant mothers are often very concerned about whether they will be a good mother, how motherhood will turn out, and whether they are ready and mature enough to care for a child for the rest of their lives. This can lead to a negative spiral of thought that can become more and more acute and lead to depression. Such depression is most common in the first and last trimester of pregnancy.
Read more on the topic: Pregnancy depression
Causes of Postoperative Depression
The term postoperative depression does not exist in German technical jargon. What is meant, however, is clear: After a stressful event, namely an operation, there are depressive symptoms.
Read more on the topic: Symptoms of depression
This is most likely what is referred to in the German psychiatry landscape as an adjustment disorder. The patients are suddenly confronted with a stressful event. You have an illness that requires an operation. In the worst case, it is a malignant disease. In addition, they are in an unfamiliar environment, surrounded by strangers. You have to put your body in the hands of anesthetists and surgeons and give up control for some time. This is extremely difficult for many people and can lead to an adjustment disorder after an operation, which is also described as postoperative depression.
Cause vitamin deficiency
The question of whether a vitamin deficiency can be the cause of depression is the subject of numerous studies. As far as vitamin D is concerned, there is evidence that a deficiency in this vitamin can lead to depressive symptoms. In studies, patients who suffered from depression also showed a vitamin D deficiency above average. For some, the substitution of vitamin D produced some therapeutic success. However, there is so far insufficient evidence on the subject. A deficiency in vitamin B 12 is also suspected to be a trigger for some types of depression. However, the data situation is by no means sufficient here either.
Read more on the topic: What role do vitamins play in depression?
Loss as a cause of depression
There used to be the term reactive depression in medicine. What this meant was that depression developed as a consequence of a stressful event. Today the term reactive depression is out of date; one speaks of an adjustment disorder. Such an adjustment disorder is associated with depressive symptoms and occurs after subjectively stressful life events.
Read more on the topic: Symptoms of depression
These include, for example, the loss of a loved one through death or divorce, serious illness of a loved one or the person concerned or the move out of grown-up children. Not all people respond to such an event with an adjustment disorder, but it is not uncommon.
Stress as the cause
Stress as a cause can also trigger a depressive reaction in the sense of an adjustment disorder. For example, psychological and physical stress caused by caring for a close relative or the serious illness of a child. There is a feeling of being overwhelmed, fears and low spirits. However, stress in the sense of psychological and physical stress in professional life more often leads to the so-called burnout syndrome. Those affected work well beyond the grain for months and years, never calm down, always want to achieve maximum performance, are very ambitious, want confirmation from superiors and colleagues and at some point completely collapse under this pressure. Burnout is by definition not a depression, but is associated with symptoms that can be similar to those of depression.
You might also be interested in: Signs of depression
Overload as the cause
As already mentioned in the previous section, the typical clinical picture that arises from permanent excessive demands and excessive self-demands in everyday working life is the burnout syndrome. It is not part of the clinical picture of depression and has not yet been classified as an independent disease. However, it is associated with depression-like symptoms and often lasts for months. It often affects people who are particularly ambitious and determined and want to achieve a lot and who overlook the fact that at some point they have come to a point where they have clearly exceeded the level of their resilience, both psychological and physical. Often people in managerial or managerial positions are affected.
Read more on the topic: Burnout syndrome
Theories on the development of depression
There are many theories about how depression develops and how it is sustained. Here are some examples:
Lewinsohn's theory of depression
According to Lewinsohn's theory, depression then occurs if only one few positive reinforcers owns or loses previous amplifiers in his life. As an amplifier are here rewarding, positive factors that influence one's own behavior.
A reinforcement loss occurs, for example, if you suddenly lose your job or a loved one from whom you have previously received positive reinforcement. Getting little credit for your efforts leads to sadness, withdrawal, and passivity.
Aaron Beck's cognitive model
Typical of many depressed people are mental distortions and negative beliefs. Thoughts like, “I am haunted by misfortune. Bad things only happen to me. ”Or“ No matter what I try, it doesn't work. I'm just a failure. ”Often shape the thoughts of those affected. These in turn control their behavior and lead to distorted views of reality. As a result, even small problems suddenly seem unsolvable.
Psychoanalytic perspectives
psychoanalyst often see the causes of depression in the negative experiences in the childhood of those affected. In this way permanent crisis relationships with siblings and parents can become one lack of self-esteem and one general pessimism to lead.
It is also assumed that especially children who are strongly involved in the Expectations of their parents orientate themselves and put their own needs in the background, suffer from depression more often than others.
