Causes of Depression and the Bad Side of a Possible Good By Jay Wyshak

Let there be no doubt that depression is a serious mental illness that sometimes requires months and years of treatment on the road to a cure. Hippocrates referred to depression as melancholia, which literally means black bile. Black bile, along with blood, phlegm, and yellow bile were the four humors (fluids) that described the basic medical physiology theory of that time. Depression, also referred to as clinical depression, has been portrayed in literature and the arts for hundreds of years, but what do we mean today when we refer to a depressive disorder? In the 19th century, depression was seen as an inherited weakness of temperament. In the first half of the 20th century, Freud linked the development of depression to guilt and conflict. John Cheever, the author and a modern sufferer of depressive disorder, wrote of conflict and experiences with his parents as influencing his development of depression.

Each year, millions of people come to the realization that they suffer from depression. To make things worse it is estimated that only a third of those who suffer the disease will ever seek treatment. Because depression is considered a mental affliction, many sufferers shy away from seeking help from a doctor. Instead of being considered mentally ill, people try to manage the problem themselves. Depression is more common- place than you might think and it will not go away on its own.

Depression has no single cause; often, it results from a combination of things. You may have no idea why depression has struck you.

Whatever its cause, depression is not just a state of mind. It is related to physical changes in the brain, and connected to an imbalance of a type of chemical that carries signals in your brain and nerves. These chemicals are called neurotransmitters.

Some of the more common factors involved in depression are:

* Family history. Genetics play an important part in depression. It can run in families for generations.

* Trauma and stress. Things like financial problems, the breakup of a relationship, or the death of a loved one can bring on depression. You can become depressed after changes in your life, like starting a new job, graduating from school, or getting married.

* Pessimistic personality. People who have low self-esteem and a negative outlook are at higher risk of becoming depressed. These traits may actually be caused by low-level depression (called dysthymia).

* Physical conditions. Serious medical conditions like heart disease, cancer, and HIV can contribute to depression, partly because of the physical weakness and stress they bring on. Depression can make medical conditions worse, since it weakens the immune system and can make pain harder to bear. In some cases, depression can be caused by medications used to treat medical conditions.

* Other psychological disorders. Anxiety disorders, eating disorders, schizophrenia, and (especially) substance abuse often appear along with depression.

Why do people get depression? The answer can get very complicated because you have to take many factors into consideration. The list is quite long. Let's list a few of the contributing factors to depression. A chemical imbalance is widely considered to be the main cause for depression. Why does this chemical problem in the brain happen? Typically the causes stem from biological, genetic, physical, mental and environmental implications. In many cases the underlying cause is never identified. Depression often follows diagnosis of other medical conditions, particularly those that result in imminent death or are chronic.

Scientists do not know why the hippocampus is smaller in those with depression. Some researchers have found that the stress hormone cortisol is produced in excess in depressed people. These investigators believe that cortisol has a toxic or poisonous effect on the hippocampus. Some experts theorize that depressed people are simply born with a smaller hippocampus and are therefore inclined to suffer from depression.

Another cause of depression can be the emotional pain felt after losing a loved one. In many cases the loss can be very traumatic. Long periods of emotional, sexual or other physical abuses can result in depression. When people abuse drugs and/or alcohol the result is often depression. People's mental states are fragile. If exposed to the wrong pressures, depression can result. There can also be a genetic element to depression. Those afflicted have a family history of the disease . Oddly, many drugs including those that regulate depression or anxiety can cause depression. High blood pressure medication can result in depression.

One of the major causes of depression is stress. Stress can derive from many different areas in our life. It's not well known, but it's true, that stress can result from the pressures associated with positive events such as a new, high paying job. The unknown is often the root cause of this stress, whether it be positive or negative. Arguments with family members, disputes with business clients can both cause stress.

The causes of clinical depression are likely to be different for different people. Sometimes a depressive episode can appear to come out of nowhere at a time when everything seems to be going fine. Other times, depression may be directly related to a significant event in our lives such as losing a loved one, experiencing trauma, or battling a chronic illness.

Research indicates that depressive illnesses are disorders of the brain. Brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different than those of people without depression. The parts of the brain responsible for regulating mood, thinking, sleep, appetite and behavior appear to function abnormally. In addition, important neurotransmitters-chemicals that brain cells use to communicate-appear to be out of balance. But these images do not reveal why the depression has occurred.

Scientists believe genetic factors play a role in some depressions. Researchers are hopeful, for instance, that they are closing in on genetic markers for susceptibility to manic-depressive disorder.

Depression in adolescence comes at a time of great personal change-when boys and girls are forming an identity distinct from their parents, grappling with gender issues and emerging sexuality, and making decisions for the first time in their lives. Depression in adolescence frequently co-occurs with other disorders such as anxiety, disruptive behavior, eating disorders or substance abuse. It can also lead to increased risk for suicide.

Teen depression cannot always be prevented, but there are some things that can help reduce the chances of an episode of depression in a teen who is at risk.

Teen Depression is presented for troubled teens or parents of teens. We offer information on teenage depression, issues, and other teen problems. Our articles were written to educate parents and teens about adolescent depression, the warning signs, and various treatment options available.

Some of the causes of depression in teenagers seem to be genetic, and those cannot be changed, but other triggers of teen depression can be avoided. Some of the risk factors for teen depression include:

* A family or personal history of depression
* A long-term illness or disability, whether physical or mental
* Experiencing a trauma or loss, including abuse, divorce of parents, death of a loved one, or a break-up
* Difficulties at home, at school, or with friends

If you know a teen who suffers from or is at risk for depression, you can help the teen by:

* Talking and listening to him or her
* Encouraging him or her to be involved in positive activities and to take good care of him or herself
* Being fair when dealing with or disciplining the teen
* Setting a good example by taking good care of yourself and getting help if you feel depressed or overwhelmed.

The majority of older adults with depression improve when they receive treatment with an antidepressant, psychotherapy, or a combination of both.18 Research has shown that medication alone and combination treatment are both effective in reducing the rate of depressive recurrences in older adults. Psychotherapy alone also can be effective in prolonging periods free of depression, especially for older adults with minor depression, and it is particularly useful for those who are unable or unwilling to take antidepressant medication.

Additional research data indicate that people suffering from depression have imbalances of neurotransmitters, natural substances that allow brain cells to communicate with one another. Two transmitters implicated in depression are serotonin and norepinephrine. Scientists think a deficiency in serotonin may cause the sleep problems, irritability, and anxiety associated with depression. Likewise, a decreased amount of norepinephrine, which regulates alertness and arousal, may contribute to the fatigue and depressed mood of the illness. Other body chemicals also may be altered in depressed people. Among them is cortisol, a hormone that the body produces in response to stress, anger, or fear. In normal people the level of cortisol in the bloodstream peaks in the morning, then decreases as the day progresses. In depressed people, however, cortisol peaks earlier in the morning and does not level off or decrease in the afternoon or evening.

There is mounting evidence that depression takes a serious toll on physical health. The most recent studies exploring health and depression have looked at patients with stroke or coronary artery disease. Results have shown that people with depression who are recovering from strokes or heart attacks have a more difficult time making health care choices, following their doctor's instructions, and coping with the challenges that their illness presents. Another study found that patients with depression also have a higher risk of death in the first few months after a heart attack.

Some people have a low threshold for stress. They're affected by events and activities that to others seem to not be stressful. The good news is that very effective treatments are available to help those who are depressed. However, only about one-third of those who are depressed actually receive treatment. This is unfortunate since upwards of 80-90% of those who do seek treatment can feel better within just a few weeks. Many people do not seek treatment for depression for a variety of reasons. Some believe that depression is the result of a personal weakness or character flaw. This is simply not true. Like diabetes, heart disease, or any other medical condition, clinical depression is an illness that should be treated by a mental health professional or physician. Another reason why many people do not seek help for depression is that they simply do not recognize the signs or symptoms that something may be wrong.

About Depression By Michelle Ooley

I have recently created a blog about depression, called Depression Hurts. Feel free to visit my blog frequently. I will be updating it frequently with new information about depression, treatments, articles, etc.

For years I have suffered from depression, at different levels, some of them being major episodes and some more on a dysthymic (low-grade chronic) level.

What is depression?

There is a tendency to use the word depression to describe periods or episodes of sadness that each of us experience from time to time. And for many of us, during these periods it is not always easy to discern where normal sorrow ends and clinical depression begins. Yet, anyone who has ever experienced an episode of major depression knows - at least after the depression has lifted - that what they feel is more than just ongoing or persistent sadness.

Clinical depression is an illness characterized by a cluster of feelings, thoughts and behaviors that are remarkably distinct from a person's normal range of feelings and functioning. Caused by a complex interaction of biologic, psychological and social factors, a major depressive disorder can make a person extremely sensitive to life circumstances, the least of which can throw him/her into total loss of hope.

During a major depression, someone can become surrounded by feelings of sadness, hopelessness, helplessness, and emptiness, and these feelings can distort every thought and experience, making life seem hopeless and unworthy. Feelings of being deeply and continually deprived, unworthy, insignificant, and guilt-ridden build on feelings of sadness. At the same time, a person may feel chronically irritable, often exploding into anger and frustration.

While a major depression may be triggered by some life event or circumstance, a person's mood reaction may seem greatly exaggerated. However, depression has less to do with life's events than with an individual's existing vulnerability to the condition.

In some cases, someone may experience a major depression as a single episode, but in most cases, clinical depression tends to recur periodically, reactively or cyclically. A major depressive episode could possibly last up to 2 or more years.

When someone experiences milder depressive episodes, this is called dysthymia. For someone suffering from dysthymia, certain life circumstances, such as loss of a job, divorce, or relocating to a new environment, may provoke a much deeper depression.

For some individuals, there is a seasonal component to their depression called Seasonal Affective Disorder (SAD). This is a form of reactive depression that is more prevalent in northern parts of the country where climatic extreme changes are greater. SAD usually affects people in the fall or winter and is characterized by fatigue, carbohydrate cravings, overeating, lack of energy or motivation to do activities normally enjoyed, and oversleeping. While the exact etiology or cause of SAD is not certain, it is possible that it may be related to the way in which the light responsive pineal gland in the brain functions.

Defining Depression:

The difficulty with many mental disorders, it is hard to tell when you need more than just a positive attitude to manage your feelings. Depression is a common problem that many people simply think they need to live with, something they need to 'tough out' in order to come out better for it. But this is not necessarily the best treatment plan for this mental illness. Here's what you should know.

What's difficult about dealing with depression is that it can manifest itself in a number of different ways. For some people, depression is merely a short bout of sadness that resolves on its own. But for others, it's a long running presence that makes them feel ineffective, as well as hopeless. Some of the more common symptoms of depression include:

o Feeling sad

o Feeling hopeless

o Becoming irritated for no reason

o Anger and frustration

o Loss of interest in favorite activities

o Change in eating habits

o Change in sleeping habits

o Thoughts about suicide

Diagnosing depression is tricky because it requires that you have these symptoms for extended periods of time - normally for at least two weeks continuously. And while some people can easily identify their down times, others might not recognize symptoms like anger as being consistent with depression.

When you have depression, what can you do?

During the time that you feel despondent, seek the emotional support from family and friends. For milder episodes of depression of short duration, the support of loved ones may be able to help you work through it. But in most cases, you will not be able to fight depression on you own, and you should not try to. Like diabetes or asthma, depression is an illness and requires medical attention so it can be managed effectively and appropriately. If you are suffering from depression, it is imperative that you seek professional help.

If you suffer from SAD (Seasonal Affective Disorder), you may very well respond to spending at least an hour a day outdoors, even during the wintertime. Increasing the amount of natural light in your house may also help. Some psychiatrists even recommend obtaining a special light to put in your room that kind of resembles sunlight. Whenever possible, take trips in winter to warmer and sunnier climates.

When to seek treatment for depression:

If you are in a major bout of depression, you may feel like you are beyond help. However, depression can be treated and managed. If you state of gloom persists more than two weeks, you feel that you cannot get out of bed, you are increasingly isolated from family and friends, and you have lost any sense of enjoyment or interest in your usual activities, call your doctor right away. Also, if you find yourself ruminating about death and the meaningless of life and you are considering suicide, SEEK HELP IMMEDIATELY.

Treatment of Depression:

Mild depression can be treated effectively through psychotherapy. Even short-term therapy can help you understand your natural inclination towards more negative and low moods. Also, you can learn to cope better with life's disappointments and triumphs. When depression is triggered by a seasonal change, light therapy, which extends exposure to bright light for measurable periods of time, may work to relieve symptoms.

In cases of more severe depression, medication will provide the main avenue for treatment. At the same time, psychotherapy is usually an important complement to medication. By restoring chemical balances within the brain, psychotropic medications will help lift the "veil of sorrow." The most commonly used anti-depressant medications are SSRIs (selective serotonin reuptake inhibitors), which include fluoxetine, sertraline, paroxetine and fluvoxamine, and TCAs (tricyclic anti-depressants), which include imipramine, nortriptyline, amitriptyline, and desipramine. Although general practitioners can usually prescribe these types of medications, it is usually best to consult with a psychiatrist or psychopharmacologist, who is specially trained to evaluate and monitor the need for and use of anti-depressant medicines.

For lots of different reasons, treatment with anti-depressants takes time to work. Because every person and his depression differ, finding the most effective medication is often a process of trial and error. While the process may be frustrating, you and your doctor will eventually find the right treatment.

During a severe episode of depression, there may be severe paranoid persecutory delusions or even hallucinations. There may even be suicidal behavior. When these occur, hospitalization, antipsychotic medication or electroconvulsive therapy (ECT) may be necessary. After the acute phase has subsided, psychopharmacologic treatment should be continued to decrease the likelihood of relapse or future recurrence.

Unlike medications for physical illness, psychotropic medicines do not work to cure the depressive illness; rather, they work to relieve acute episodes and prevent recurrences. For many people, medications work most effective in conjunction with psychotherapy. Insight-oriented therapy can allow you to consider how such contributing factors as early experiences of loss and cumulative negative life circumstances and disappointments have colored your disposition. Cognitive techniques can also provide significant relief insofar as they address the negative and distorted thinking that typically characterizes depression.

Prognosis for Depression:

Prognosis is good. Recent progress in the development of new medicines that act directly on specific parts of the brain make the treatment of depression even more positive. SAD responds well to light therapy.

In some instances, one course of treatment is sufficient to manage or remedy major depressive illness. However, for many others, depression is a chronic lifelong condition that requires continued or episodic intervention. Ever after a successful round of treatment, it is important that you remain sensitive to stresses that are likely to trigger a depression. If you are able to recognize early signs, you will be able to contact your physician or clinician before you find yourself deep into another depressive episode. Learning to manage depression through therapy, medications and lifestyle will lessen the likelihood that it will take over your life.

Again, please visit my blog as I will be updating frequently with interesting news, treatments, recommended books and much more.

General Depression Information: Understanding Depression Symptoms and Treatments By Craig Wilcox

The first thing to know about depression is that it is not just in your head. Depression is, in fact, a whole body disease that affects multiple systems.

In addition to feeling sad, hopeless, or helpless, a person may suffer from extreme fatigue, decreased motor (muscle) coordination, changes in appetite and weight, and a loss of interest in activities that are usually pleasurable--just to name a few of the more common symptoms.

Anxiety, which is commonly understood to consist of fear without any direct cause, is highly correlated with depression. Anxiety is an imbalance not just of brain chemicals, but of the entire nervous system, which is over-responding throughout the body as if a physical threat is impending. This can often cause the depressed person to feel very jittery, and some people experience extra clumsiness as they go about their day.

Only a doctor can diagnose depression, and if you are suffering from what you believe to be depression, you should make an appointment immediately. (If you need help sooner, please dial 9-1-1.) When you speak to a doctor during a formal assessment, he/she will ask you questions like the following, which are adapted from the Diagnostic and Statistical Manual of Mental Disorders IV:

1. Are you experiencing a depressed mood?

2. Have you lost interest in most or all of your normal activities, including normally pleasurable ones?

3. Have you experienced a dramatic change in your appetite, leading to noticeable weight gain or weight loss in the last month?

4. Have your sleep habits changed? Do you sleep much more or much less than normal, or do you have trouble getting to sleep or waking up?

5. Do you feel agitated or jumpy, or have others noticed that you are more irritable than normal?

6. Have you had trouble concentrating or thinking clearly?

7. Do you feel abnormally tired throughout the day?

8. Do you have overwhelming feelings of worthlessness, guilt, or hopelessness that things won’t improve?

9. Have you been thinking about death or suicide more than usual, or have you tried to commit suicide?

If you answered “yes” to questions 1 and/or 2, plus any four of the other questions, and these symptoms have persisted for at least two weeks with little change, you may be suffering from clinical depression.

Your doctor will also want to make sure that these symptoms are not due to what would be considered a normal reaction to a life situation, like a death in the family. It is completely normal to feel those things after a traumatic life event, unless those feelings persist for longer than two months without seeming to become easier to handle.

Additionally, the doctor will want to know whether these symptoms are causing you great difficulty in completing your normal daily activities. Depression is serious enough that it can cause a person to miss work and be unable to fulfill family obligations.

Risk Factors

People who suffer from depression are much more likely to suffer from other life threatening diseases, including diabetes, cancer, and heart disease. Much focus has been put on discovering why depressed patients are about four times as likely as their peers to suffer a heart attack within 14 years of their first depressive episode.

Underscoring the whole body effect of depression is the research finding that depressed patients have lower heart rate variability (HRV) than normal. HRV is lowered when the parasympathetic branch of the nervous system is not fully functioning, and people with low HRH are at high risk for suffering heart attacks.

The malfunctioning of the parasympathetic branch may be a key in understanding how mental perception of events that lead to depression affect the entire body.

Causes of Depression

Depression can be caused by any number of circumstances. For some, genetics may play a role (this is especially true for bipolar disorder, or manic depression, which is not covered in this article). For others, it could be the result of their life situation, such as an overly stressful stretch of time or a disease.

Many times, depression can be caused by “uncontrollable stress”. In this case, a person is going through a negative event in which they perceive their efforts will not affect the outcome. Caregivers are especially prone to this. With the advent of disease such as Alzheimer’s, a patient may need constant attention from a family member for years, causing great disruption in the caregiver’s life.

In cases of stress, it should be repeated that the effects will be on the whole body, not just the mind. Stress can cause the secretion of excess cortisol, which in turn can damage tissues in the brain and body. Stress hormones can also cause the nervous system to become overworked in trying to maintain balance, eventually causing it to shut down due to exhaustion.

Depression Treatment Options

Anti-Depressants

One of the great advances in pharmaceutical medicine was the advent of the SSRI class of anti-depressants. Depression can cause an imbalance in the brain chemical called serotonin. Serotonin is a neurotransmitter that helps us feel calm and relaxed with a sense of wellbeing.

In people who are depressed, serotonin production may be lowered, or it may not be utilized most effectively in the brain.

Neurotransmitters are secreted into the spaces between the brain cells. SSRIs, or Selective Serotonin Reuptake Inhibitors, prevent the serotonin from being absorbed back into brain cells as quickly, and brain researchers believe that leaving more of the serotonin in between the cells has a mood-enhancing effect.

Examples of SSRI class anti-depressant drugs include Prozac, Zoloft, and Paxil. They have been shown to be highly effective for alleviating depression and anxiety in a wide range of people, though their safety in children has recently been questioned.

Counseling

In addition to medication, patients are usually also referred to a counselor for what is often referred to as “talk therapy”, or more formally as cognitive behavior therapy. With this type of counseling, the depressed person learns to notice their negative thinking patterns and challenge them. Over time, patients are able to prevent negative moods by intervening in their own to reflect a more positive outlook.

Exercise

Research has shown that consistent aerobic exercise in a specific heart rate zone has very beneficial effects in fighting depression in both the short- and long-term.

While it may be difficult for someone experiencing a major depressive episode to rally the energy necessary to exercise, most people who do experience at least some relief from depression within just 10 minutes of starting.

Though not widely publicized, the effects of exercise have been repeatedly shown to result in decreases in depression that are on par with both drug and counseling therapies. For more information on an exercise program that may help alleviate depression symptoms, please go to http://www.hrh-for-depression.com.

Herbal Therapies

Interest in herbal therapies for depression has always been high, and in some countries, such as Germany, herbal therapies are preferred over medicinal therapies, according to the National Institute of Mental Health. Many people prefer herbal therapies in general, because they believe the side effects of anti-depressants may affect them negatively.

Herbs such as ginseng and gingko biloba have been used to treat depression, but the only herb to be tested in a large scale study is St. John’s wort. Patients who were followed for 26 weeks of St. John’s Wort use did experience a reduction in depression that was nearly comparable to sertraline, an SSRI.

Researchers warned, however, that St. John’s wort may utilize the same metabolic pathways as other drugs for depression, heart disease, seizures, and some cancers. As a result, patients need to be certain to consult their doctors on the use of St. John’s wort with other medications.

Getting Help

Nearly 10% of Americans will experience a depressive illness in any given year. If you feel you are in the throes of depression, please understand that there are very effective treatments available to you. Modern SSRI medications, which are the most commonly prescribed anti-depressants, can start working within 2 weeks of taking the first dose. By engaging in some moderate exercise, you might even feel somewhat better by the end of today.

Though doing anything while suffering from depression is difficult, please do make it a priority to seek some sort of help. If you need others to intervene on your behalf, please communicate that to them.