What Causes Depression?

Anthony’s comment: 

Although depression is not 100% heritable, I believe it often  runs in families even if one is not aware of it being present in  other family members. In the early 1970s, due to severe anxiety over my identity, I went to see a psychiatrist and received  treatment with medication. I needed something that allowed  me to function. I was the only one in my extended family,  however, who ever sought professional help to deal with anxiety and depression. As a result I was labeled with everything  under the sun. But, although no one else has actually been  diagnosed with depression in my family, it is my impression  that there are in fact family members who deal with depression and anxiety, but due to unawareness, stigma, etc. have  not been formally diagnosed or treated.     

The causes of depression are not easily defined. When  speaking of cause, it is typical to think in terms of  infections of the lungs causing pneumonia or of cigarette smoking causing lung cancer. In actuality, most  medical conditions cannot be so easily defined as having clearly linked causes. In fact, it took many years of  statistical analysis before scientists could demonstrate a  clear causal link between cigarette smoking and lung  cancer. Even today, people argue, “My grandmother  smoked her entire life and died at the ripe old age of  90 from natural causes. How can cigarettes possibly  cause cancer?”

The reality is that cigarette smoking is  only one portion, albeit a big one, of the causal puzzle,  which when pieced together leads to lung cancer. This  is true of most diseases today. Instead, when physicians  talk about cause, they are really talking about risk factors that influence the odds of developing a particular  illness.  Depression, a complex illness, is more like an  illness with multiple causes that influence the odds of  someone developing it. 

Depression runs in families but  is not 100% heritable. Depression may occur in some-one with no family history for the illness. When considering the causes of depression, the odds are impacted  by a variety of sources inside and outside of a person.  This variety constitutes what is called the  biopsychosocial model  that is typically used.  In this model consideration is given to biologic, psychological, and social  factors that may contribute to the onset of depression.   This model influences most diseases of lifestyle. Look  at, for instance, heart disease. Applying the biopsychosocial model to heart disease demonstrates biologic risk  factors of family history, the presence of high blood  pressure and high cholesterol, and atherosclerosis; psychological risk factors of type A personality and/or an  inability to handle stressful events; and social risk factors of smoking, diet, and activity level.  

Biologically,  depression is associated with changes in  various neurotransmitter levels and activity, commonly  referred to as a   chemical  imbalance  in the brain.   Additionally, depression frequently runs in families,  suggesting a genetic, or heritable, aspect to the illness.  Medical conditions and sometimes the medications  used to treat those conditions can also cause depressive  symptoms. Psychologically, certain personality types  are more prone to developing depression.

People who  have low self-esteem and a pessimistic outlook are at  higher risk for depression. Other psychological disorders, such as anxiety, psychosis, or substance abuse dis-orders, increase the odds of developing depression.  Socially, depression is linked to stressful life events,  usually entailing loss, such as of a spouse, child, job, or  financial security. Depression, however, can also be  linked to events generally considered to be uplifting  rather than stressful, although from the body’s reaction they are stressful. These events can include marriage,  the birth of a child, a job change or promotion, or a  move to a new neighborhood or home.