What causes depression?
Depression is a complicated phenomenon. Almost everyone has experienced it to some degree and some depression is even normal. In fact, sometimes depression is even beneficial. But there is a broad range of how painful and debilitating depression is, how long it lasts, and how often it comes. There is also variety in what causes it, what helps it, what benefits it brings, what thoughts and behaviors come with it, and what aspects of each person it attacks.
Depression is caused by a variety of factors, including:
1. Negative, distorted thought patterns, including self-attack, which is basically: "I'm bad (unlovable, a failure, unworthy, defective, disgusting etc), I've always been bad, and I always will be bad", and hopelessness/helplessness, which is basically: "My life is bad, always was bad, and always will be bad."
2. Insufficient amounts of the brain chemicals that cause us to feel all the pleasures possible for humans--love, pride, desire, peace, connection, satisfaction, joy, self-love, etc. These chemicals include: serotonin, endorphins, dopamine, norepinephrine…I refer to these chemicals collectively as the “pleasure chemicals”.
3. Feelings that have not been expressed to and understood by a trusted person, especially feelings resulting from trauma and loss.
4. What we inherited in our genes.
5. Not setting limits for demands made on us, or otherwise getting depleted or drained emotionally.
6. What we eat and/or don’t eat and what chemicals (food, drugs) we ingest or produce, especially through addictions.
7. Electrical factors in the brain.
The causes of depression act in a circular fashion with one another. I say it’s circular, because, each cause can cause each other cause—got that? No? Okay, for example:
Negative thinking and self-attacking thoughts cause our brain chemistry to turn sour on us. On the other hand, chemical imbalances in the brain cause negative thinking. Negative thinking or brain chemistry imbalance can cause depression.
Trauma or grief that is not resolved through expressing one’s feelings to an empathic listener can cause self-attack. Self-attack leads to depression. But depression can also cause self-attack!
Trauma changes brain chemistry, and neurological structure, reducing pleasure chemicals, often for years until the trauma is processed.
Eating disorders, chemical dependency and other addictions wreak havoc on brain chemistry, and chemical imbalances can contribute to causing addictions. Addictions not only cause brain chemistry changes, but also negatively change self-image, and cause emotional stressors. So addictions can cause depression, and depression can make addictions seem appealing and necessary.
It is all related. Intervention can happen at any point on the circle, and lead to a positive domino effect of change, or intervention can happen at several points on the circle to undermine the interlocking system’s tendency to keep things as they are. For example, psychotherapy can change the self-attack, which relieves the depression and re-balances the brain chemicals. Sometimes medication has to change brain chemistry first, before psychotherapy can work to change patterns of thoughts or behaviors. A combination of both can be a very powerful treatment for some people. If all contributing factors are addressed--physical health, emotional resolution, brain chemistry balancing, & abstinence from addictions, depression can be relieved in most people relatively quickly.
What types of depression are there?
You may have heard or read various words labelling depression. Here are some:
"Clinical Depression" This is a lay term generally used to mean a depression that is really serious and potentially requires medical attention.
"Major Depression" This is a term used by professionals to refer to a severe form of depression that can be a one-time "major depressive episode" or can happen repeatedly and be labelled "major depressive disorder."
"Manic Depression" This is a lay term referring to "Bi-Polar Disorder." People who have Bi-Polar Disorder experience both severe depression and manic episodes.
"Agitated Depression" This is a major depression that includes restlessness, anxiety, often pacing--depression that manifests most obviously as intense, irrational, uncontrollable anxiety.
"Postpartum Depression" This is a mostly hormonally-induced depression that occurs in some women after giving birth. How the baby affects the woman's life, can also be a factor. It is usually short-lived (a few days to a few weeks), but sometimes can be very serious and dangerous for both mother and child.
"Pre-menstrual or Hormonal Depression" Some women get depressed due to hormonal changes shortly before having a menstrual period.
"Dysthymia" This is the clinical term for depression that is less intense than major depression and lasts for months, or years.
"Bi-Polar Disorder" This is the clinical term for someone who has had both depressive and manic episodes. Manic episodes are periods of extremely high energy, similar to the experience of using amphetamines, an uncontrollable need to talk, a lack of need for sleep, racing thoughts, grand ideas, and very poor judgement.
What are the symptoms of depression?
Depression comes in many forms, and people don’t always recognize that depression is the cause of their symptoms, because people think of depression as really bad sadness. Actually, depression can manifest as:
· irritability,
· hopelessness and/or thoughts of suicide & dying,
. physical pain (especially back, head, and stomach),
· anxiety,
· withdrawal from people,
· addictive use of substances and/or activities,
· angry outbursts,
. tearfulness or uncontrollable crying
· excessive sleep,
· inability to sleep,
· a major change in eating patterns,
· making impulsive huge life changes,
· intense jealousy,
· lack of motivation,
· poor work performance,
· lateness,
· inability to accomplish ordinary life tasks such as cleaning, laundry, dishes, showering, paying bills, etc.,
. feeling a heaviness in ones arms that make it difficult to lift them,
. insecurity, self-hate, self-attack, feeling undeserving,
. inability to love or feel joy or pleasure,
. unreasonable guilt,
. some loss of thinking ability in concentration, memory, or decisions,
. hallucinations and/or delusions (rarely)
. feeling numb or detached
. a loss of interest in sex and/or anything that previously felt pleasurable
. a loss of self-confidence
. a lack of interest in food
. compulsive overeating
. criticalness
. pessimism
. suicidal thoughts/desire
. self-injury
. and more...
Depression frequently causes relationship conflict, and divorce. It can cause a chronic pattern of not living up to one’s potential. Below are questions about some of these symptoms.
1. Do you criticize yourself frequently for what you do, and who you are? Do you think of yourself as "weak," a "failure," "not good enough," "unlovable," "a loser," etc.?
2. Are you unable to feel compassion for yourself, or grant yourself forgiveness most of the time? Are you cruel to yourself when you make mistakes? Do you constantly fail to reach your standards for yourself?
3. Do you lack energy, and have trouble motivating yourself to do things? Do your arms, legs or back feel heavy, achy, and hard to move (not due to injury)?
4. Do you feel agitated, restless, anxious much of the time?
5. Do you believe that things are unlikely to get better?
6. Do you feel irritable much of the time? Do you often lash out or explode at those around you and then condemn yourself for doing it?
7. Do you think you are eating and sleeping way too much or way too little?
8. Do you feel overwhelmed by your life?
9. Do you feel emotionally numb, except for just feeling bad?
10. Are you frequently tearful; do you frequently feel sad for no apparent reason?
11. Are you having trouble enjoying anything? Have you lost interest in activities you used to enjoy? Have you lost interest in sex?
12. Are you having trouble concentrating, or making decisions?
13. Do you find yourself compelled (meaning do you feel unable to stop when what you are doing causes serious risks or negative consequences to your relationships, work, health, self-esteem, integrity, etc.) to eat, drink alcohol, use drugs, have sex, put yourself in danger, gamble, shop, look at pornography, or anything else for the purpose of giving yourself emotional relief from your suffering?
13. Are you withdrawing from people when you can?
14. Do you wish for death to end your pain; do you think everyone would be better off if you were dead?
15. Do you have any of the above experiences regularly with the cycle of your period, or in the wintertime? Have you recently given birth?
If you answered "yes" to two or more of these, you may be experiencing some form of depression. Please consider getting a professional evaluation, and some therapy to relieve your suffering. Counseling really can help.
Call me, and we will figure out what you need and how to get it so you don't have to suffer any more. (510-525-2341, or cynthialubow@yahoo.com)
If you feel in any danger of killing yourself, or letting yourself be killed by not being careful, please call your local crisis line (or go to suicidehotlines.com) IMMEDIATELY!
If you are experiencing postpartum blues, or depression, please get support. You may need physical support to get more sleep and to take better care of yourself, and you may also need emotional support. You may be able to find a group of women going through what you are, and that might be the best choice for you. Postpartum depression is especially painful, and potentially dangerous, because it can include feelings of anger or numbness toward the baby. Since most women find these feelings to be unforgivable, they don’t want to admit to them, and then don’t get the help they need. Women who have a history of depression have a very good chance of getting postpartum depression. If this is you, please get help now! Ignoring these depressed thoughts and feelings can be dangerous to you, the baby, and your family.
Men and women respond to depression very differently. Statistics tell us that twice to ten times as many women as men fit the criteria for depression. This may not mean that more women are depressed than men. The medical definition of depression is based on how women generally express it. Men tend to express their depression differently, so statistics don't count most depressed men as depressed. Men feel more shame about being depressed, so are less likely to admit it, or get help for it. In men, some of the common signs of depression actually mask the depression. These include anger and blaming, alcohol and drug use, addiction to pornography, impotence, dependence on sex to improve mood, difficulty being friendly, trouble concentrating and making decisions.
What treatments are there for depression and how successful are they?
There are numerous treatments for depression, and most people can get relief from depression either through talking, crying, circumstances changing and time passing without any professional treatment, or through one or more treatments. Treatment usually involves forming a warm, trusting connection with a non-judgemental, active-listening professional who can help you resolve the cause of the depression. Sometimes medication also helps. Sometimes learning how to think in a way that doesn't support depression helps. Sometimes self-help, like exercise and healthy eating helps. Herbs can help, accupunture, homeopathy and other wholistic treatments can help. Psychotherapy itself can include a variety of methods and techniques that are helpful for depression. It appears as if each individual responds to some treatments and not others. For most people, psychotherapy is the best place to start. If other forms of treatment are needed, your psychotherapist can usually assess that and refer you to other professionals for additional support in healing.