While some illnesses have a specific medical cause, making treatment straightforward, depression is far more complicated. Certain medications, such as barbiturates, corticosteroids, benzodiazepines, opioid painkillers, and specific blood pressure medicine can trigger symptoms in some people—as can hypothyroidism (an underactive thyroid gland). But most commonly, depression is caused by a combination of biological, psychological, and social factors that can vary wildly from one person to another.
Despite what you may have seen in TV ads, read in newspaper articles, or maybe even heard from a doctor, depression is not just the result of a chemical imbalance in the brain, having too much or too little of any brain chemical that can be simply cured with medication. Biological factors can certainly play a role in depression, including inflammation, hormonal changes, immune system suppression, abnormal activity in certain parts of the brain, nutritional deficiencies, and shrinking brain cells. But psychological and social factors—such as past trauma, substance abuse, loneliness, low self-esteem, and lifestyle choices—can also play an enormous part.
Risk factors that can make you more vulnerable
Depression most often results from a combination of factors, rather than one single cause. For example, if you went through a divorce, were diagnosed with a serious medical condition, or lost your job, the stress could prompt you to start drinking more, which in turn could cause you to withdraw from family and friends. Those factors combined could then trigger depression.
The following are examples of risk factors that can make you more susceptible:
Loneliness and isolation. There’s a strong relationship between loneliness and depression. Not only can lack of social support heighten your risk, but having depression can cause you to withdraw from others, exacerbating feelings of isolation. Having close friends or family to talk to can help you maintain perspective on your issues and avoid having to deal with problems alone.
Marital or relationship problems. While a network of strong and supportive relationships can be crucial to good mental health, troubled, unhappy, or abusive relationships can have the opposite effect and increase your risk for depression.
Recent stressful life experiences. Major life changes, such as a bereavement, divorce, unemployment, or financial problems can often bring overwhelming levels of stress and increase your risk of developing depression.
Chronic illness or pain. Unmanaged pain or being diagnosed with a serious illness, such as cancer, heart disease, or diabetes, can trigger feelings of hopelessness and helplessness.
Family history of depression. Since it can run in families, it’s likely some people have a genetic susceptibility to the problem. However, there is no single “depression” gene. And just because a close relative suffers from depression, it doesn’t mean you will, too. Your lifestyle choices, relationships, and coping skills matter just as much as genetics.
Personality. Whether your personality traits are inherited from your parents or the result of life experiences, they can impact your risk of depression. For example, you may be at a greater risk if you tend to worry excessively, have a negative outlook on life, are highly self-critical, or suffer from low self-esteem.
Early childhood trauma or abuse. Early life stresses such as childhood trauma, abuse, or bullying can make you more susceptible to a number of future health conditions, including depression.
Alcohol or drug abuse. Substance abuse can often co-occur with depression. Many people use alcohol or drugs as a means of self-medicating their moods or cope with stress or difficult emotions. If you are already at risk, abusing alcohol or drugs may push you over the edge. There is also evidence that those who abuse opioid painkillers are at greater risk for depression.
Whether you’re able to isolate the causes or not, the most important thing is to recognize that you have a problem, reach out for support, and pursue the coping strategies that can help you to feel better.
What you can do to feel better
When you’re depressed, it can feel like there’s no light at the end of the tunnel. But there are many things you can do to lift and stabilize your mood. The key is to start with a few small goals and slowly build from there, trying to do a little more each day. Feeling better takes time, but you can get there by making positive choices for yourself.
Reach out to other people. Isolation fuels depression, so reach out to friends and loved ones, even if you feel like being alone or don’t want to be a burden to others. The simple act of talking to someone face-to-face about how you feel can be an enormous help. The person you talk to doesn’t have to be able to fix you. They just need to be a good listener—someone who’ll listen attentively without being distracted or judging you.
Get moving. When you’re depressed, just getting out of bed can seem daunting, let alone exercising. But regular exercise can be as effective as antidepressant medication in countering the symptoms of depression. Take a short walk or put some music on and dance around. Start with small activities and build up from there.
Eat a mood boosting diet. Reduce your intake of foods that can adversely affect your mood, such as caffeine, alcohol, trans fats, sugar and refined carbs. And increase mood-enhancing nutrients such as Omega-3 fatty acids.
Find ways to engage again with the world. Spend some time in nature, care for a pet, volunteer, pick up a hobby you used to enjoy (or take up a new one). You won’t feel like it at first, but as you participate in the world again, you will start to feel better.
When to seek professional help
If support from family and friends and positive lifestyle changes aren’t enough, it may be time to seek help from a mental health professional. There are many effective treatments for depression, including:
Therapy. Consulting a therapist can provide you tools to treat depression from a variety of angles and motivate you to take the action necessary. Therapy can also offer you the skills and insight to prevent the problem from coming back.