What causes clinical depression

Causes - Clinical depression - NHS

There's no single cause of depression. It can occur for a variety of reasons and it has many different triggers.

For some people, an upsetting or stressful life event, such as bereavement, divorce, illness, redundancy and job or money worries, can be the cause.

Different causes can often combine to trigger depression. For example, you may feel low after being ill and then experience a traumatic event, such as a bereavement, which brings on depression.

People often talk about a "downward spiral" of events that leads to depression. For example, if your relationship with your partner breaks down, you're likely to feel low, you may stop seeing friends and family and you may start drinking more. All of this can make you feel worse and trigger depression.

Some studies have also suggested that you're more likely to get depression as you get older, and that it's more common in people who live in difficult social and economic circumstances.

Stressful events

Most people take time to come to terms with stressful events, such as bereavement or a relationship breakdown. When these stressful events occur, your risk of becoming depressed is increased if you stop seeing your friends and family and try to deal with your problems on your own.

Personality

You may be more vulnerable to depression if you have certain personality traits, such as low self-esteem or being overly self-critical. This may be because of the genes you've inherited from your parents, your early life experiences, or both.

Family history

If someone in your family has had depression in the past, such as a parent or sister or brother, it's more likely that you'll also develop it.

Giving birth

Some women are particularly vulnerable to depression after pregnancy. The hormonal and physical changes, as well as the added responsibility of a new life, can lead to postnatal depression.

Loneliness

Feelings of loneliness, caused by things such as becoming cut off from your family and friends can increase your risk of depression.

Alcohol and drugs

When life is getting them down, some people try to cope by drinking too much alcohol or taking drugs. This can result in a spiral of depression.

Cannabis can help you relax, but there's evidence that it can also bring on depression, particularly in teenagers.

"Drowning your sorrows" with a drink is also not recommended. Alcohol affects the chemistry of the brain, which increases the risk of depression.

Illness

You may have a higher risk of depression if you have a longstanding or life-threatening illness, such as coronary heart disease or cancer.

Head injuries are also an often under-recognised cause of depression. A severe head injury can trigger mood swings and emotional problems.

Some people may have an underactive thyroid (hypothyroidism) resulting from problems with their immune system. In rarer cases, a minor head injury can damage the pituitary gland, which is a pea-sized gland at the base of your brain that produces thyroid-stimulating hormones.

This can cause a number of symptoms, such as extreme tiredness and a lack of interest in sex (loss of libido), which can in turn lead to depression.

Page last reviewed: 10 December 2019
Next review due: 10 December 2022

SAMHSA’s National Helpline | SAMHSA

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SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service (in English and Spanish) for individuals and families facing mental and/or substance use disorders.
Also visit the online treatment locator.

SAMHSA’s National Helpline, 1-800-662-HELP (4357) (also known as the Treatment Referral Routing Service), or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

Also visit the online treatment locator, or send your zip code via text message: 435748 (HELP4U) to find help near you. Read more about the HELP4U text messaging service.

The service is open 24/7, 365 days a year.

English and Spanish are available if you select the option to speak with a national representative. Currently, the 435748 (HELP4U) text messaging service is only available in English.

In 2020, the Helpline received 833,598 calls. This is a 27 percent increase from 2019, when the Helpline received a total of 656,953 calls for the year.

The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.

The service is confidential. We will not ask you for any personal information. We may ask for your zip code or other pertinent geographic information in order to track calls being routed to other offices or to accurately identify the local resources appropriate to your needs.

No, we do not provide counseling. Trained information specialists answer calls, transfer callers to state services or other appropriate intake centers in their states, and connect them with local assistance and support.

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Types of depression - iFightDepression [EN]

There are different types of depression, which are different.

Signs and symptoms vary in number, time, severity and frequency, but are generally very similar. Because different types of depression are treated differently, it is important to pinpoint the type of depression. Depending on gender, age and cultural characteristics, people have different symptoms and severity of depression.

Neurotic, reactive (minor) depression is treated with psychotherapy. nine0003

Somatic and psychotic - medication. These terms are used by psychiatrists.

Studies have shown that depression has a phasic course. Periods of normal mood alternate with depressive episodes. Sometimes, instead of a depressive phase,

there may be a manic phase, which is manifested by irritability and high mood. If so, then it is not depression, but bipolar disorder (a more serious illness).

1. Depressive episode

The most common and typical form of depression is the depressive episode. An episode lasts from a few weeks to a year, but is always longer than 2 weeks. A single depressive episode is called a unipolar episode. Approximately one third of affected people experience only one episode, or "phase", during their lifetime. However, if a person does not receive appropriate treatment for depression, there is a risk of recurrent depressive episodes in the future. Depressive episodes always affect a person's performance to one degree or another. nine0003

2. Intermittent (recurrent) depressive disorder

When a depressive episode recurs, it is recurrent depressive disorder or major depressive disorder, which usually begins in adolescence or early adulthood. With this kind of depression, depressive phases, which can last from several months to several years, alternate with phases of normal mood. This type of depressive disorder can seriously affect performance and is unipolar in nature (no manic or hypomanic phase). This is the so-called "classic" or "clinical" depression. nine0003

3. Dysthymia

Dysthymia presents with milder and less severe symptoms than a depressive episode or recurrent depression. However, the disorder is permanent, with symptoms lasting much longer, at least 2 years, sometimes decades, which is why it is called "chronic depression". This disorder is unipolar and also affects performance. This type of depression sometimes develops into a more severe form (major depressive episode) and if this happens it is called double depression. nine0003

4. Bipolar depression, type I

This is the type of depression in bipolar disorder, formerly called manic-depressive illness, and is less common than unipolar depression. It consists of alternating depressive phases, phases of normal mood and so-called manic phases.

Manic phases are characterized by excessively high mood associated with hyperactivity, anxiety, and decreased need for sleep.

Mania affects thinking, judgment and social behavior causing serious problems and difficulties. When a person is in a manic phase, he makes frequent casual unsafe sex, makes unwise financial decisions. After a manic episode, such people often experience depression. nine0003

The best way to describe these "emotional upheavals" is "to be on top of the world and fall into the depths of despair".

Symptoms of the phases of depression in bipolar disorder are sometimes difficult to distinguish from unipolar depression.

5. Bipolar depression type II

More like recurrent depressive disorder than bipolar disorder. In this disorder, multiple depressive phases alternate with phases of mania, but with less pronounced euphoria. During these phases, family and loved ones may even mistakenly assume that the person is doing well. nine0003

6. Mixed anxiety-depressive disorder

In anxiety-depressive disorder, the clinical picture is very similar to depression, however, in depression, depressive syndromes always come first. In this case, both anxious and depressive symptoms are evenly combined.

7. Depressive psychotic episode

A special form of depressive episode is psychotic or delusional depression. Psychosis is a condition in which people see or hear things that do not exist (hallucinations) and/or have false ideas or beliefs (delusions). There are various types of delusions such as self-accusation for no reason (delusion of guilt), financial ruin (delusions of poverty), feeling of an incomprehensible illness (hypochondriac delusions). People with delusional depression almost always require inpatient psychiatric treatment. Psychotic episodes can be either unipolar or bipolar. nine0003

8. Atypical depression

This type of depression is characterized by hypersensitivity and mood swings, overeating and drowsiness, panic attacks. This type of depression is mild and can be bipolar.

9. Seasonal depressive disorder

This type of depression is similar to atypical depression and comes on seasonally with climate change, usually in autumn or winter. Usually, when the season ends, people return to normal functioning again. nine0003

10. Brief depressive disorder

This is a milder variant of depression that more often affects young people and is characterized by short depressive episodes lasting less than 2 weeks.

symptoms, causes in men and women, remedies

Lack of vitality, unwillingness to get out of bed, bad mood for a long time, and even unwillingness to live are all signs of depression. Depression has a negative effect on the health and general well-being of a person. That is why it is so important to get medical help from a specialist in time. nine0003

How to determine the presence of depression?

Pathology can appear after experienced stressful situations. If there is no disorder, after the problem is resolved, a good mood returns to the person. But when the cause is eliminated, and apathy, depression and loss of strength do not leave the person, it is necessary to seek help from a specialist. It may also decrease performance.

You can determine the presence of depression on your own, but you should not self-medicate even at an early stage of development. This should be done by a doctor, since self-medication can only aggravate everything. nine0003

Depression in women is often postpartum, as their lives change dramatically, and sleepless nights add fatigue. This is where frustration and apathy come in.

When the pathology is in advanced form, then a person has the following symptoms of depression - not only a bad mood and impotence, but also persistent disorders of the nervous system. There are also symptoms such as: a significant decrease in self-esteem, disadaptation in society, despondency and loss of interest in any events. nine0003

In physiological terms, appetite changes, intimate needs and energy decrease, sleep and bowel function are disturbed (constipation, weakness, fatigue during physical and intellectual stress are observed), pain in the body (in the heart, in muscles, in the stomach area).

The patient shows signs of depression such as loss of interest in other people, a tendency to frequent solitude, refusal of entertainment, use of alcohol and psychotropic substances. nine0003

Mental signs of depression include difficulty in concentrating, concentrating, making decisions, slowness of thinking, a pessimistic view of the future with a lack of perspective and thoughts about the meaninglessness of one's existence, suicide attempts, due to their uselessness, helplessness, insignificance.

Causes of depression

The appearance of the disorder is not influenced by age category or social class. Most often, depression appears against the background of stressful negative situations, with constant failures - then a person falls into despair from the inability to somehow influence the course of events. nine0003

But in addition to the social factor, severe psychological trauma can also lead to the development of depression, for example: family breakup, death of a loved one, a serious illness that affects not only the patient himself, but also his relatives. In this case, depressions are referred to as reactive.

The likelihood of depression increases with changes in hormonal levels: during adolescence, after delivery, with the onset of menopause, and also in old age. It can affect the emotional and physical level. nine0003

Another factor is brain damage and somatic pathologies. Often depression affects patients who have had a stroke, suffering from a chronic lack of blood circulation in the brain, after a traumatic brain injury.

The causes of depression can manifest themselves as a result of the side effects of drugs (benzodiazepines, corticosteroids). Often this condition disappears on its own after the drug is discontinued.

Types of depression

Neurotic - people with low self-esteem, insecure, straightforward people often suffer. They constantly feel a sense of injustice, and apathy arises from this.
Clinical - bad mood, loss of energy, problems with appetite and sleep. Often there is a tendency to suicide. This clinical picture can last at least 2 weeks.

Vegetative - manifested by such signs as tachycardia, a drop in blood pressure, tinnitus.

Psychogenic - develops after severe psychological trauma - divorce, loss of a loved one, dismissal from work, betrayal, etc. Accompanied by mood swings, anxiety, excessive sensitivity.
Masked - often the disease manifests itself secretly. Apathy, solitude and a decrease in interest in life can only appear as negativity and fatigue accumulate. nine0003
Asthenic - the condition is manifested by fatigue, sleep disturbance, emotional imbalance due to accumulated difficulties, stress, physical and psychological stress.
Postpartum - usually occurs 10-14 days after delivery. A young mother shows an increased sense of excitement for the baby, and constant lack of sleep and fatigue worsen the situation even more. In addition, the hormonal background also affects the state of the mother. nine0003
Somatogenic - attacks occur due to disturbances in the endocrine system, the formation and growth of neoplasms, both benign and malignant.
Alcoholic - depression is accompanied by excessive consumption of alcoholic beverages. The post-alcohol state is accompanied by an uncontrolled craving for alcohol and the growth of withdrawal syndrome when alcohol is refused. nine0003
Bipolar - the patient is changing euphoria depressive, manic disorder. But in the period between these phenomena, caused by various factors: stress, loss of means of popularity, etc., a person lives an ordinary life and does not show symptoms of the disease.

How does depression develop in stages?

First, the patient has a depressed state, which he himself attributes to fatigue, a hard working week, drinking alcohol and other reasons. At the same time, he wants to retire from others and at the same time is afraid to be alone. nine0003

Then the stage of acceptance arises: the awareness of the dangerous state comes, the problem worsens, the intensity of negative thoughts grows, the body and the immune system fail.

The third stage - in the absence of adequate therapy, the patient loses control over himself, aggression increases.

Diagnosis and treatment of depression

To identify the disease, experienced specialists use short questionnaires - screening tools to identify symptoms: anxiety, anhedonia (loss of pleasure from life), suicidal tendencies. Thanks to this, it is possible to determine whether the patient has chronic depression, symptoms and treatments for depression, what form and severity it is. nine0003

To fully understand the picture of the disease, the doctor needs to familiarize himself with the symptoms that indicate depression, and not another psychological disorder.

For the treatment of depression, you can contact the following specialists:

Psychiatrist - treatment of depression with hypnosis, drugs for acute mental pathologies - schizophrenia, mental retardation, epilepsy, as well as other less severe ailments - neurosis, depression, alcoholism, drug addiction, etc. nine0003
Psychotherapist - treatment is carried out through special therapy, which provides for explanations, conversations, searching for solutions to problems together with the patient.
Psychologist - advises the patient, cannot prescribe medications and examinations. Clinical psychologists use modern test methods to identify problems that caused a psychological disorder. nine0003

The main directions of therapy in treatment are psychotherapy, pharmacotherapy, social therapy.

A necessary condition for the effectiveness of treatment is cooperation and trust in the doctor. It is important to strictly follow the prescription of the therapy regimen, visit the doctor regularly, and give a detailed account of your condition.

Preparations for the treatment of depression

For the treatment of the disorder, antidepressants are used for anxious depression or when the pathology is accompanied by lethargy. Antidepressants are prescribed directly by a doctor and are not recommended for self-administration. The action of many antidepressants manifests itself two weeks after administration, their dosage for the patient is determined individually. nine0003

In bipolar depression, depression is treated with insomnia. While it has a negative effect on a healthy person, in a patient with a psychological disorder, sleep deprivation, on the contrary, brings the psyche back to normal.

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