There is no single cause. Usually it is a combination of physical causes with things from the past, what you go through in your life and your personal characteristics.
Causes of depression
Things from the past
1. Early childhood adversity (or trauma) is an important cause of depression later in life.
Threatening circumstances such as sexual, physical or emotional abuse can call up a depressive episode years later, often in combination with symptoms of post-traumatic stress.
2. Early loss of a parent or another important person.
3. Bullying at school.
Genetic factors
4. Genetic factors play a part, because depression is much more common in some families than in others.
The genetic susceptibility to depression has to do with sensitivity to stress. Genetically, one person is more sensitive to stress than another. This plays a part above all when depression occurs in combination with manic episodes.
5. Depression is twice as common in women as in men.
Mental distress in men more often takes the form of addiction, the autism spectrum and hyperactivity. In women emotional problems such as susceptibility to depression and anxiety are more common.
6. The use of medicines, alcohol and drugs can also contribute to a depression.
7. Finally, there is a raised chance of a depressive episode for people with a brain condition or a chronic physical illness, such as diabetes, dementia, Parkinson’s disease or a stroke.
Social factors
8. A major life event can also cause a depression. For example the death of someone close to you, a divorce or losing your job.
The trigger is not always so obvious or so drastic. People who feel lonely for a long time, or who have a small social network, also run an extra risk of developing a depression.
Psychological factors
9. Most people who go through something terrible can be sad for a long time, but do not become depressed. But if someone has a psychological susceptibility, an event can result in a depression after all.
Psychological factors or character traits that can play a part are:
- Fear of failure
- Little self-confidence
- Difficulty asking for support
- Being overly self-critical
- Perfectionism
- Worrying
- Ruminating
Consequences
For people with a depressive episode
A depression can have far-reaching consequences for daily life. People can often work, care for their family or follow education only partly, or not at all. Feelings of anxiety, gloom, despair and hopelessness can also be so unbearable that someone considers ending their life.
There are often physical complaints too, which can disrupt life and the people close by. For example:
- A disturbed sleep rhythm
- Loss of energy
- Changed appetite
- Constipation
- Loss of libido
Finally, people with a depressive episode have a raised risk of cardiovascular disease.
For the people around you
Living with someone with a depression is not easy. The capacity of partner, children and other close family and friends to adapt and to take things is often under pressure.
With so many negative signals from the person who has a depression, it is hard for the people around them to stay positive and show understanding. They can feel powerless, frustrated, lonely and desperate as a result.
Where do I find help?
Your doctor can help you. If the depression is severe or does not pass, talks with a psychologist (psychotherapy) are possible, and medicines may help.
Do you need help now?
PsychosisNet offers information. We do not offer a chat, a helpline or crisis support. If you or someone else is in immediate danger, call the emergency number in your country. If you are thinking about suicide, or you need to talk to someone now, see Need help now? for helplines by country.
Prof. dr. Ralph Kupka is professor of Bipolar Disorders at Amsterdam University Medical Center, and clinical psychiatrist at two large mental health centers: GGZinGeest in Amsterdam, and Altrecht in Utrecht. He is chair of the Dutch Foundation for Bipolar Disorders (KenBiS) and Vice-President of Education of the International Society for Bipolar Disorders (ISBD).
Ralph has been active in national and international research consortia of bipolar disorders since 1995, and chief editor of the first Dutch handbook about this illness. He has chaired guideline committees and is board member of AKWA, the quality institute for mental health in the Netherlands.
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