Depression has no single cause; often, it results from a combination
of things. You may have no idea why depression has struck you. Whatever
its cause, depression is not just a state of mind. It is related to
physical changes in the brain, and connected to an imbalance of a type
of chemical that carries signals in your brain and nerves. These
chemicals are called neurotransmitters.
Depression is a combination of biological, genetic and psychological
factors. At the biological level, depression results from abnormal
levels of certain neurotransmitters in the brain. This can be caused by
changing levels of hormones, explaining why many people first experience
depression during puberty.
Some of the more common factors involved in depression are:
* Family history. Genetics play an important part in depression. It
can run in families for generations.
* Trauma and stress. Things like financial problems, the breakup of a
relationship, or the death of a loved one can bring on depression. You
can become depressed after changes in your life, like starting a new
job,
graduating from school, or getting married.
* Pessimistic personality. People who have low self-esteem and a
negative outlook are at higher risk of becoming depressed.
These traits may actually be caused by low-level depression (called
dysthymia).
* Physical conditions. Serious medical conditions like heart disease,
cancer, and HIV can contribute to depression, partly because of the
physical weakness and stress they bring on. Depression can make medical
conditions worse, since it weakens the immune system and can make pain
harder to bear. In some cases, depression can be caused by medications
used to treat medical conditions.
* Other psychological disorders. Anxiety disorders, eating disorders,
schizophrenia, and (especially) substance abuse often appear along with
depression.
What Causes depression?
The multiple causes of depression aren't completely understood.
Current research suggests possible genetic, familial, biochemical,
physical, psychological, and social causes.
Psychological causes (the focus of many nursing interventions) may
include feelings of helplessness and vulnerability, anger, hopelessness
and pessimism, and low self-esteem.
They may be related to abnormal character and behavior patterns and
troubled personal relationships. In many patients, the history
identifies a specific personal loss or severe stressor that probably
interacts with the person's predisposition to provoke major depression.
Depression may be secondary to a specific medical condition, for
example:
* metabolic disturbances, such as hypoxia and hypercalcemia
* endocrine disorders, such as diabetes and Cushing's syndrome
* neurologic diseases, such as Parkinson's disease and Alzheimer's
disease
* cancer (especially of the pancreas)
* viral and bacterial infections, such as influenza and pneumonia
* cardiovascular disorders such as heart failure
* pulmonary disorders such as chronic obstructive pulmonary disease
* musculoskeletal disorders such as degenerative arthritis
* GI disorders such as irritable bowel syndrome
* genitourinary problems such as incontinence
* collagen vascular diseases such as lupus
* anemia
Drugs prescribed for medical and psychiatric conditions as well as
many commonly abused substances can also cause depression.
Examples include antihypertensives, psychotropics, narcotic and
nonnarcotic analgesics, antiparkinsonian drugs, numerous cardiovascular
medications, oral anti diabetics, antimicrobials, steroids,
chemotherapeutic agents, cimetidine, and alcohol.
People who have low self-esteem, who consistently view themselves and
the world with pessimism or who are readily overwhelmed by stress, are
prone to depression. Whether this represents a psychological
predisposition or an early form of the illness is not clear.
It is important to remember that all of the depressive disorders are
treatable conditions.
Continue to read the rest of this article - next: what causes major
depression?
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