What causes depression?
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Here you can learn about what causes depression. But there are no easy answers.
We know exactly what causes flu as we can identify the virus, but we don't know exactly what causes depression. However, we do know a number of important things about depression.
We know that it probably arises due to a combination of:
- Genetic/hereditary susceptibility.
- Factors during your upbringing.
Here you can read about what causes depression:
- Genes
- Sex
- Age
- Socio-economic
- Psychological trauma
- Sexual abuse
- Divorce
- Unemployment
- Bereavement
- Illness
- Pregnancy and birth
- Psychological shocks preceding first depression
Genes
Depression may run in families. If your parents, children or siblings have repeated bouts of depression, there is unfortunately a 20% risk that you too will have one or more episodes of depression.
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Sex
Women are twice as likely as men to develop depression.
However, it has been argued in recent years that in reality more men suffer from depression than originally thought, but they may be more reluctant to seek help than women. Depression manifests itself differently in men and many don't realise that they're suffering from depression. This results in the low percentages found in studies. Read more about male depression...
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Age
You can develop depression at any age but the risk is slightly higher for women aged between 40 and 50. Unfortunately the risk of having more than one bout of depression increases with age. It is important to note that depression is also common among young adults in the 18-24 year old age group. If you do not fall into one of these age groups it does not mean that you are not depressed.
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Socio-economic
The link between social status and depression has yet to be definitively confirmed but people in a low socio-economic group seem to be at a greater risk of developing depression.
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Psychological trauma
Some people who have been exposed to psychological shocks or traumas react by developing depression.
Others react with anxiety or alcoholism. Some do not have any psychological damage. Your reaction is largely dependent on your genetic make-up and your personality.
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Sexual abuse
People who have been subjected to sexual abuse during childhood seem to be at increased risk of depression.
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Divorce
We don't know whether divorce increases the risk of depression. People suffering from depression are more likely to be divorced than other people, but we don't know whether people get depressed because of the divorce or get divorced because of the depression.
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Unemployment
People who are depressed are more likely to be unemployed. But we don't know whether people get depressed because they are unemployed or are unemployed because they are depressed.
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Bereavement
You will probably be surprised to learn that there is no definite link between the death of a close friend or relative and the risk of developing depression. Grief is different to depression unless it lasts for a very long time or becomes incapacitating, in which case you may become depressed.
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Illness
Physical illness increases the risk of depression. Nearly all types of illness can lead to depression. This applies to both minor problems like the flu and serious problems such as coronary thrombosis and cancer.
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Pregnancy and birth
The following article has been written for DepNet by a prominent Australian psychiatrist.
Postnatal Depression
Dr. Jon Rampono, Consultant Psychiatrist
About 14% of women in Australia who deliver a baby will develop a clinically significant depressive disorder in the first 12 months after birth.
The great majority of women will start having symptoms within 3 months of delivery. However, a smaller percentage will first experience the symptoms some time later within that first year.
In addition, a further 12% will experience some symptoms of depressive disorder not enough to warrant a diagnosis of clinical depression but serious enough to have a significant impact on themselves and possibly their relationship with their baby and/or partner.
Therefore, around 1 in 4 women having a baby in Australia will experience the negative impact of a depressive disorder in the first 12 months after the birth of their baby.
Risk Factors
A number of factors increase the risk for postnatal depression however, it is important to note that none of these are absolute causes in their own right. These include:
- A past history of depressive disorder
- A family history of depressive disorder
- Major changes in personal circumstances e.g. moving home, renovating a house
- Problems in the relationship with the father of the baby
- Perceived lack of support in the pregnancy and the postnatal period, significant disparity between expectations of motherhood and the reality of motherhood
- Unexpected and major medical complications around the time of delivery
- A baby who is perceived as “difficult” in relation to sleeping problems, feeding and/or reflux.
Symptoms
Postnatal depression is not simply about feeling down or not coping. Postnatal depression involves a wide range of clinical symptoms that are present for at least 2 weeks. These include:
- Low mood
- Feeling particularly worse on waking in the morning or in the evening
- Changes in sleep pattern, difficulty going off to sleep in the evening, difficulty returning to sleep if you wake in the middle of the night, waking too early in the morning or hypersomnia, sleeping excessively
- Reduction in appetite and/or increase in comfort eating
- Reduction in interest in household chores, looking after the baby and/or leisure
- Low libido
- Tearfulness
- Irritability
- Despair
- Fleeting thoughts of either escaping from it, feeling that a fatal, unintentional accident would not be such a bad thing or, in some cases, actively thinking about ending your own life
- More impairment in memory, concentration and/or decision-making more than what usually occurs for many women in the postnatal period
- Reduction in the quality of enjoyment of the day
- Reduced energy
- Feelings of guilt lack of self-worth and failure as a mother.
- In many women these feelings of depression are accompanied by varying degrees of anxiety. In some people there are physical symptoms of anxiety including chest tightness, palpitations, difficulty in breathing, headaches, tremor and/or irritable bowel and bladder.
In more severe cases, panic attacks, feeling unable to cope with crowds and/or feeling dissociated from oneself or the environment may occur.
The above symptoms may occur at different times in all normal people. However, if there are any concerns about ongoing symptoms and/or the number of symptoms present, it is very important to be assessed.
Where to get help
Many people find it valuable to talk to a trusted friend to get an outside perspective. Many family physicians have a specific interest in women’s health and in some cases, postnatal depression in particular.
Some Psychologists and Psychiatrists have a special interest in postnatal depression. In most cases, a family physician or a nurse can direct you to these individuals. Please do not feel embarrassed or uncomfortable about seeing a specialist in this regard. Very few people would be embarrassed about seeing a Neurologist about a persistent headache, migraine or double vision.
Postnatal depression is a treatable recognised disorder and not a personal failure.
Management of postnatal depression is best done with the support and involvement of a partner. Most men are troubled, bewildered and/or exasperated by the changes that have unravelled in front of their eyes. Information and a clear management strategy are very valuable.
Steps in Management:
- A full medical assessment
- Explanation and information
- Outlining treatment strategies
Management Options:
Personal and Environmental Changes
In many cases, an understanding of the matter and the implementation of personal and environmental changes are all it takes to reverse the course of postnatal depression.
These options would include things such as:
- The partner doing the feeds and looking after the baby until around midnight enabling the mother to get some sleep before being woken for the first feed at night.
- Practical assistance with household chores,
- Time out from baby,
- Return to previous activities such as exercise, leisure or manageable parts of a previous job.
Counselling, Cognitive Behavioural Therapy and/or Psychotherapy
Medication
This should be considered in cases of moderate to severe postnatal depression.
Usually, medication consists of one of the newer antidepressants.
There is now extensive information about the use of antidepressants in breastfeeding. Your Family Physician or Specialist can access this information for you.
Antidepressants are not addictive. Antidepressants will not make you happy. They simply reverse the medical symptoms of Depression and enable a woman to be the mother she wishes to be.
In Summary
Postnatal depression can have a profoundly negative effect on a woman and her baby at this important stage of her life that should be a time of great fulfilment and joy.
Postnatal depression is potentially dangerous.
Postnatal depression is an eminently treatable and manageable Disorder.
The first step is acknowledgement that this may be occurring followed by an appropriate and thorough assessment leading to a logical plan and pathway out of the shadows of a Mood Disorder into mothering in its fullness.
If you are concerned you have postnatal depression please contact your family physician.
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Psychological shocks preceding first depression
Many people suffering from recurring episodes of depression experienced a major psychological trauma prior to their first bout. Subsequent episodes then follow in the wake of lesser psychological shocks. You do not necessarily need a trigger to become depressed.
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