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The exact cause of depression is unknown. There is evidence to suggest that depression is an illness. There are also many theories regarding further aspects of this diverse condition. Different causes may operate in different people. This may be why there is variation in the way depression develops, in the symptoms, and in the course.
Some facts about the causes of depression are:
There is clear genetic (inherited) factor in the cause of the condition. If someone in the family has depression, relatives have an increased risk of developing it. The overall risk is one in four for women, one in 10 for men. If a parent, brother or sister has the condition, this risk is up to three times greater. There is also an association between alcoholism and depression in some families, with men having increased risk of alcoholism, and women increased risk of depression.
A number of abnormal laboratory findings are seen in groups of people with depression, compared with groups who are well. These findings are not diagnostic, in that they are not seen in all people with the condition, but they are more frequent when the depression is more severe. The findings include sleep changes seen on recordings of brain electrical waves during sleep; changes in the daily cycle of levels of a hormone called cortisol, and changes in the regulation of thyroid hormone.
A number of different kinds of brain scan show changes in function in some brain areas during episodes of depression.
Changes in some of the brain chemical messenger systems occur in some people with depression. In particular, reductions in levels of two messengers called serotonin and noradrenaline seem to occur.
Stressful events in early life can increase the risk of later depression. Loss of a parent before age 18 may increase risk of later depression, as may other traumatic events such as childhood abuse (physical, sexual, emotional).
Stressful life events or situations such as divorce, social isolation or loss of a job can precipitate episodes of depression.
There are no factors which are seen in all people with depression - these things apply to some but not all.
The stress-vulnerability model suggests that these different factors together make a person more vulnerable to developing depression. Stress then acts to trigger episodes of illness. If your vulnerability is high, then the stress of daily living may be overwhelming and you become depressed. With lower vulnerability, higher levels of stress can be tolerated before triggering a depressive episode.
People with depression often believe they developed a mental illness because things have gone wrong in their lives - it could be poverty, abandonment, sexual or physical abuse, being in an unhappy family or whanau, feeling alienated from society or not living up to people's expectations.
Other people with depression cannot so easily find things that have gone wrong in their lives. They may agree with the view that their depression is genetic or biological in origin. A lot of people believe it is due to a combination of these things. Sometimes people think their mental illness is a punishment for their moral or spiritual failure. It's important to remember that it is not your fault you have depression.
Families and whanau, especially parents, can worry that they caused their child's depression. Sometimes they feel blamed by mental health professionals which can be very distressing for them. Most families and whanau want the best for their relative. It is important for them to understand what factors have contributed to their relative's problem and to be able to discuss their own feelings about this without feeling guilty or blamed.
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