What Causes Depression? or, Why Can't I Just Feel Better?

Two children are bullied by the same aggressive child on the same playground.  One, frustrated  and hurt, seeks support from teachers and family, eventually moving on from the traumatic experience.  The other also seeks support from teachers and family, but eventually sinks into a chronic depression. At first, he's identified as an "angry child," or "loner," " a "sensitive boy," or just the child who doesn't fit in.  It takes an observant parent, interested teacher or, perhaps, a competent therapist to put two and two together--this kid is depressed.  


Given our increasing understanding of depression in children, it may not be surprising to know that, according to a Harvard University study, almost one in four children are clinically depressed.  What may actually surprise you (it surely surprised me) is a study published by Psychiatric Services (2002), which reported that the fastest growing market for antidepressants is--yes this is true--preschoolers.  Medication, and its place in depression treatment, is food for a future post. In the meantime...


So why does one child move through this trauma, and another, through no fault of his own, carry forward a dark feeling of hopelessness and despair?

The scientific community has a variety of explanations ranging from trauma (emotional and/or physical), genetics, neurochemisty, brain structure--even learned behaviors and beliefs.  Lifelong or chronic depression is thought to originate from childhood trauma including yelling or threats of abuse, sexual abuse, neglect, persistent and severe criticism, unclear or inappropriate expectations, separation from one's mother, exposure to violence (real or vicarious), poverty, racism and more.

Short-term depression is often attributed to loss or extreme trauma, physical or emotional or both.  Severe and persistent stress is also associated with depressive states.

Some studies suggest that depression is genetic in nature, but posit that the genetic tendency must be "triggered" by some stressful or traumatic event.

Neurochemical imbalance and structural problems in the brain are also cited as causes of depression. Serotonin levels have long been the target of most anti-depressants; recently, the presence of the stress hormone, cortisol, has been tied to the incidence of depression.

Finally, the things we learn--as children and as adults--can shape our reactions to the world as well as our ability to make functional decisions, causing not only stress but also situational or longer-term depression.

Regardless of the cause, depression is not simply a deep sadness. It's a more complicated, pervasive and difficult-to-shake disorder.  It's not a weakness or an inability to "take life's lumps."  It hurts. It can be overwhelming. And, while there's no definitive understanding of why it affects some people and not others, there are trends of understanding who it does affect. The research continues.

In the meantime, if you know someone--perhaps yourself--who seems perpetually sad, or feels hopeless more often than not, I invite you to exercise compassion.  No one who has ever felt true depression would ever wish it on anyone.

The good news is, that, with treatment, much headway can be made in lessening depressive symptoms and restoring those afflicted to happier, productive lives.

Feeling better--it can happen.

Coming soon--Myths About Depression: What It Is And Isn't.

Until then, thanks for listening.