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More than just the result of brain chemistry, the causes of depression are complex. Very often a combination of genetic, psychological and environmental factors is involved. At times, however, depression occurs for no apparent reason. Regardless of the cause, depression is almost always treatable.

Genetics, family history
Some types of depression run in families. Susceptibility to a depressive disorder is two to four times greater for people whose parent had the disorder. For those whose parent had bipolar disorder, the risk is six to eight times greater. However, depression can also occur in people who have no family history of depression.

Genetic makeup can be a factor, but the vulnerability to depression could also be the result of nurture rather than nature: Family members may live in the same environment, share similar values and be subjected to similar stressors.

Stress
Psychological and environmental stressors can contribute to a depressive episode. But, social, psychological, and genetic factors act together to predispose to, or protect against, depression.

The death of a loved one is one of the most powerful life stressors. Parental neglect or abuse, major family or work changes, a serious loss or financial problems can also be stressful enough to trigger a depressive episode.

Negative thinking
How individuals view and interpret stressful events contributes to their risk of depression.

Distorted interpretations of stressful events may be internalized, exaggerated or seen as irreversible: "This event will change everything," "This is all my fault," or "I'll never be able to recover from this."

Negative thinking by itself cannot cause depression. But, in combination with mildly depressed mood and adverse life events, a downward spiral can lead to depression or cause a recurrence of depression.

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Behavior
Depressed mood can cause a person to become less active, physically and socially. They withdraw from people and stop participating in enjoyable activities. The behaviors that accompany a down mood can, themselves, worsen the depression.

Physical conditions
Studies have found that physical changes in the body can be accompanied by mental changes. Medical illnesses such as stroke, a heart attack, cancer, Parkinson's disease, and hormonal disorders can cause depressive illness.

Gender
Women experience depression about twice as often as men. Many hormonal factors may contribute to the increased rate of depression in women. Many women also face additional stresses such as responsibilities both at work and home, single parenthood, and caring for children and aging parents.

Take care of yourself
If you are at risk of depression or are living with the disorder, there are steps you can take to keep depression from taking over your life.

• Inform yourself about the illness. Consult with your doctor.
• If you and your doctor decide on medications, take them as prescribed - don't skip.
• Find a therapist you feel comfortable with. Learn how to keep negative thinking from bringing you down.
• Consider a support group.
• Eat a healthy diet and exercise regularly.
• Stay involved and engaged. Participate in enjoyable activities and keep in touch with people.

You are not your depression. You are a person who is coping with it.

Related articles
All about antidepressants
Understanding depression

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Sources
NIMH
Mental Health: A Report of the Surgeon General

Page updated March 1, 2010