by Margaret Wood Sept. 19, 2017

According to the World Health Organization (WHO), 350 million people worldwide suffer from depression – and 20% of people with major depressive disorder develop psychotic symptoms.

In an article on depression written by Ann Pietrangelo and medically reviewed by George T. Krucik, MD, MBA on January 28, 2015 Pietrangelo states that:

”Sadness and grief are normal human emotions. We all have those feelings from time to time, but they usually go away within a few days. Major depression is something more. It’s a period of overwhelming sadness. It involves a loss of interest in things that used to bring pleasure. Those feelings are usually accompanied by other emotional and physical symptoms. Untreated, depression can lead to serious complications that put your life at risk. Fortunately, most people can be effectively treated.”

Types of Depression

According to the National Alliance on Mental Illness (NAMI), depressions are classified according to their unique identifiers:

Major Depression – a single bout or can be recurring leading to Persistent Depressive Disorder
Bipolar Disorder aka Manic Depressive Illness – cyclical with alternating highs and manias
Post-Partum – typically attributed to hormonal changes, lack of sleep and the overwhelming care of a new baby
Psychotic Depression – hallucinations, delusions or paranoia ae part of a major depression

This raises 2 question: Does depression stem from a single cause or event? Or is it a case of multiple causes – a compilation of issues resulting in mood change?

It can be either. Situations that trigger depression in one person may not affect another in the same way. However, in many cases there appears to be more than one reason. Sometimes the reason(s), or part of the reason, may be obvious…or not.

Here we will examine the 8 most common triggers of depression:

1. Is it Genes or Environment?

So far, no single gene has been identified as a contributing factor to depression. Yet studies indicate that depression may run in families. Statistically, if one parent becomes severely depressed, your chances of becoming depressed are approximately 8X more likely to occur – certain people therefore, may be predisposed to depression. Alternately, the environment rather than genes may have the most impact; when depression is the norm, it may become so ingrained that only complete removal from the toxic environment in conjunction with behavior modification therapy could start the healing process.

2. What are the Economic Impacts

Depression ranks among the top three workplace issues, following only family crisis and stress. (Employee Assistance Professionals Association Survey, 1996)
Depression’s annual toll on U.S. businesses amounts to about $70 billion in medical expenditures, lost productivity and other costs. (The Wall Street Journal, 2001, National Institute of Mental Health, 1999)
Depression accounts for close to $12 billion in lost workdays each year. Additionally, more than $11 billion in other costs accrue from decreased productivity due to symptoms that sap energy, affect work habits, cause problems with concentration, memory, and decision-making. (The Wall Street Journal, 2001, National Institute of Mental Health, 1999)

3. How Does Gender Impact Depression?

Women experience depression at twice the rate of men. This 2:1 ratio exists regardless of racial or ethnic background or economic status. The lifetime prevalence of major depression is 20-26% for women and 8-12% for men. (Journal of the American Medical Association, 1996)
Postpartum mood changes can range from transient “blues” immediately following childbirth to an episode of major depression and even to severe, incapacitating, psychotic depression. Studies suggest that women who experience major depression after childbirth very often have had prior depressive episodes even though they may not have been diagnosed or treated. (National Institute of Mental Health, 1999)

4. Alcohol

Seeking to escape depression, many people turn to alcohol as a form of self-medication; however, prolonged use of alcohol is also known to bring about depression. People that fall into this category are not capable of recognizing this; they need a support group, such as family and friends as well as professional support through professional counseling and therapy organizations.

5. Isolation and Loneliness

About six million people are affected by late life depression, but only 10% ever receive treatment. (Brown University Long Term Care Quarterly, 1997)
Solitude is not to be confused with loneliness. Most people enjoy a little alone-time; there’s a big difference though between solitude and loneliness.
Feeling socially isolated is confidence sapping and your inner voice begins to question your worth as a person and your value to society. The feeling that you have nothing to contribute and no one to turn to is highly stressful and can easily lead to depression.

6. Life events

Any number of major life events has the potential to result in depression. Job loss, divorce or relationship breakdown and bereavement are common examples.

7. How Does Illness Impact Depression?

Even short-term illnesses such as influenza can change mood, but some longer term or chronic conditions can be life changing.

Cancer: 25% of cancer patients experience depression. (National Institute of Mental Health, 2002)
Strokes: 10-27% of post-stroke patients experience depression. (National Institute of Mental Health, 2002)
Heart attacks: 1 in 3 heart attack survivors experience depression. (National Institute of Mental Health, 2002)
HIV: 1 in 3 HIV patients may experience depression. (National Institute of Mental Health, 2002)
Parkinson’s Disease: 50% of Parkinson’s disease patients may experience depression. (National Institute of Mental Health, 2002)
Eating disorders: 50-75% of eating disorder patients (anorexia and bulimia) experience depression. (National Institute of Mental Health, 1999)
Substance use: 27% of individuals with substance abuse disorders (both alcohol and other substances) experience depression. (National Institute of Mental Health, 1999)
Diabetes:5-27% of persons with diabetes experience depression. (Rosen and Amador, 1996)

8. Personality

Whether due to genes, early life experiences or a combination of both, the argument is that from early adulthood some people develop a generally gloomy view on life and become critical, negative, unhappy pessimists who worry and feel personally inadequate. People with these traits are argued to be more likely to suffer with major depressive episodes.

Treatments for Depression?

There are many options to the treatment of depression, with successful outcomes:

Up to 80% of those treated for depression show an improvement in their symptoms generally within 4-6 weeks of beginning medication, psychotherapy, attending support groups or a combination of these treatments. (National Institute of Health, 1998)
An estimated 50% of unsuccessful treatment for depression is due to medical non-compliance. Patients stop taking their medication too soon due to unacceptable side effects, financial factors, fears of addiction and/or short-term improvement of symptoms, leading them to believe that continuing treatment is unnecessary. (DBSA, 1999)
Participation in patient-to-patient support group improved treatment compliance by almost 86% and reduced in-patient hospitalization. Support group participants are 86% more willing to take medication and cope with side effects. (DBSA, 1999)