What causes depression?
There is no single cause that has been identified, but scientists believe that genetic factors may play a role in depression. What scientists and clinicians agree on is that depression is a real illness and that having depression does not mean that the person who has it has a weak or flawed character but rather, their brain chemistry has become abnormal. Specifically, substances in the brain that are called neurotransmitters such as Serotonin, Dopamine and Norepinephrine have been shown to act differently in people with depression then in people without depression.
The advanced technology of brain imaging has enabled us to actually see the differences between the brains of depressed and non-depressed people. However, identifying differences in brain activity only implies that these differences are there when a person has depression. They do not prove that these differences cause the depression because we do not know if the differences were there before the onset of depression. Mental health professionals now agree that depression is brought about by a combination of physiological, psychological and social factors. Some people may be genetically predisposed to depression but will only experience it if certain psychological and social factors simultaneously come into play.
Depression is a serious illness that is often devastating and should be treated as soon as possible. The following are the types of treatment that have been found effective for treating people with depression:
Cognitive-Behavioural Therapy (CBT) – This is a short term, highly structured therapy that explores the connections between behaviours, feelings, physical sensations and the environment. For example, the way an individual thinks, influences the way they feel. Therefore, identifying thought patterns and assessing their impact on the person’s mood and then learning to change them, is an important part of CBT. Also, behaviours affect and are affected by thoughts and feelings. Realizing how thought, feelings and behaviours are interrelated and working on creating some changes in each one of them has been found to be helpful in alleviating the symptoms of depression. CBT has been found to be as effective as medication in treating mild to moderate depression.
Interpersonal Psychotherapy (IPT) – This therapy is a brief and highly structured model of treatment that addresses interpersonal issues in depression. It is based on the notion that psychological problems occur in social contexts and are influenced as well as influence these contexts. The problem areas that are explored by IPT are: 1. Interpersonal disputes, 2. Role transitions, 3. Grief and, 4. Interpersonal deficits. IPT usually runs for 12-16 hour-long sessions. There are a variety of therapeutic techniques, which are used in IPT sessions, such as Clarification, Supportive listening, Communication analysis and Encouragement of affect. Research that compared a few treatment options such as medication and CBT has found IPT to be as effective for the treatment of depression as the other treatments.
Couples Therapy – For people with depression who experience relationship distress, couples therapy has been found to be highly effective. Couples therapy for depression focuses on the interrelationships between the quality and nature of the couple relationship and the depression. That is, it explores the ways the depression affects the couple relationship and vice versa. In a recent study out of London, UK, researchers found that couples therapy was as effective as anti-depression medication in alleviating symptoms of depression. Couples therapy was more effective than anti-depressants in terms of relapse prevention as it was measured two years after completion of treatment. Read more about couples therapy.
Medications – Anti-depressants, such as Prozac, Zoloft and Paxil (the SSRI & SNRI groups) have been found to be highly effective in treating depression. The new generation anti-depressants have fewer side effects than older generation medications and are therefore more tolerable. One of the challenges with anti-depressants is that during the first few weeks their positive effect on symptoms is minimal or non-existent, while the side effects may be bothersome. After approximately 6 weeks, things usually turn around and the person may start to feel better. Medication should be prescribed and supervised by a physician and should be taken exactly as instructed.
It is often recommended to combine medication with another type of treatment such as CBT, because medications do not treat the psychological and social roots of depression. Contact your counsellor first.