If you get a G.P. (crèole term for heartbreak or when your lover leaves you), lose a job (or can’t find one), lose your house or a family member, chances are you’re going to feel pretty low, down, depressed.
This is what you might call exogenous depression, or depression brought about by external factors. In medical lingo, we talk about endogenous depression, clinical depression, unipolar disorder, or Major Depression Episode, which is an actual illness from within.
As it turns out, you may have had a tendency to clinical depression, which may not have surfaced without an exogenous factor taking place, much like having a tendency to schizophrenia which only surfaced after smoking a spliff (marijuana).
In looking at depression in an overall sense, here are a few of the factors that can play a role in causing it.
– Biological. Although we still don’t know exactly what happens in the brain when people become depressed, studies show that certain parts of the brain don’t seem to work normally. Among the many neurotransmitters that pass from one nerve cell to the other are Serotonin, Dopamine and Norepinephrine. It is thought that low levels of serotonin “permit” levels of norepinephrine to drop, leading to the symptoms and signs of depression, the endogenous “from within” type.
– Genetics. If depression runs in your family, you have a higher chance of becoming depressed. This again is more in keeping with the endogenous, Unipolar Disorder I touched on above.
– Gender. Studies show that women are about twice as likely as men to become depressed. Why? We don’t know. It may be that the hormonal changes that women go through at different times of their lives may be a factor.
– Age. Elderly people are at higher risk of depression. This can be compounded by other (external) factors – living alone and having a lack of social support.
– Health Conditions. Conditions such as cancer, heart disease, thyroid problems, chronic pain, and many others increase your risk of becoming depressed.
– Trauma and Grief. Trauma, such as violence or physical or emotional abuse – early in life or more recent – can trigger depression. Grief after the death of a friend or loved one – I mentioned this in the first line – can do the same thing.
– Changes and Stressful Events. It’s not terribly surprising that people might become depressed during stressful times – such as during a divorce or while caring for a sick relative. But even positive changes – like getting married or starting a new job – can sometimes bring on a depression.
– Medications and Substances. A lot of prescription drugs can cause symptoms of depression. Alcohol or substance abuse is common in depressed people. It often makes their condition worse.
Some people have a clear sense of why they become depressed, that is, what the external factors are. Although time often takes care of things, if the depression that results interferes with your social and/or occupational functioning, you are advised to seek help and jump ahead of time.
For those cases that have to do with genetics and biology, over which you have no control – the endogenous depression – the most important thing to remember is that the depression is not your fault. It’s not the result of a character flaw. It’s a disease that can affect anyone, and regardless of the cause, there are many ways to treat it.
This is a fascinating subject, many more aspects of which I could get into. But because I AM NOT A PSYCHIATRIST, I think it’s best to leave it to one, like DR. Griffin Benjamin, to deal with if he’s so inclined.
I do advise you, however, if you have been told you suffer from depression, or feel like you do, to see the psychiatrist. If you know anyone with the problem, get them to avail themselves of the available services as well. There’s nothing to feel badly about, anymore than you should feel badly about having diabetes or cancer, over which you have no control.
See you next week.
Dr. Emanuel, based in the Commonwealth of Dominica, has been an educator of medical professionals, in training and the public, for over 20 years.