Many people who suffer from depression, and those close to them, ask themselves what brought the depression on and whether anything can be done about it. Depression is nobody’s fault, and it has no single cause. Experts agree that it takes several factors coming together to bring on a depression.
Depression occurs more often in some families. It is therefore assumed that a genetic predisposition plays an important part. Neurobiological disturbances are involved in the development of depression as well. In the view of many researchers, certain neurotransmitters in the brain, among them serotonin, dopamine and noradrenaline, go out of balance during a depression. So there is a metabolic disturbance in the brain. The activity of the so-called limbic system — the part of the brain regarded as the system that regulates stress — also appears to change.
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It brings on depression....
Some people have genetic and neurobiological preconditions that make them more susceptible to depression. Picture a barrel that can be filled up at different speeds. The water flowing into the barrel stands for stress at work and in private life, or for acute stress such as the death of a close relative or the loss of a job.
The barrel itself is people. In some people the “capacity” is smaller — their vulnerability is high, and a depression develops.
Features of development and of personality — an early loss of parents, say, or a lack of self-worth — are also discussed as possible factors in the development of depression. Chronic illnesses such as diabetes, multiple sclerosis or cancer, and even some medicines, can bring on depression too. These include antibiotics, drugs that lower blood pressure and cholesterol, heart medicines and medicines for Parkinson’s disease and epilepsy.
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Are there other risk factors for developing depression?
In general, anyone runs the risk of falling into depression. From scientific research, however, we know that some people are more prone to depression than others. These include:
- Women
- People who live alone
- People living in big cities
- The unemployed
- People with a low level of education
- Alcoholics, heavy drinkers and drug addicts
It is important that you, as the person affected, should not feel shame or responsibility for your depression. Because these feelings can make the depression worse. You are no more to blame for your mental illness than a person suffering from rheumatism or from any other organic disease.
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What are the typical symptoms of depression?
A depressive illness can show itself in different ways. Its characteristic features are low mood and a loss of interests and of drive. People suffering from depression can find it hard to rouse themselves for such things as housework or a walk. Conversations and even watching television are felt to be exhausting. Social contacts are no longer kept up, and even personal hygiene and eating can become a burden. Some patients have no self-confidence left, they feel worthless or guilty; others worry excessively about their future. Everyday life is marked by a lack of energy and an inner emptiness. In most patients depression comes together with a feeling of anxiety.
Often, however, it is complaints about the physical condition that come to the fore, for example
- Sleep disturbances (difficulty falling asleep and / or staying asleep)
- Fatigue, tiring easily
- Discomfort in the gastrointestinal tract (pressure in the stomach, constipation or diarrhoea)
- Reduced appetite, weight loss
- Headache or other pain
- Cardiovascular problems (cardiac arrhythmia, a racing heart, shortness of breath)
- Disturbances of memory and of concentration
- A feeling of pressure in the throat and chest, of tightness in the throat (the so-called “globus sensation”).
- Dizziness, flickering before the eyes, blurred vision
- Muscle tension, sudden shooting pain
- Sexual disorders (loss of sexual interest, impotence)
Because the symptoms are so varied, the family doctor often fails to recognise depression. That is why it is important that you should not tell your doctor about your physical symptoms alone. Talk about how you feel as well, and about the worries or fears that trouble you.
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The concept of “neurosis” was introduced into medicine in 1776 by the Scottish physician William Cullen. The content of the term has been revised more than once, and to this day it has no single generally accepted definition. It should also be borne in mind that in medicine and
