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Unfortunately, there is no simple answer to what causes depression because several factors may play a critical part in the onset of the disorder. These include a genetic or family history of depression, psychological or emotional vulnerability to depression, biological factors, and life event or environmental stressors. The fact that you may be undertaking one type of treatment (e.g. antidepressant medication), it does not mean your depression is entirely biological. What it does mean is that often depression can be effectively treated by focusing on one area, such as the biochemistry in the brain.

The type of treatment recommended, in addition, is often influenced by the severity of your depression. If someone is severely depressed, for instance, it is difficult for the person to undertake the ‘talking therapies’. As a result, medication may be the first stage of treatment, followed by psychotherapy as a second stage of intervention. Once you are feeling somewhat better, you may therefore be able to tolerate talking about other life problems that contribute to your depression.

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1. GENETIC AND FAMILY HISTORY

A family history of depression does not necessarily mean that children or other relatives will develop major depression. However, people with a family history of depression have a slightly higher chance of becoming depressed at some stage in their lives. There are several theories to explain this phenomenon. First, genetic research suggests that depression can run in families. Studies of twins raised separately have shown that if one twin develops the disorder, the other has a 40 to 50 per cent chance of also being affected. This rate, even though it is moderate, suggests that some people may have a genetic predisposition to developing depression.

Second, a genetic predisposition alone, however, is unlikely to cause depression. Other factors, such as traumatic childhood or adult life events, may act as triggers. The onset of depression may also be influenced by what we learn as children. Some people may have been exposed to the depressive symptoms of their parents and have learned this as a way of reacting to certain problems. As adults, they may go on to use these strategies to deal with their own life stressors. In short, growing up with one parent who has been depressed puts a child at a 10 per cent risk of developing the disorder. If both parents were depressed, there is a 30 per cent risk.

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2. LIFE EVENTS OR ENVIRONMENTAL STRESSES

Some studies suggest that early childhood trauma and losses, such as the death or separation of parents or adult life events like the death of a loved one, divorce, the loss of a job, retirement, serious financial problems, or family conflict — all of these can lead to the onset of depression. Experiencing multiple severe and prolonged difficult life events magnifies a person’s chances of developing a depressive disorder. Once depressed, it is common for a person to remember earlier traumatic life events, such as the loss of a parent or childhood abuse, which make the depression worse.

Furthermore, living with chronic family problems can also seriously affect a person’s mood and lead to depressive symptoms. People living in emotionally abusive or violent relationships can feel trapped both financially and emotionally, as they feel hopeless about their future. This is particularly true of mothers with young children. The ongoing stress and social isolation associated with these family circumstances can lead to depressive symptoms. Nevertheless, once a person develops a serious depression, he or she may need intensive treatment before feeling able to deal with the situation or life stressors that triggered the onset of the illness.

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3. BIOLOGICAL FACTORS

Depression may appear after unusual physiological changes, such as childbirth or other infections. This has given rise to the theory that hormonal or chemical imbalances in the brain may cause depression. Studies have shown that there are differences in the levels of certain biochemical elements between people who are depressed and those who are not. The fact that depression can be helped by antidepressant medication and brain intervention therapies tends to support this theory.

Perhaps, “Seasonal Affective Disorder (SAD)” is a good example of how biology and personality may work together to influence the onset of depression. Researchers are investigating whether chemicals in the brain that regulate mood, sleep and appetite are affected by changes in levels of light. What’s more, research has also discovered that people experiencing sad seem to be highly sensitive to their own feelings and events around them, and that these reactions are amplified by seasonal changes in light levels. Whatever it is, for many people with depression and their families trying to understand the various theories that explain the onset of depression can be very confusing. While research has yet to fully explain the causes of depression, it is important to know that effective treatments are still available.