Causes Of Depression Among Adults Essay
The Key Factor Which Causes Depression: Genetic or Environment
Depression is a quite widespread disease of nowadays. Scientific sources and mass media already have some success in conveying to society the thought that depression is something more than negative mood that can changed by itself. It is the disease, and like any other disease, it requires treatment. Even though depression can be successfully cured, it is always the better way to prevent the disease. However, preventing depression requires at first answer the question about the causes of this disease. There are different views about this issue. Some researchers claim that the main cause of depression is genetic. Others claim that environment is more important in the context of depression. However, as it often happens, and as the studies confirmed, the both sides have correct suggestions and the both causes, genetic and environmental, are important for the development of depression.
As it was already mentioned above, there are some researchers who claim that genetic factor is the main cause of depression. For example, Lohoff (2010) noticed in the study that genetic factors play important roles in the development of major depressive disorder (MDD), “as indicated by family, twin, and adoption studies, and may reveal important information about disease mechanisms” (p. 539). As one can see, there are some studies that confirm the importance of genetic factor for the development of depression. However, not only the studies about the family, twin, and adoption show such results. England & Sim, (2009) refer to the studies of Kendler et al., (2006) and Sullivan, Neale, and Kendler, (2000), claiming that “about one-third of the risk for major depression in adults derives from genetic differences between individuals.” Moreover, the researchers even point to the specific genes that are related to the development of depression. Thus, England & Sim (2009) noticed that there are “several genetic polymorphisms have been linked to increased risk of depression in response to stress. Foremost among these are genes of the serotonin system (5-HT).” The fact that there are specific genes that take part in causing depression make the thesis about genetic as the key factor that causes depression especially strong. In any case, it must be clear that for depression, as for any other mental disease, genetic factor has quite an important role. Thus, Hyman (2000) wrote that “family, twin, and adoption studies have shown that, for schizophrenia, autism, manic depressive illness, major depression, attention deficit hyperactivity disorder, panic disorder and other mental illnesses, the transmission of risk is due to heredity” (456). In this way, there is a list of many mental disorders caused by genetic factors, and it is logical that depression can be among them. Besides, as it was mentioned above, the studies found specific genes that are related to the development of depression.
However, there is one more view on this issue. As far as depression is mental health, it is related not only to the physical state of human body, including all complex process and part of it but also with the human psyche. It is known the fact that human psyche and state of the body are related. Depending on the human emotions, the body produces different types of hormones which can affect the state of the body in one or another way and causes a person’s mood. Taking this into account one can consider an environmental factor as that which causes depression, comparing it with effect on low temperature on a human body. It is known fact that if a human is under the influence of low temperature long enough, he or she can get sick. However, it is also known that the low temperature by itself is not the reason for disease. Impact of low-temperature affects the human body, in particular, reduces the immunity, and that is why risks to get sick increases after the cases of freezing. The environmental factors can have the similar relationship with the depression. Even though the negative environmental factors can not be the main reason for depression they can have a generally negative effect on the mental state of the human, thus, they become the key factor that causes depression because without their impact it could not develop. There are some studies that confirm that the environmental factors cause depression. For example, Saveanu & Nemeroff (2012) claim that “onset of mood disorders such as depression is undoubtedly impacted by stressful life events that occur in childhood” (p. 59). The authors considered the study in which the researchers paid attention to the experience of approximately two thousands women of various socioeconomic levels, and came to the conclusion that “those with a history of childhood physical or sexual abuse had an increased risk of depression and anxiety” (p. 59). The study also showed that women with a history of childhood abuse “have a four-fold increased risk of developing depression” and “early life trauma has also been shown to impact the clinical course of depression” (p. 59). Generalizing the conclusion of the study, the researchers identified four main points about patients with depression who have a history of childhood trauma. The researchers wrote that such patients have “(a) lower rates of remission and recovery, (b) longer episodes of depression, (c) a more chronic disease course, and (d) earlier onset of depressive symptoms” (Saveanu & Nemeroff, 2012, p. 59). Tese results clearly show that the life experience and environmental factors are significant as causes of depression.
However, it is not only one study that shows the importance of environmental factors in the context of depression. Beattie (2005) also identifies interpersonal relationships among the others factors that cause depression. Considering the types of interpersonal relationships that can cause depression Beattie (2005) identifies the following types: “(a) within the family, such as between the parents and between parents and children; (b) the social environment where differences in ethnicity and social class come into play; and (c) interactions between genders across age groups for both females and males.” These interpersonal relationships are quite clear as the causes of depression. The first two types are environments where a person is forced to be the most of the time. It is clear that issues in the family when it is not occasional difficulties but the permanent tensity, it will cause a permanent stressful state in which person can be vulnerable to mental disorders. The same is with another type of social environment in which a person forced to be almost every day. Interactions between genders, or, in some cases it can be within one gender, also can be significant for causing depression. Interpersonal relationships such as friendship or romantic relationships can be significant for personality; thus their breach or absence can have a negative impact on a person’s mental state, and that also can be the cause of depression. Moreover, there is one more study that confirms relation of environmental factors and depression. Peyrot et al. (2013) wrote that “stressful life-events, sexual abuse, and childhood trauma were significantly more frequent and educational attainment was significantly lower in major depressive disorder patients compared to healthy controls” (p. 94). It can be clear that there are some traumatic life-events, which can affect the mental state of a person during the whole life, especially if such events happened in childhood. In this way, the facts shown above proves that there is a strong relationship between environmental factors and depression and that environmental factors can be the factors that cause depression.
As one can see from the facts shown above, the both factors, genetic and environmental, are important for the development of depression. In fact, this is the correct answer on the question about the key factor which causes depression – the both of them. One can notice that it is not only the compromise found between two opposite but the fact confirmed by the scientific studies. Thus, Saveanu & Nemeroff (2012) wrote that between genetic predisposition to depression and the impact of early traumatic experiences during critical phases of development there is a strong relationship. The researchers noticed that even though early life stress increases a risk of depression, “there are important differences in the way individuals respond to the same stressful event, and these differences may be explained in part by genetic factors” (Saveanu & Nemeroff, 2012, p. 60). In this way, the authors claim that the both factors – genetic and environmental are important for the development of depression. Some researchers paid attention to the specific impact of the genes and noticed that “the short form of the gene triggers a more intense activation of the amygdala, also known as the cerebellar tonsil, a brain structure involved in emotions and in the recognition of danger signals” (CNRS (Délégation Paris Michel-Ange), 2011). The researchers also noticed that “the activity of the amygdala varied according to not only to the form of the gene, but also to the type of mental activity” (CNRS (Délégation Paris Michel-Ange), 2011). They came to the conclusion that “the stress experienced during the year also affected the influence of the gene on the activation of the amygdala – such “genetic-environmental” interaction being itself modified by the individual’s mental activity” (CNRS (Délégation Paris Michel-Ange), 2011). In this way, an importance of impact of both, genetic and environmental factors are confirmed by the facts shown above. England & Sim (2009) also come to this conclusion writing that that gene-environment correlations contribute to outcomes and appeals to the example when “genetic factors may influence a depressed person’s parenting styles as well as the offspring’s heritable traits so that the child’s genotype and rearing environment are correlated.” In this way, the authors show the importance of the genetic factors. However, they also pay attention to their correlation with environmental factors, writing that “youth with particular heritable characteristics evoke reactions from others and select or create experiences that are congruent with their heritable characteristics—processes that might increase the likelihood of depressive outcomes under relevant conditions” (England & Sim, 2009). Carola et al. (2008) also pay attention to the correlation between the genetic factors and environmental factors. They used scientific approach and paid attention to the functions of gene, writing that “alterations in hippocampal gene expression and function underlie at least part of the interaction between 5-HTT and rearing environment and point to a role for this structure in the increased anxiety and depression-related behavior that is a risk factor for major depression” (Carola et al., 2008, p. 845). This result shows the correlation between the genetic factors and environmental factors in the context of the depression on the level of chemical processes in the human body. Considering the correlation between genetic and environmental factors one can see their close correlation. On the one hand, the genetic factors cause some predisposition to depression. On the other hand, without some environmental factors, this predisposition can never develop. However, in some cases, the impact on the only one factor – genetic or environmental can be enough for development of depression.
In this way, the above was considered the different views on the issue of the key factors which cause depression. There are different views about this issue. Some researchers claim that the key factor is genetic and show evidence to confirm this statement, including the studies which pay attention to the chemical processes in human body. Other researchers claim the key factor is environmental and confirms their statement with the studies which considered the different groups of people and came to the conclusion that people who felt an impact of negative environmental factors have a higher propensity for depression. However, as the one more type of the studies shown the both factors have high importance for developing of depression; thus the both factors can be key.
Beattie, G. (2005). Social Causes of Depression. Personalityresearch.org. Retrieved 31 August 2017, from http://www.personalityresearch.org/papers/beattie.html
Carola, V., Frazzetto, G., Pascucci, T., Audero, E., Puglisi-Allegra, S., & Cabib, S. et al. (2008). Identifying Molecular Substrates in a Mouse Model of the Serotonin Transporter × Environment Risk Factor for Anxiety and Depression. Biological Psychiatry, 63(9), 840-846.
CNRS (Délégation Paris Michel-Ange). (2011). Depression: Combination of environmental, psychological and genetic factors. Sciencedaily.com. Retrieved 31 August 2017, from https://www.sciencedaily.com/releases/2011/11/111103143518.htm
England, M., & Sim, L. (2009). Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention. Ncbi.nlm.nih.gov. Retrieved 31 August 2017, from https://www.ncbi.nlm.nih.gov/books/NBK215119/
Hyman, S. (2000). The genetics of mental illness: implications for practice. Bulletin Of The World Health Organization, 78(4), 455-463.
Lohoff, F. (2010). Overview of the Genetics of Major Depressive Disorder. Current Psychiatry Reports, 12(6), 539-546.
Peyrot, W., Middeldorp, C., Jansen, R., Smit, J., de Geus, E., & Hottenga, J. et al. (2013). Strong effects of environmental factors on prevalence and course of major depressive disorder are not moderated by 5-HTTLPR polymorphisms in a large Dutch sample. Journal Of Affective Disorders, 146(1), 91-99.
Saveanu, R., & Nemeroff, C. (2012). Etiology of Depression: Genetic and Environmental Factors. Psychiatric Clinics Of North America, 35(1), 51-71.
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According to the Centers for Disease Control and Prevention (CDC), 7.6 percent of people over the age of 12 have depression in any 2-week period. This is substantial and shows the scale of the issue.
According to the World Health Organization (WHO), depression is the most common illness worldwide and the leading cause of disability. They estimate that 350 million people are affected by depression, globally.
- Depression seems to be more common among women than men.
- Symptoms include lack of joy and reduced interest in things that used to bring a person happiness.
- Life events, such as bereavement, produce mood changes that can usually be distinguished from the features of depression.
- The causes of depression are not fully understood but are likely to be a complex combination of genetic, biological, environmental, and psychosocial factors.
Depression is a mood disorder characterized by persistently low mood and a feeling of sadness and loss of interest. It is a persistent problem, not a passing one, lasting on average 6 to 8 months.
Diagnosis of depression starts with a consultation with a doctor or mental health specialist. It is important to seek the help of a health professional to rule out different causes of depression, ensure an accurate differential diagnosis, and secure safe and effective treatment.
As for most visits to the doctor, there may be a physical examination to check for physical causes and coexisting conditions. Questions will also be asked - "taking a history" - to establish the symptoms, their time course, and so on.
Some questionnaires help doctors to assess the severity of depression. The Hamilton depression rating scale, for example, has 21 questions, with resulting scores describing the severity of the condition. The Hamilton scale is one of the most widely used assessment instruments in the world for clinicians rating depression.
What does not class as depression?
Depression is different from the fluctuations in mood that people experience as a part of normal life. Temporary emotional responses to the challenges of everyday life do not constitute depression.
Likewise, even the feeling of grief resulting from the death of someone close is not itself depression if it does not persist. Depression can, however, be related to bereavement - when depression follows a loss, psychologists call it a "complicated bereavement."
Signs and symptoms
Symptoms of depression can include:
- depressed mood
- reduced interest or pleasure in activities previously enjoyed, loss of sexual desire
- unintentional weight loss (without dieting) or low appetite
- insomnia (difficulty sleeping) or hypersomnia (excessive sleeping)
- psychomotor agitation, for example, restlessness, pacing up and down
- delayed psychomotor skills, for example, slowed movement and speech
- fatigue or loss of energy
- feelings of worthlessness or guilt
- impaired ability to think, concentrate, or make decisions
- recurrent thoughts of death or suicide, or attempt at suicide
The causes of depression are not fully understood and may not be down to a single source. Depression is likely to be due to a complex combination of factors that include:
- biological - changes in neurotransmitter levels
- psychological and social (psychosocial)
Some people are at higher risk of depression than others; risk factors include:
- Life events: These include bereavement, divorce, work issues, relationships with friends and family, financial problems, medical concerns, or acute stress.
- Personality: Those with less successful coping strategies, or previous life trauma are more suceptible.
- Genetic factors: Having a first-degree relatives with depression increases the risk.
- Childhood trauma.
- Some prescription drugs: These include corticosteroids, some beta-blockers, interferon, and other prescription drugs.
- Abuse of recreational drugs: Abuse of alcohol, amphetamines, and other drugs are strongly linked to depression.
- A past head injury.
- Having had one episode of major depression: This increases the risk of a subsequent one.
- Chronic pain syndromes: These and other chronic conditions, such as diabetes, chronic obstructive pulmonary disease, and cardiovascular disease make depression more likely.
Depression is a treatable mental illness. There are three components to the management of depression:
- Support, ranging from discussing practical solutions and contributing stresses, to educating family members.
- Psychotherapy, also known as talking therapies, such as cognitive behavioral therapy (CBT).
- Drug treatment, specifically antidepressants.
Psychological or talking therapies for depression include cognitive-behavioral therapy (CBT), interpersonal psychotherapy, and problem-solving treatment. In mild cases of depression, psychotherapies are the first option for treatment; in moderate and severe cases, they may be used alongside other treatment.
CBT and interpersonal therapy are the two main types of psychotherapy used in depression. CBT may be delivered in individual sessions with a therapist, face-to-face, in groups, or over the telephone. Some recent studies suggest that CBT may be delivered effectively through a computer
Interpersonal therapy helps patients to identify emotional problems that affect relationships and communication, and how these, in turn, affect mood and can be changed.
Antidepressants are drugs available on prescription from a doctor. Drugs come into use for moderate to severe depression, but are not recommended for children, and will be prescribed only with caution for adolescents.
A number of classes of medication are available in the treatment of depression:
- selective serotonin reuptake inhibitors (SSRIs)
- monoamine oxidase inhibitors (MAOIs)
- tricyclic antidepressants
- atypical antidepressants
- selective serotonin and norepinephrine reuptake inhibitors (SNRI)
Each class of antidepressant acts on a different neurotransmitter. The drugs should be continued as prescribed by the doctor, even after symptoms have improved, to prevent relapse.
A warning from the Food and Drug Administration (FDA) says that "antidepressant medications may increase suicidal thoughts or actions in some children, teenagers, and young adults within the first few months of treatment."
Any concerns should always be raised with a doctor - including any intention to stop taking antidepressants.
Exercise and other therapies
Aerobic exercise may help against mild depression since it raises endorphin levels and stimulates the neurotransmitter norepinephrine, which is related to mood.
Brain stimulation therapies - including electroconvulsive therapy - are also used in depression. Repetitive transcranial magnetic stimulation sends magnetic pulses to the brain and may be effective in major depressive disorder.
Severe cases of depression that have not responded to drug treatment may benefit from electroconvulsive therapy (ECT); this is particularly effective for psychotic depression.
Unipolar and bipolar depression
If the predominant feature is a depressed mood, it is called unipolar depression. However, if it is characterized by both manic and depressive episodes separated by periods of normal mood, it is referred to as bipolar disorder (previously called manic depression).
Unipolar depression can involve anxiety and other symptoms - but no manic episodes. However, research shows that for around 40 percent of the time, individuals with bipolar disorder are depressed, making the two conditions difficult to distinguish.
Major depressive disorder with psychotic features
This condition is characterized by depression accompanied by psychosis. Psychosis can involve delusions - false beliefs and detachment from reality, or hallucinations - sensing things that do not exist.
Women often experience "baby blues" with a newborn, but postpartum depression - also known as postnatal depression - is more severe.
Major depressive disorder with seasonal pattern
Previously called seasonal affective disorder (SAD), this condition is related to the reduced daylight of winter - the depression occurs during this season but lifts for the rest of the year and in response to light therapy.
Countries with long or severe winters seem to be affected more by this condition.