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The Causes of DepressionThe causes of depression are hotly debated by the psychiatric community. There are the neurological, behavioral, chemical, environmental, and cognitive groups. You can roughly divide them into Body, Mind, and environment viewpoints. Reminiscent of the nature and nurture debate. The nature versus nurture division is not quite correct, because there are large and diverse groups that believes the different areas over lap. But the debate is further complicated by depression being both a disease itself and a symptom of other diseases. I'll try to explain the different viewpoints and then express my own, completely non-professional opinion.
Neurological Causes of DepressionThis group advocates that structures in the brain are a primary cause. With advances in imaging technology ( CAT Scan and MRI) neurologists can observe differences in the structure of the brain. They have observed differences between depressed people and 'normal' people. There are theories that even assign types of depression to different areas of the brain. Yes these changes are real and observable. The hippocampus, an area of the brain that is important to the storage of memories, is smaller in those with a record of depression than in others that have never been depressed. The question is, do these differences cause depression or does depression cause these differences? It's really hard to prove because it's nearly impossible to get before depression pictures, but they have observed a reduction in the differences when the depressed person recovers. But it's only a reduction. Is that because of an inherant differnce from birth?
Chemical causes of depressionBesides the obvious Drug abuse as a cause of depression, there is a large group of researchers focusing on chemical imbalance as a primary source. This is demonstrated by the effectiveness of anti-depressant medication. Research is focused on the neurotransmitters serotonin and norepinephrine, and the hormone cortisol . There was an experiment by a Russian psychologist who injected dogs with serum from bipolar patients when they were depressed and when they were in the manic period. Then the dogs had to negotiate a maze. The dogs performance time more than doubled when injected with the depressed patients serum and reduced when injected from the manic patient. This seems to imply that chemical imbalance may indeed have a significant implication as a primary cause of depression and not just a symptom or byproduct. Both the neurological and the chemical theories make a case for the propensity toward depression to be something you are born with. Being perhaps genetic or a 'birth defect'. But they also don't completely discount traumatic events from causing variations in the brain or body chemistry, as seen in Post Traumatic Stress Disorder (PTSD). Either way, they are more 'nature' schemes. These are popular with certain groups of patients and family members as well as the researchers and pharmaceutical industry. The problems with these theories is that a significant number of depressed people do not respond to the chemical treatments.
Behavioral and Environmental Causes of DepressionI am lumping Behavioral and Environmental together as causes of depression because, to me, the environment generally precipitates the behavior. The environmental factors include such things as
Cognitive Causes of DepressionThoughts, or cognitions, are believed to be the largest of the causes of depression. Thinking of things predominately in a negative light. Especially thinking of themselves in a negative light. Depressed people often catastrophsize events. Not only making the bad events seem worse but they mis-interpret neutral or even slightly good happenings as bad. Those mental health professionals that hold is view believe, of course, that Cognitive Behavior Therapy (CBT) is the way to treat it. CBT focuses on recognizing the automatic thoughts we have and changing them.
My Conclusion about the causes of depressionIt's a interplay of all of the above. More professionals are coming to this belief, including the developer of Cognitive Behavior Therapy, Aaron T. Beck M.D.Neurological and chemical sources may be a genetic or abnormal biological development that pre-deposes a person to think and react negatively to frightening events. It's like a piece of metal having a weak spot that gives out under stress. When they incur a trauma, these people interpret it much more negatively than most. They do this over and over which creates a pattern of behavior. Scientists and reasearchers can argue all they want about the causes of depression. What eveyone else cares most about is fixing it. At this point a combination of chemical and cognitive therapy seems to be the best treatment.
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