Treatment for Depression

What causes major depression?

While it cannot be said that we fully understand exactly what causes major depression, it is now widely agreed that it is caused by a combination of biological, psychological and social factors (the biopsychosocial model).

Furthermore, it is suggested by the diathesis – stress model that people who suffer major depression had a pre-existing vulnerability to the condition that has somehow been triggered by some of the more stressful events that occur in day-to-day life. To take this one stage further, the same model suggests that this pre-existing vulnerability can be either genetic or something that has been learned during the course of the sufferer’s life.

Because it is believed that major depression is a biopsychosocial condition, it is one that is generally treated on three levels, with attention being paid to the biological, psychological and social conditions that have prompted the illness.

It is also worth noting that research over the years has indicated that some types of depression tend to run in families, suggesting that certain family groups have a ‘hardwired’ genetic vulnerability to depression. It also appears that some families have a tendency to suffer from depression generation after generation, and major depression is certainly a primary culprit in both of these situations. The importance of family background cannot therefore be underestimated or ignored.

Medical (biological) treatment for major depression

Psychiatrists and other physicians will usually try to treat major depression by prescribing antidepressants, which are drugs that work by altering the levels of various neurotransmitters in the brain of anyone suffering from the condition. In turn, neurotransmitters are chemicals that relay information between the neurons of the brain and other cells.

The neurotransmitter that is most commonly affected by antidepressants is serotonin, which is a neurotransmitter that controls and regulates the levels of other neurotransmitters in the brain. Low levels of serotonin are believed to result in equally low levels of norepinephrine in the brain, and it is this that is generally believed to cause major depression.

Consequently, antidepressants are designed to either increase the levels of serotonin or norepinephrine or alternatively the levels of a third neurotransmitter, dopamine. Dopamine is a close relation of adrenalin which is the hormone that controls action and energy levels, so to a certain degree, the specific antidepressant to be prescribed will depend upon the specific symptoms the patient exhibits.
For example, if the primary symptoms are anxiety and irritability, then norepinephrine based antidepressants are more likely, whereas dopamine-based drugs are more likely to be prescribed when a patient reports lack of energy and enjoyment of life.

In addition to treating major depression on a biological level, psychiatrists will also treat the condition on a psychological level. Most importantly in this respect, it is believed that the ability of an individual who suffers major depressive attacks to deal with everyday events in a normal way is somehow impaired. For example, while most major depression sufferers are very quick to blame themselves for negative events, they are far less likely to take credit for positive ones.

Finally, you have the social aspects that are believed to contribute to major depression, such as social isolation, abuse or major deprivation.

The ability to deal with the social aspects of major depression causation will to a large extent depend upon whether those causes are in the past or still present. In the first situation, the social aspects can be dealt with by appropriate counseling, whereas in the latter situation, it could be considerably more difficult to do anything about the problem.