Depression – Depressive Disorder

Causes of depression

Depression can be triggered by a specific event trigger or spontaneously without a clear reason. It can result from a combination of factors, including:

• Genetic predisposition: If someone in your family has depression, you are more likely to get it.
• Life events: Environmental changes such as marital status, relationships, financial standing, living arrangements and chronic stress can influence the development of depression.
• Personality traits: Traits such as low self-esteem, pessimism or being easily overwhelmed by stress are liked to a higher risk of depression.
• Medical conditions: People with a history of medical illness, biochemical imbalance, chronic pain, sleep disturbances, anxiety or attention deficit hyperactivity disorder (ADHD) are more likely to develop depression.
• Hormonal fluctuations: For women, hormonal fluctuations during pregnancy, postpartum and menopause can trigger depressive episodes.
• Trauma: Experiencing psychological trauma, particularly at an early age, may cause long-term changes in how the brain responds to fear and stress, and can lead to depression.
• Medications: Certain medications have side effects that can cause or worsen the symptoms of depression.
• Substance misuse: People with a substance use disorder (SUD) are at significantly higher risk for experiencing depression.

Types of depression

The most common form of depression is major depressive disorder (clinical depression). This form is characterized by symptoms that last for at least two weeks.

Additional types of depression include:

• Persistent depressive disorder (chronic depression): A form of depression that tends to have less intense symptoms and lasts for a minimum of two years
• Seasonal affective disorder (SAD): A form of mild to moderate depression that occurs during certain seasons, most commonly fall and winter
• Postpartum depression: A common but serious form of depression that affects about three in 20 new mothers after childbirth
• Premenstrual dysphoric disorder (PMDD): Severe emotional and mental symptoms caused by changes in hormone levels during a woman’s menstruation cycle (period) that usually improve after her period starts
• Bipolar depression: Extreme mood swings between feeling high — which may lead to engaging in risky activities — and feeling low and hopeless
• Substance- or medication-induced depressive disorder: Use of alcohol, drugs or medication may impact your brain chemistry and increase your risk of developing depression

Who is at risk of depression?

More than 13% of adults and adolescents in the United States have experienced depression. It affects people of all ages and all racial, ethnic and socioeconomic backgrounds, even those who seemingly “have it all.” But it does affect some groups more than others. Risk factors include:

• Family history of depression
• Personal history of other mental health disorders
• Gender, as females are more susceptible to depression than males
• Age, as depression is more common in young adults
• Chronic stress
• Low self-esteem
• Isolation and loneliness
• Continuous exposure to violence, abuse, neglect or poverty
• Traumatic life events
• Chronic Illnesses, such as cancer, stroke or heart disease
• Neurodegenerative diseases, such as Alzheimer’s or Parkinson’s
• Substance misuse

Depression treatment options

At Main Line Health’s treatment centers for depression, our skilled behavioral health specialists can determine the most effective individualized approach to treatment. We offer 24/7 inpatient mental health treatment and outpatient behavioral health programs.

Your care may include one or more of the following:

• Medication: There are several classes of medications available to treat depression. The most common are selective serotonin reuptake inhibitors (SSRIs), followed by serotonin-norepinephrine reuptake inhibitors (SNRIs).
• Psychotherapy: Psychotherapy can include cognitive behavioral therapy (CBT) and interpersonal therapy (IPT), among others, to help people develop coping strategies and address the underlying causes of your depression.
• Support groups: Connecting with peers who have shared experiences can provide emotional support, comfort and offer helpful coping strategies.
• Lifestyle changes: Self-care, including exercise, balanced nutrition, mindfulness practices and sufficient sleep, can decrease symptoms. As can making genuine connections and maintaining healthy relationships.

Diagnosis and testing for depression

A thorough assessment is critical in diagnosing depression. It is also necessary to rule out underlying medical or mental health conditions that could cause similar symptoms. Your assessment may include:

• Physical exam: Evaluation for depression typically begins with a physical exam by a healthcare professional. It screens for medical conditions that can mimic depression symptoms, such as vitamin deficiencies, hormonal imbalances, neurological concerns and substance misuse. Laboratory and imaging tests may be part of this evaluation.
• Psychiatric/psychological assessment: A mental health provider will use a comprehensive set of assessment tools to conduct a detailed psychological evaluation for multiple disorders.