Depression

I was following the suicide threads that have popped up recently and a question came into my head. I think there might be a factual answer, so I’m sticking it here instead of IMHO.

For people with clinical depression: Does there have to be a reason for the depression? A starting off point? Or can you become depression for no particular reason?

What do you mean by “reason”? Is being a biological condition a “reason”? Or are you asking whether there has to be an event that triggers the depression? And/or that the person consciously identifies a “reason”? etc…

no particular reason.

I have had it come on for no external reason, no trigger. Some things in fact, that ought to have triggered it, seem not to do so. It just happens.

I’m asking the above. I.E. does there have to be an event to trigger depression.

From some of the responses I’d say there doesn’t.

Mine is usually triggered by stress, most often from loss of/lack of something, such as a job, relationship, etc. I used to get depressed at the end of every semester, but that was due to one of the above causes, and the stress of school just added to it. My last episode was a few weeks ago, and was triggered by the realization that my life was going nowhere in terms of the Big Three, school, relationship, career. Thank heaven for wellbutrin.

Well the biological reason is usually associated with low seratonin amounts in the brain, though other neuro-transmitters can also be implicated. Another cause can be thyroid problems, though this isn’t depression in the true sence of the disease it can give very similar symptoms. As for an external reason, it seems likely that stress, pain, loss, and other things can exasperate the situation but the brain chemical imballance seems to be key to wether these cause temporary depression or ‘permanent’ depression.
This from a study of medical journals I made about 8 years ago when I had access to my University library and was learning about clinical depression having been diagnosed with it.

I also think that in many cases environment early in life can make the potential for becoming depressed higher later in life. So the depression can happen in early childhood development and then any stress later can induce, or trigger, a depressive episode.

There is also depression that is linked to hormonal change or even medication. People experiencing this type of depression don’t necessarily have an event that triggers it. You just become overly stressed and fall back into depression to cope it seems.

Purely anecdotally, the first time that I suffered from depression, I was in my teens. This lasted for about five years and was defiantly situational–I.e. once I got out of the situation, I slowly recovered. There were really good reasons for me to be depressed–hormones, being the outcast at my high school, my father dying.

But I find now that the depression can come on really suddenly–sometimes with no reason at all. For instance, I could be driving home from a perfectly normal day, and suddenly be overwhelmed with incredible hopelessness. Or I will wake up and want to sob. Just sudden, unexplainable, incredible sadness.

There are times that I know there is a reason to be depressed–something bad happened, or I think of something disturbing–but I recover more quickly from these incidents than the other kind, which can sometimes last days.

Mood disorders do run through my father’s side of the family, and Dad was bipolar, but I appear to be the only person in my generation to suffer from depression–yay me.

I saw–not too long ago, (but no cite) that people who suffer from untreated depression tend to be more likely to suffer from bouts of depression later in life–as if the brain gets trained somehow to be depressed, and I’m pretty sure that’s what happened to me–a genetic susceptibility combined with a history of it.

So I am a combo platter of both depression with a reason and reasonless depression.

Hope that helps with the OP.

Horrible nitpick but I think you mean “exacerbate: To make more violent, bitter or severe” vs “exasperate: to incite the anger of.”

IANAD but in my experience Major depression is triggerless, in fact, in most cases where the depressed person identifies a trigger, they are fooling themselves. (If I only was in a relationship, I would never get depressed again, etc.) Even when the triggering situation is removed, the depression remains or quickly returns after a brief high.

Darn, I didn’t even know they were two different words :slight_smile:
But thanks, this is the place for fighting ignorwents.

Bippy

I believe the cause of depression is still in debate. It’s a chicken-before-the-egg argument: does an external event cause a depressed mood and thus alter brain chemistry (we’re speaking in long-term where medicinal intervention is needed) or is the brain chemistry already abnormal or predisposed to alteration (genetics?) and an external event just triggers it.

We know that an antidepressant can replace depleted neurotransmitters and thus cause someone to ‘feel’ less depressed.
But is the low neurotransmitter only a symptom of something else like a hormonal problem, cognitive trauma, diet, etc?

When working with depressed people (the extreme cases), these antidepressants never worked enough on their own. Behavioral, family, and cognitive therapies were all needed and even then the ideal mental state was never achieved. This is my experience anyway.

As for those who only need out-patient antidepressant treatment, I’ve heard about half say the pill ‘cured’ them, and the other half said it just “numbed” their depressed feelings enough to get on with daily living but they knew the depression was always there.

sometimes though people get depressed for good reason, where its not a medical condition but a natural reaction, for example you lose a loved one or you unhappy with your surroundings. the only ‘true’ way to cure depression is to address what is making you feel depressed in the first place, only where the issue cannot be addressed naturally should drugs be used.

syntax you are talking about healthy depression, which is IMHO very different from clinical depression. Clinical depression can exist without there being anything (other than chemical imballance) “making you feel depressed in the first place”. If you are actively contemplating suicide, have made suicide plans, often feeling suicidal, the waiting for the issue to “be addressed naturally” would be a very dangerous thing to do.

Also keep in mind that depressive episodes don’t always manifest as “sadness” either. My last major episode manifested as a slow backslide into gradually increasing mental sluggishness, impaired capacity to think (I’d start thinking or speaking and never finish the sentence because I couldn’t remember where I was going with it), moderate photophobia (sunlight made my brain hurt), a lack of desire to deal with people, and only toward the very end of the cycle would there be any “emotional” symptom (about a day’s worth of deep-seated, burning rage). So in this case, no, there was no external trigger – I wasn’t upset about anything, I just couldn’t think. And the rage itself (which wasn’t always present in the cycle anyway) frequently didn’t have an object – I wasn’t pissed AT anyone/thing, I was just pissed.

And it may be just me, but I can clearly feel the difference between normal, situational “depression” (I’m sad because my dog died), and clinical depression. Clinical symptoms feel distinctly like physical symptoms just like any other somatic illness. Being upset that my dog died feels like an emotion.

Whoa, Meatros, that’s a good question…

In 1999 I was diagnosed with “Major Depressive Disorder with Psychotic Features” and finally, after being treated with medications for over a year (one, Nardil, worked, by caused my blood pressure to soar) becoming nearly comatose, had convulsive electro-shock treatments (which helped tremendously).

I had a number of different shrinks from 1999-2002 and, as I was regaining my marbles, I asked “What caused this?” The most common answer I got was “brain chemistry” (low serotonin levels, low GABA levels, neurons not firing properly, etc.) but one shrink actually delved into what was going on in my life prior to my diagnosis and we came up with a seemingly non-dramatic but, nonetheless, traumatic ‘event’ that occurred in October of 1998 that was (we came to believe) the ‘trigger’ for the bad brain chemistry to engage. His theory was that the potential for depression was there - genetics - but that it needed a trigger of some sort to go into play. I’ve had no psychosis since November of 2000 and little depression since (roughly) June of 2001 and have been on no psychotropic meds since January of 2002, so I’m personally inclined to believe in a situational/chemical explanation of ‘clinical’ depression.

(As an aside - when I finally came to my Mom and told her of my diagnosis and asked for her help in August of 1999, she told me that she did not believe in mental illness - that people should just ‘get over’ their problems. She also said, of my two suicide attempts, that suicide was ‘cowardly’ and that only cowards would commit suicide rather than face their problems. On March 25, 2002, having taken massive dosages of anti-depressants for almost a year, she blew her brains out. I guess she changed her mind…).
-bbb-

That should read “In 1999 I was diagnosed with “Major Depressive Disorder with Psychotic Features” and finally, after being treated with medications for over a year (one, Nardil, worked, but caused my blood pressure to soar) and becoming nearly comatose, I received electro-convulsive therapy (ECT) (which helped tremendously).”

I always seem to transpose the convulsive/electro parts… and I always blame it on the fact that ECT causes some memory loss (oddly enough, it had somewhat of an opposite effect on me - I can now remember the addresses and phone numbers of every place I’ve lived since 1963 (19 places in all) and can remember phone numbers and birthdays, anniversaries, etc. (anything to do with numbers or dates) with alarming accuracy. And not just 1066 and 1666, but Michael Nesmith (the former Monkee) birthday of December 30th, for instance.

“It’s a strange world isn’t it?” - repeated throughout David Lynch’s Blue Velvet.

-bbb-

Wow, that’s the first time I’ve been accused of that! :smiley: