Talk to different professionals, medical, research, anthropological, biochemical, and psychological, and you’ll get different answers about what causes depression. Even the “chemical imbalance” theory is suspect, although it’s the most common, because research now shows that brain chemistry can be influenced by changing thinking, behavior and self-awareness; which makes it a “which comes first” question.
It’s very common for people to say they are “depressed” when they’re overwhelmed or upset, but true clinical depression is a different condition. It comes on in cycles, often seasonal, and has specific triggers. Some depression, like Post-Partum (after giving birth) Depression are partly situational (caused by feeling overwhelmed by the responsibilities of parenthood, stress of losing sleep, etc.) and hormonal (a result of hormonal changes.) Estimates of how prevalent depression is vary widely, and the definition of which people are considered depressed also varies a lot.
Any situation in which the expectations are unrealistic can be considered a “”set up” for disappointment, which some people experience as depression. If there’s an underlying belief that “I don’t deserve happiness” then the common difficulties of developing a new relationship after marriage will be seen as disasters, and depression can result.
Most couples experience some kind of disappointment and worry that their relationship is not going to work. Whether they react to that disappointment by going into depression is dependent on the individual.
Men more often react to difficult life experiences by getting depressed, because they are less comfortable expressing their feelings, so their disappointment and hurt gets compacted into a hopeless, depressed feeling. Men are also more prone to depression and other mood disorders, partly because they try to “tough it out” are less likely to have or utilize the support of family and friends.
Women are more likely to have a hormonal component to their depression, which can cycle with the menstrual cycle. Women will express their emotions more, have family and friends to talk to, and thus often stave off depression.
In my experience, I find that the tendency to become depressed is largely a result of a learned behavior and belief system that is focused on hopelessness. In my office, people who are depressed often express hopelessness and a feeling that they can’t be in charge of their own lives. When that belief system changes, there is no longer depression. There is also a cyclical nature to depression, which could be a result of genetics, but no one knows for sure. Situational depression is experienced when people are deeply hurt, disappointed, or have experienced a great loss or tragic situation. This type of depression is gradually worked through and can be overcome. Symptoms of depression include having no energy, perhaps not able to get out of bed, withdrawing, avoidance of intimacy, lack of communication and feeling hopeless and helpless to solve life problems. But may people keep going through it working hard, yet living a colorless, empty-feeling life.
Studies show that depression responds best to a combination of antidepressants and cognitive/behavioral therapy. If the depression is severe, in-patient treatment in a facility that provides behavioral conditioning is the most effective. If you think someone you love is depressed, don’t try to make a diagnosis. You can point out whatever behavior you’re noticing and say “I see that you’re crying a lot (or sleeping too much, hiding out or unwilling to talk) and I think that indicates a problem. Will you come to counseling with me?” If loved one will go to counseling with you, the therapist will be able to diagnose the depression and make recommendations; without causing him or her to feel criticized, as he or she would if you said it was depression. Counseling will also help you handle situations more effectively, and help you not create more drama and dysfunction in the relationship.
Americans tend to look for the quick fix. It seems easier to take a pill than to solve the problem. But the side effects of antidepressants are no joke. Research shows that the most effective treatment for depression is Cognitive Behavioral Therapy, in combination with mild antidepressants. The drugs do not fix the depression; they lift mood to make it more easy to resolve the emotional issues.
Depression is emotionally, as well as physically, wearing not only on the afflicted individual, but on spouse and family as well. Here a few of many steps you can do to help your loved one survive and thrive.
How To Help a Loved One with Depression:
1. Understand the diagnosis and what it means Go with your loved one medical to appointments, so you’ll understand what the doctor says. A depressed person may not completely understand what the doctor says. For extra support, search online for special interest groups focused on the disease such as those sponsored by Mental Health America (MHA) or the Depression and Bipolar Support Alliance (DBSA) which are geared toward meeting the needs of those with depression. While depression support groups are not psychotherapy groups, they can provide you with a safe and accepting place to vent your frustrations and fears and receive comfort and encouragement from others. You will learn a lot from those who are already experienced.
2. Help your loved one do what the Dr. says, but don’t take charge Managing depression is a big adjustment, so help your loved one remember to take medicine, keep dr. appointments, and do whatever exercise, medical at-home procedures, or other self-care processes. However, make sure these things are still your loved one’s responsibility to do. Both of you will feel better if you are supportive, not parental.
3. Take very good care of yourself. Taking care of a depressed spouse is exhausting, so you must take extra care of yourself, too. Utilize whatever help is available from medical insurance, family and friends. Arrange for other people to be available to give you a break, and don’t feel bad about going off on your own from time to time — you need it.
4. Keep your connection, friendship or romance alive Find as many ways as you can to let each other know you care about one another. However you may have to adjust your social and intimate life, do it. Do whatever you can to keep your connection alive within the limits of the illness. Have as much fun as you can, every chance you get. Make it a challenge to discover new ways to enjoy each other, and to relax and laugh together.
My newest book, How To Be Happy Partners: Working It Out Together shows how to have successful conversations with your partner on difficult topics, and how to work together to help each other through emotional problems.