What is depression?

How does depression develop?

Depression is nobody's fault! Anyone can be struck by this condition.

The causes of depression cannot be clearly defined and vary from person to person. The current state of research assumes that there are genetic predispositions, personal development and personality factors, but also family conditions and traumatic life experiences that contribute to the development of depression.

Genetic predispositions

One contribution to the development of depression is in the genetic predisposition. If depression was more common in your family tree, there's a good chance you might have it too. If direct relatives of the first degree (parents, siblings) are affected, this increases the risk of developing depression by 15%. For identical twins, the risk of both developing depression if another immediate relative was affected is about 50%. However, scientifically it is not possible to say exactly whether environmental influences affect these observations, since siblings, for example, usually grow up under similar conditions. Even the depression of a parent does not have to be genetic, but could have arisen from experiences. So there is no “depression gene” and the role of genetics should not be overstated. 

Neurology

Depression is related to hormonal changes in certain neurotransmitters (chemical messengers) in the brain. These messenger substances such as serotonin, dopamine and noradrenaline are in a hormonal imbalance in depression. Serotonin and dopamine are neurotransmitters that make us happy. In depressed patients, the measured concentrations of serotonin and dopamine are lower than in healthy people. This is why treatment with antidepressants is often successful, since the active ingredients in the drugs increase the production of these messenger substances, among other things. It should be noted, however, that antidepressants are not effective for everyone. The reason for this can be an individual neurotransmitter disorder that causes the hormonal imbalance. 

In addition to the hormonal imbalance, altered activity of the limbic system can be observed in depression. The limbic system is responsible, among other things, for regulating stress and controls emotions. A disruption in this system alters how emotions are processed, increasing psychological vulnerability. Everyday low moods, but also environmental influences are evaluated more strongly and experienced more intensely, which can lead to depression.

Medication

Depressive symptoms can occur as a result of drug treatments and their discontinuation. Stopping certain medications can trigger withdrawal symptoms that result in depression. Anabolic steroids are a good example as they are highly addictive. Discontinuation of the active ingredient is similar to drug withdrawal. Many other prescription medications such as antibiotics, neuroleptics, beta blockers or hormonal contraceptives (e.g. “the pill”) can cause depressive symptoms as side effects. 

Illicit drugs

Drugs and psychotropic substances have a direct impact on neuronal messengers and their transmitters. In this way, they can specifically influence their release and inhibition. Drugs also have a high potential for addiction, which can lead to serious physical and psychological withdrawal symptoms in the event of withdrawal. These withdrawal symptoms often lead to depression, as the body and psyche long for the supposedly missing substance.

Pregnancy and childbirth

From a hormonal point of view, pregnancy is a phase of many changes for all women. Your own hormone balance is turned upside down and mood swings are regularly noticeable. Studies have shown that around one in ten women experience depression during their pregnancy. 

1. Postpartum mood swings/baby blues 

Due to the abrupt hormonal changes after childbirth, it is estimated that 50-80% of all new mothers experience postpartum mood swings and sadness immediately after childbirth. This phenomenon, known as "baby blues," is the mildest form of postpartum emotional irritation and is characterized by frequent and sometimes sudden crying and sadness. In addition, general irritability, worry about the child, exhaustion, loss of appetite, difficulty concentrating, anxiety and insomnia can occur. However, the baby blues usually subside after a few days.

2. Postpartum depression

If the baby blues only sets in about a week after birth or has lasted for more than two weeks, this is referred to as postpartum depression. Typical symptoms of depression, such as joylessness and listlessness, appear. Statistically, 10-20% of all new mothers experience a depressive episode in the first year after giving birth. The triggers of this postpartum depression cannot only be traced back to the lack of sleep, the physical change or the new role as a mother. It can also be a combination of the hormonal changes in your own body and certain feelings such as fear, a feeling of overload and insecurity occurs. Mothers who have postpartum depression constantly feel exhausted, overwhelmed, irritable and blame themselves for not really loving her child. They are not coping with their chores and feel guilty because they are not happy about the baby.  

According to studies, a key factor in the development of postpartum depression is the lack of social support during childbirth. 

If the mother suffered from depressive episodes or other mental illnesses before the birth, the risk of postpartum depression is increased. Postpartum depression should be treated, since the depressive symptoms experienced are a significant source of suffering and the mother-child relationship can be compromised.

Parenting style and other environmental influences

Another reason for the development of depression can already lie in the upbringing style of one's own parents. An anxious-caring parenting style can result in what is known as "learned helplessness" in the child. This means: If the child grows up in an overprotected environment, it does not learn to deal with problems independently enough, so that the psychological vulnerability increases in adulthood.  

This learned helplessness reduces the ability to deal with stressful stimuli (stressors), affects self-esteem and therefore offers a risk factor for the development of depression. 

Traumatic experiences such as the loss of a loved one, sexual abuse, accidents, experiences of catastrophes or crisis situations such as separation from a partner can also promote the development of depression.