Depression: Description and Causes
She can hardly get up this morning. It is almost seven o'clock. Time to get up and get the kids ready for school. But her head hurts. Her whole body feels heavy. She knows the feeling may last for hours. Recently she has taken to going back to bed after the children have left for school. She can hardly face the day. So many things to do, but she can't organize her thoughts.
She gets up and rushes through breakfast as quickly as possible. No Bible reading. Short prayer. Kids off to school. And then back to the bedroom, dark with the blinds down. Sometimes she stays in bed until almost noon. And she doesn't feel rested at all. She almost always feels dead tired lately. And cries over nothing.
She realizes in her heart that there is something wrong here, but she doesn't have the energy to change anything. The kids are such a burden. And her husband seems so remote. He doesn't seem to appreciate her any more. She feels angry, but at the same time she feels guilty. She doesn't give much reason for her husband and children to show a lot of love to her either. She feels useless to everyone. And she wishes she could pray about it, but she can't. The God of love and mercy seems so far away.
Last Sunday, in church she heard the minister say that those who really believe the promises of God will be given strength to renew their lives and to live in the joy of their salvation. She felt cold and dead inside when she came out of church. She was sure now that her faith was as good as dead. It was no use praying any more. All the others in church seemed to be happy and to get along all right. She felt as if she didn't really belong at all. She feels remote from her husband and family. Remote from God. She feels so awful and so alone and so unable to do anything about it all. And every day those feelings come back. She can hardly face another day. It would have been better if she had never been born…
This story isn't true, but it is very real. This is the kind of sad state many women and men and even adolescents fall into during the course of their lives. They suffer from what is commonly known as “depression.”
What is depression?
Depression is an illness, an emotional illness. And it's a very common illness. It has been called “the common cold of the emotions.” It can range from very mild, hardly noticeable, forms to very severe forms which disrupt one's life and make it very difficult for the person to function at all. It can strike almost anyone. The Reformer Martin Luther had bouts of deep depression. It also appears that John Calvin had to deal with depressive symptoms. Atheists too, such as the famous writer Ernest Hemingway, may suffer from severe depression. In fact, many people suffer from a major episode of depression at one time or another during the course of their lives. It is more common among women. Estimates vary greatly, but as a general figure, approximately one out of four women and one out of every eight men will experience depression.
Age is no barrier either. Recently more attention has been given to depression among children. Children and adolescents can suffer from very real bouts of depression, causing extreme changes in behaviour. More attention has also been paid of late to depression among seniors. Numerous factors, such as loneliness, inability to keep up with the pace of life, and certain heart medications can make seniors vulnerable to depression.
In order to determine if someone is suffering from true depression, psychologists look for a number of symptoms. A person may not experience all the symptoms, but if five or more of the following symptoms are present for more than two weeks, the person has full-blown depression and requires some help to deal with it.
- Feeling of deep melancholy.
- Loss of interest in people or activities that used to please.
- Sombre mood lasting whole days regardless of circumstances.
- Very noticeable changes in behaviour from the usual behaviour.
- Sad expression and crying easily.
- Lack of motivation to do anything.
- Sleep disturbances, e.g. trouble sleeping, excessive sleeping.
- Appetite problems, e.g. cravings, loss of appetite, bulimia.
- Strong reduction of sex drive.
- Constant fatigue.
- Slow or hesitant speech.
- Increased signs of agitation, e.g. pacing, clearing throat.
- Thoughts of death or suicide.
- Inability to concentrate, slow thought processes.
- Inability to make decisions.
- Negative or pessimistic thinking regardless of circumstances.
- Intensified and overblown feelings of guilt.
- Feeling worthless, unwanted, unloved.
- Inability to function interpersonally, withdrawn.
- Loss of ability and desire for personal care and appearance.
- Irritable, over-reactive.
- Dull headache present much of the time.
- Chronic pain, especially in back or abdomen.
It generally appears that the more supportive the environment, the less severe the symptoms and development of depression. Poor personal support systems result in more pronounced symptoms. For example, there are families who do not foster honesty about emotions and feelings. As a result, feelings related to depression are suppressed as much as possible, resulting in more severe symptoms and forms of depression.
By far, most cases of depression are of the mild type which have only a minimal impact on one's life. Sometimes it is hardly even noticed by those close to the individual. The person is moody, apathetic and grumpy, and “gets over it” in a short time. Severe depression over a prolonged period of time, however, often requires professional treatment and possibly medication and/or hospitalization. Then it is debilitating and difficult to deal with, not only for the depressed person, but also for relatives and close friends who often are at a loss as to how to react or how to help. The most severe forms of depression include symptoms such as delusions and hallucinations. Manic depression is a severe type of depression that includes drastic mood swings from deep gloom, incommunicativeness and low self-worth to high euphoria, constant talking and inflated self-esteem.
What causes depression?
There are different types of depression, depending largely on the causes. The causes of any single case of depression can be multiple and complex, making it difficult to come to a simple diagnosis. In fact, numerous theories about the causes of depression have been proposed. Most have some element of truth to them, but it would be too simplistic to ascribe someone's depression to a single one of them. Most likely a whole network of causes all work together at a certain time. Some of the more likely ideas about the causes of depression are as follows.
Some place emphasis on biochemical causes. Research has shown that some persons with severe or chronic depression have a chemical imbalance in their brain. This means that they are missing or have too much of a certain chemical in their brain which affects the transmission of signals within the mind. This can result in depression which requires medical treatment to restore the chemical balance.
Closely related to biochemical imbalance is the theory that genetic factors may cause predisposition towards depression in some persons. This usually involves the more severe depressive disorders. If a person's family history includes evidence of severe depression among predecessors, that person appears to have a greater chance of becoming similarly depressed. Medication is a regular method of treatment when genetic factors are suspected.
Some emphasize psychological causes for depression. Depression has been shown to result from the way certain people deal with feelings and emotions. For instance, if individuals have learned as children that it is not safe or proper to express grief or anger, these emotions are internalized and the person's mind and body eventually react to this internalization with depression. Similar internalization of emotions can also result from sexual abuse or other traumatic experiences. These persons are also susceptible then to drug and alcohol abuse, by which they attempt to mask their feelings. A major loss in one's life or a tragedy can also trigger depression when there are strong feelings of guilt. A person may have received fairly constant criticism and condemnation for things he did at home or among peers. This may result in a habit of subconsciously drawing blame upon himself, even though he is not to blame. When traumatic events take place in such a person's life which are completely beyond his control such as the loss of a good job or the death of a loved one, that person feels in some way to blame for the misfortune, and becomes depressed. This is closely connected with negative thinking patterns in which self-accusation plays a great role: “Everything always goes wrong for me, I do everything wrong, no one wants me.” What ensues is lack of self-worth and possibly looking for self-affirmation in wrong ways. Then guilt is confirmed and a vicious circle of depression results.
Depression may be caused by physiological factors. People who have suffered from certain physical illnesses such as hepatitis, mononucleosis, strokes and various cancers are prone to depression. Some women suffer from post-natal or menopausal depression because of hormonal adjustments in their bodies. As well, some medications or combinations of medication have depressive side-effects, especially taking certain heart medications. One of the first things that depressed persons – especially seniors – require is a review of their medication and a physical examination.
For Christians there can also be spiritual causes for depression. Among mystically-inclined groups, melancholy is sometimes seen as evidence of true struggling with one's doubts and guilt. This kind of environment can actually cause deep depression. A misinterpretation of some Scripture passages can lead to wrong thinking about what the Bible says. Speculations about “the unforgivable sin” and exaggerated feelings of guilt can lead to depression. There is then selective reading of the Bible and selective listening to the preaching. Only the condemnatory phrases are remembered, and by way of self-imposed doubts and overblown sense of guilt a person might feel that he or she is not “good enough” to be saved. This form of “works-righteousness,” which fails to see the amazing grace of God, can result in deep depression.
Depression, as shown above, is an illness that affects the whole person. But what makes it so serious is the emotional pain, which can be more severe than the pain of a broken limb. The pain of depression affects the whole person, and comes on more gradually and lasts much longer than a physical injury. But again, the more supportive the environment, the less severely the symptoms manifest themselves.