Thursday, April 9, 2009

Depression, Recovery part 4

I will continue this series on depression moving on to a few common questions.

Is there any test for depression? There is no medical test currently available to assist in the diagnosis of depression. Laboratory blood work is usually obtained to help assess for other medical conditions that may be contributing to depression or that may affect treatment.

What causes depression? There have been a variety of possible explanations that have been examined over the years. Ancient Greek physicians believed that depression was caused by abnormalities in what they called 'black bile". Although our understanding of physiology has advanced the idea that depression involves some abnormality in the body is an old idea. One psychological explanation has been that depression is anger that is "turned inward" and directed against the self. Another is the idea of learned helplessness. This is the recognition that we like all mammals will respond to stress which we are unable to change with a tendency to become helpless and give up. There is also the chemical idea that there is an imbalance of neurotransmitters which need to be corrected.

While all of these probably have some truth to them they are over simplistic and do not take into account that there are a variety of factors that may contribute to depression. One way to see depression is as a stress-vulnerability condition. This means that there are varying degrees of vulnerability to depression that each one of us has and that many different stresses may contribute to the development of depression. These factors include genetic predisposition, ongoing abuse of alcohol or drugs, history of early life trauma, chronic relationship stress, chronic pain, hormonal influences, medical illnesses, diet and exercise, and negative thinking patterns. Recognizing this is important for treatment as we want to address as many of these factors as possible and treat not just symptoms but also raise one's resiliency to development of depression in the future.

I will address treatment in my next post.

Thought for the day

Nothing is psychiatry is simple. All is multifactorial.

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