WHAT CAUSES DEPRESSION ?
“Treating causes is avoiding relapses”
It is essential to look for “causes” or “factors of depression“, if possible in the first episode but even more so during a recurrence. It is these factors that often lead to relapses of depression and the chronicization of the disease or the continuation of treatments found to be “ineffective”.
“One cause can hide another”
Several factors of depression can be superimposed. The most obvious, a traumatic factor for example. can hide hereditary or hormonal factors.
“To each cause its treatment”
The treatment specific to each detected cause must be put in place parallel to the treatment of the depressive state. A distinction must be made between “treatment of the depressed state” and “treatment of the causes of your depression” and the diagnosis of both. This is the goal of the center of depression and the trajectory of care practiced there.
It is therefore necessary to make an etiological assessment (search for causes).
· HEREDITARY CAUSES
There are hereditary factors that can lead to mood disorders. The genes involved are known. These depressions appear “without cause” because they are not linked to events in your life, since they are written in the chromosomes.
One must look into the personal history of the patient’s illness:
- Regular unipolar or bipolar cycles
- Periods of remission between episodes
- Bipolarity by interrogation and specific tests (CLH-32)
- An early start 20/25 years
- The absence of other psychological disorders, test called “Comorbidity”
- In family histories:
– often hidden in family history by alcoholism
– attempted suicides
Only depression is hereditary and not other pathologies. The risk of transmission to your children can be calculated.
Treatment of the hereditary factor:
When the presence of this hereditary factor is proven, mood stabilizers are the only way to limit relapses, they allow to regulate the mood. These treatments are indispensable when there is a bipolarity or even a risk of bipolarity revealed by a balance (Bipolarity type 1 or 2). Bipolarity is the alternation of “depressive” phase and “manic” phase. For some, there is an association of depressive and manic symptoms, called a mixed state.
They are long-term treatments and their efficacy is often seen only during an untimely shutdown, when “you feel good”. Their prescription therefore requires your adhesion. They are subject to specific monitoring.
SUGGESTED BALANCE SHEET: Complete history
· PHYSIOLOGICAL CAUSES
All hormones can affect your mood and these factors should be systematically researched and treated. Hormonal factors:
- Thyroid hormones
- Female hormones (Postpartum)
Depression is twice as common in women than in men, it means the impact of hormonal problems on this disease even if they are not the sole cause of this condition.
Any change in normal hormonal levels (pregnancy, childbirth, menopause …) or pathological (involvement of the genital sphere) can lead to the development of a mood disorder.
Recommended balance: thyroid examination
Many psychiatric disorders are accompanied by the appearance of depressive disorders such as anxiety disorders (Obsessive compulsive disorders TOC, generalized anxiety disorders TAG …), addictions, psychotic disorders, personality disorders etc. These diseases may not be apparent or not detected.
It is the anxiety disorders that are most frequently related to depression:
– The OCD : The obsessional is invaded by parasitic thoughts that are generally agonizing, that he fights by repetitive behaviors or recurrent thoughts to contain them.
He is in a permanent struggle and in a sterile mental activity.
His thoughts can overflow and invade all his psychic space and behaviors, reducing his living space.
The obsessional lives a living bustle, he is aware of his trouble, is helpless spectator of these behaviors.
– The TAG : the anxiety is constantly in a state of permanent tension / anxiety. It is invaded by worries. These fears have no object, he anticipates a possible danger that can affect any sphere of his life (personal, family, professional). This excessive anxiety that it has difficulty to control, causes great distress.
Because they greatly affect the functioning of the body and have a considerable impact on the quality of life and the family, the presence of a somatic disease often leads to the appearance of depressive symptoms.
BALANCE SHEET: medical check-up
· CHEMICAL CAUSES:
Toxic (alcohol, drugs):
Any abuse of toxic and even more their care can lead to genuine depressive states. Sometimes it is the cause, sometimes the consequence.
Depression often starts with massive and concealed alcohol intake, which the patient experiences as a “medicine”.
This type of intoxication is often hidden from the doctor and from himself.
BALANCE SHEET: Toxicological Assessment
Any taking medication can influence mood as well as stopping it. These “disadvantages” are often noted in the package leaflet.
SUGGESTED BALANCE SHEET: A balance sheet presupposes knowing precisely what “drug route” has been followed.
· PSYCHOLOGICAL CAUSES:
– Psychological Vulnerability : Our psychological mode of operation is detectable. It is our way of being in the world, our psychic identity card. According to its nature, it makes us more or less sensitive to the occurrence of a depression. If it dysfunctional, it puts us in a real state of suffering. We are then more vulnerable when dealing with certain negative situations.
Sometimes our way of perceiving our environment or ourselves is not objective. We then tend to analyze everything negatively that conditions our thoughts, behaviors and emotions.
– Psychotraumatism : Situations are recognized as traumatic and others as very stressful (divorce, mourning, accident …). These events can be experienced in different ways according to the people and their psychic state at that moment. : An event is said to be “traumatic” when a person has lived, witnessed or been confronted with death, fear of death (being threatened with death or seriously injured), or when his or her physical integrity or other person may have been threatened.
One can speak of a “post-traumatic stress disorder” or a “complex trauma”.
BALANCE SHEET: Full psychological assessment
· OTHER CAUSES
– The change of season : The disease arises at certain seasons, especially at the beginning of Autumn and Winter. Seasons that correspond to sudden changes in exposure to light can be a major trigger.
The hormone involved is melatonin, which synchronizes all the biological hormones.
SUGGESTED ASSESSMENT: Research into the patient’s life of sensitivity to changing schedules