Causes of Depression

Written by Pang Ji Cheng
Psychiatry and Psychology
Updated on September 04, 2024
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The causes of depression are often unclear and may be closely related to multiple factors such as biological, social, and psychological aspects. From a biological perspective, genetics is a primary factor, especially as indicated by family studies, which have found genetics to play a significant role. Genetic factors typically involve multiple gene loci. Furthermore, neurochemical factors like serotonin and norepinephrine are notably related. Beyond biological factors, psychological elements, particularly in individuals with certain depressive traits or personality characteristics, significantly increase the incidence of developing the condition. Social environmental factors are primarily associated with adverse major life events. After experiencing acute life events, individuals may become susceptible to depressive episodes. Hence, it is observed that depression in patients results from multifactorial influences rather than a single factor, culminating from a complex interplay of these elements.

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Psychiatry and Psychology
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Will depression get better?

Patients with depression can achieve clinical recovery. Large-scale survey studies have found that about 85% of patients can reach clinical recovery as long as they undergo systematic and standardized treatment. At the same time, systematic and standardized psychotherapy and physical therapy should also be conducted. This can uphold the recurrence rate or relapse rate of the patients. Studies have found that about 20% relapse within six months after the initial treatment, and the relapse rate reaches 50% within two years. For older patients, their relapse rate may be even higher. Therefore, depression is a highly curable disease, but also a highly recurrent disease. Systematic, standardized, and scientifically reasonable treatment is still a very important means to achieve good recovery rates and reduce relapses in depression.

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Do patients with mild depression need to be hospitalized?

Patients with mild depression can choose inpatient treatment or outpatient treatment. The main decision depends on the communication between the patient, their family, and medical professionals. Patients with mild depression have relatively mild depressive symptoms, so psychological therapy is primarily used, with pharmacotherapy and physical therapy serving as supplementary treatments. Psychological therapy mainly employs cognitive-behavioral therapy to improve the patient’s unreasonable beliefs and alleviate emotional stress. This includes identifying automatic thoughts, recognizing the irrationality of cognition, and employing reality testing, ultimately aiming to improve the patient's symptoms. Pharmacological treatment primarily uses serotonin reuptake inhibitors, and patients can adhere to a regular medication schedule at home during outpatient treatment periods. Physical therapy consists mainly of transcranial magnetic stimulation, which can be administered either as an outpatient or inpatient treatment. The final treatment choice should involve comprehensive communication with the patient's family and physicians to make an informed decision.

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Symptoms of depression

The symptoms of depression almost always include persistent low mood throughout most of the day, and patients generally lack interest or pleasure in all activities. Patients may exhibit psychomotor agitation or retardation, and experience fatigue, weakness, and feelings of inadequacy. They may feel that their lives are worthless and meaningless, have feelings of self-reproach or guilt, and suffer from poor concentration and indecisiveness. Recurrent thoughts or behaviors of suicide may occur, and some patients may even make specific plans for suicide. Therefore, these are the primary symptoms of depression. Some patients may present primarily with physical symptoms, such as dizziness, headaches, palpitations, frequent or urgent urination, and gastrointestinal discomfort. It is important to conduct relevant examinations to avoid misdiagnosis.

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Is depression considered a mental illness?

Depression is clinically classified as a mental illness, specifically a type of mood disorder. Its main clinical manifestations include low mood, slow thought processes, reduced volitional activity, fatigue, lack of interest, lack of pleasure, often accompanied by sleep disturbances, changes in weight, changes in sexual desire, and low self-esteem. Patients often feel fatigued and dissatisfied throughout the day, and their attention may decline. They may experience feelings of guilt, worthlessness, futility, and despair. It is not uncommon for patients to have thoughts or behaviors of self-harm or suicide. Thus, depression is a mental disorder that requires systematic antidepressant treatment once diagnosed. Effective treatment outcomes can often be achieved through a combination of medication, psychotherapy, and physiotherapy.

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Treatment of Depression

The treatment of depression in clinical settings primarily utilizes pharmacotherapy, psychotherapy, and physical therapy. Pharmacotherapy, as the first-line treatment for depression, mainly relies on selective serotonin reuptake inhibitors such as paroxetine, fluoxetine, sertraline, escitalopram, venlafaxine, and duloxetine. Adequate dosages and treatment duration with a systematic approach are essential when using pharmacotherapy. Secondly, psychotherapy. The main psychotherapeutic approaches include cognitive-behavioral therapy, psychoanalytic therapy, and interpersonal therapy, which aim to improve the patient's irrational cognitions and rebuild their cognitive framework. Thirdly, physical therapy. In clinical practice, physical therapy mainly encompasses electroconvulsive therapy and transcranial magnetic stimulation, both of which can yield significant therapeutic outcomes. (Specific medications should be used under the guidance of a physician.)