Talk to different professionals—medical, research, anthropological, biochemical, and psychological—and you’ll get different answers about what causes depression. Even the “chemical imbalance” theory is suspect, though it’s the most common, because research now shows that brain chemistry can be influenced by changes in thinking, behavior, and self-awareness; which makes it a “what comes first” question.
It’s very common for people to say they’re “down” when they’re overwhelmed or upset, but true clinical depression is a different condition. It comes in cycles, often seasonal, and has specific triggers. Some depressions, such as postpartum depression (after giving birth) are partly situational (caused by feeling overwhelmed by parenting responsibilities, the stress of losing sleep, etc.) and hormonal (result of hormonal changes). This varies widely, and the definition of who is considered depressed varies widely as well.
Any situation where expectations are unrealistic can be considered a “set up” for disappointment, which some people experience as depression. If there is an underlying belief that “I don’t deserve happiness”, then the common difficulties in developing a new relationship after marriage will be seen as a disaster and may result in depression.
Most couples experience some form of disappointment and worry that their relationship isn’t going to work out. Whether they react to that disappointment by going into depression depends on the individual.
Men more often react to difficult life experiences by becoming depressed, because they feel less comfortable expressing their feelings, so their disappointment and pain condense into a feeling of despair and depression. Men are also more prone to depression and other mood disorders, in part because they try to “resist” and are less likely to have or use the support of family and friends.
Women are more likely to have a hormonal component to their depression, which can alternate with the menstrual cycle. Women will express their emotions more, have family and friends to talk to, and therefore often avoid depression.
In my experience, I find that the tendency to become depressed is largely the result of learned behavior and a belief system that centers on hopelessness. In my office, people who are depressed often express hopelessness and a feeling that they cannot be in charge of their own lives. When that belief system changes, there is no longer depression. There is also a cyclical nature to depression, which could be the result of genetics, but no one knows for sure. Situational depression is experienced when people are deeply hurt, disappointed, or have experienced a great loss or tragic situation. This type of depression resolves gradually and can be overcome. Symptoms of depression include lack of energy, perhaps not being able to get out of bed, withdrawal, avoidance of intimacy, lack of communication, and feeling hopeless and powerless to solve life’s problems. But may people continue to go through it by working hard, but living a colorless life with a feeling of emptiness.
Studies show that depression responds best to a combination of antidepressants and cognitive/behavioral therapy. If the depression is severe, inpatient treatment at a center that provides behavioral conditioning is most effective. If you think someone you love is depressed, don’t try to make a diagnosis. You can point to any behavior you’re noticing and say, “I see you’re crying a lot (or sleeping too much, hiding, or not wanting to talk) and I think that indicates a problem. Would you come to counseling with me?” ?” If a loved one is going to counseling with you, the therapist will be able to diagnose depression and make recommendations—without making you feel criticized, as you would if you told them it’s depression. Counseling will also help you deal with situations of depression. more effectively and will help you not create more drama and dysfunction in the relationship.
Americans tend to look for the quick fix. It seems easier to take a pill than to fix the problem. But the side effects of antidepressants are no joke. Research shows that the most effective treatment for depression is Cognitive Behavioral Therapy, in combination with mild antidepressants. Drugs don’t fix depression; they lift your spirits to make it easier to resolve emotional problems.
Depression affects both emotionally and physically, not only the affected person, but also their spouse and family. Here are some of the many steps you can take to help your loved one survive and thrive.
How to help a loved one with depression:
1. Understand the diagnosis and what it means Take your loved one to medical appointments so you understand what the doctor is saying. A depressed person may not fully understand what the doctor is saying. For additional support, look online for disease-focused special interest groups, such as those sponsored by Mental Health America (MHA) or the Depression and Bipolar Support Alliance (DBSA), which are geared toward meeting the needs of people with depression. Although depression support groups are not psychotherapy groups, they can provide you with a safe and nurturing place to vent your frustrations and fears and receive comfort and encouragement from others. You will learn a lot from those who already have experience.
2. Help your loved one do what the Dr says, but don’t take over Managing depression is a big adjustment, so help your loved one remember to take medicine, keep Dr. appointments, and do any exercise , home medical procedures or other personal care processes. However, make sure these things remain your loved one’s responsibility. Both of you will feel better if you support them, not the parents.
3. Take care of yourself. Taking care of a depressed spouse is exhausting, so you need to take extra care of yourself as well. Use any available help from health insurance, family, and friends. Arrange for other people to be available to give you a break, and don’t feel bad about going out alone once in a while when you need it.
4. Keep your connection, friendship or romance alive Find as many ways as you can to let them know you care for each other. However, you may have to adjust your social and intimate life, do it. Do what you can to keep your connection alive within the confines of the disease. Have as much fun as you can, whenever you can. Make it a challenge to discover new ways to enjoy each other and to relax and laugh together.
My most recent book, How To Be Happy Partners: Working It Out Together shows how to have successful conversations with your partner about difficult topics and how to work together to help each other through emotional issues.