There are many potential causes of depression. Some depression runs in families, and researchers believe it's possible to inherit a tendency towards depression; this seems to be especially true for bipolar disorder (manic depression). Studies of families with several generations of bipolar disorder (BPD) found that those who develop the disorder have differences in their genes from most who don't develop BPD. But some people with the genes for BPD don't actually develop the disorder. Other factors, such as stresses at home, work, or school, are also important.
Major depression also seems to run in families, but it can develop in people who have no family history of depression. Either way, major depressive disorder is often associated with changes in brain structure or function.
People who have low self-esteem, who are consistently pessimistic, or who are readily overwhelmed by stress are also prone to depression. Physical changes in the body can also trigger mental health problems such as depression. Research demonstrates that stroke, heart attack, cancer, Parkinson's disease, and hormonal disorders can cause depression. A severe stressor such as a serious loss, difficult relationship, financial problem can also trigger a depressive episode. A combination of genetic, psychological, and environmental factors is often involved in the onset of depression.
Depression in Women
Studies suggest that women experience depression up to twice as often as men. Hormonal factors may contribute to the increased rate of depression in women; such as menstrual cycle changes, pregnancy, miscarriage, postpartum period, pre-menopause, and menopause. Women may also face unique stressors such as responsibilities both at work and home, single parenthood, and caring for children and for aging parents.
Many women are particularly vulnerable to depression after the birth of a baby. The hormonal and physical changes, as well as the added responsibility of a new life, can be factors that lead to postpartum depression in some women. Some periods of sadness are common in new mothers; but a full depressive episode is not normal and requires intervention. Treatment by a sympathetic health care provider and emotional support from friends and family are important in helping her to recover her physical and mental well-being and her ability to care for and enjoy her baby.
Depression in Men
Men are less likely to suffer from depression than women, but three to four million men in the United States are affected by the depression. Men are less likely to admit to depression, and doctors are less likely to suspect it. More women attempt suicide, but more men actually commit suicide. After age 65, the rate of men's suicide increases, especially among white men older than 85.
Depression also can affect the physical health in men differently from women. One study showed that men suffer a high death rate from coronary heart disease following depression. Men's depression may be masked by alcohol or drugs, or by working excessively long hours. Rather than feeling hopeless and helpless, men may feel irritable, angry, and discouraged.
Even if a man realizes that he is depressed, he may be less willing than a woman to seek help. In the workplace, employee assistance professionals or worksite mental health programs can help men understand and accept depression as a mental health disorder that needs treatment.
Depression in the Elderly
It's not normal for elderly people to feel depressed. Most older people feel satisfied with their lives. Depression in the elderly is sometimes dismissed as a normal part of aging, causing needless suffering for the family and for the individual. Depressed elderly persons usually tell their doctor about their physical symptom but may be hesitant to bring up their emotions.
Some symptoms of depression in the elderly may be side effects of medication the person is taking for a physical problem, or they may be caused by a co-occurring illness. If a diagnosis of depression is made, treatment with medication and/or psychotherapy will help the depressed person return to a happier, more fulfilling life. Psychotherapy is also useful in older patients who cannot or will not take medication.