It was the year 1620. As the clock passed midnight, a young man was drawn out from his dormitory. The lack of voices in the hallway that let him know it was safe to travel through the campus.
At night, he could explore his thoughts and the world outside while avoiding human interaction.
After making his way across campus to the library, he sat alone in a leather bound wooden chair. The light from his lantern flickered faintly on the cathedral-like ceiling; he felt alert and motivated.
With a sharpened quill in hand he wrote… 1
While attempting to relieve his depression through writing, he was also writing about his depression… or in his words melancholy.
The singing of the birds was his clue that morning was near and soon the campus would be full of life. He took long deep breaths as he walked steadily through the courtyard back to his dormitory.
Robert Burton is considered one of the founding fathers of the study of depression. His book published in 1620 titled The Anatomy of Melancholy explored both the causes and remedies for depression and cited nearly 500 medical authors. He revised and expanded his book five times throughout his life.
Since the time of Robert Burton, the medical community has agreed on three primary theories on the cause of depression.
- Depression is a biological disease, caused by a neurochemical imbalance. 2
- Depression is a psychological condition.
- Depression is a result of traumatic experiences.
Over the past five decades these theories have been segmented into many sub-theories. I explore some of those of those sub-theories below, but first I’ll start with the first primary theory…
Theory 1: Depression is Biological
According to my doctors, my depression is believed to be biological.
This means that they believe no amount of psychological therapy will have a lasting impact on my depression.
There are some pro’s and con’s of biological depression. One pro is that there are many therapies to modify our biology (antidepressants, artificial sunlight, exercise) while on the con side, this depression is usually chronic. If you find a therapy that works, there is a strong chance that if you stop using that therapy your depression will return.
These causes can stem from various trigger: genetics, chronic stress, geographic location, medical conditions and even our circadian rhythms.
I took some time to put together a list of biological causes and sub-causes in more detail. It’s a pretty long list so I thought it might be best to create a google doc so I can keep the document updated as I learn of more causes.
I’m using this document as my road map on my path to cure my depression. Enter your email below for the link.
Theory 2: Depression is Psychological
A diagnosis of Psychological depression is the most common. It’s also the most complicated. Unlike biological depression, finding empirical evidence is no easy feat; determining the most important subject matter and what tests are best used to study the subject matter have concluded in many disagreements among medical professionals.
There are two main Psychodynamic theories within the psychological realm. Anger Turned Inward and Object Relation Disorder.
Anger Turned Inward
This theory assumes that someone who has had poor relationships, possibly with parents or siblings, and out of fear, guilt and/or love, they begin to blame themselves and direct their anger inward.
Here is an example of an inward anger thought: “I’m not a good person; I don’t deserve to be happy.”
As life progresses, this person may develop a neurotic need to please. Many traditional therapies aim to help the individual overcome their feelings of inadequacy and decrease their desire of perfection.
Object Relations Theory
According to the object relations theory, a person may have difficultly understanding and manifesting healthy relationships. The symptoms of Object Relations Theory manifest themselves in two primary ways:
Anaclitic Depression – a person fears or grieves over the loss of relationships. They often fear abandonment and seek to maintain physical contact with a person or object.
Introjective Depression – a person feels like they inadequately meet their own or other people’s standards. They often fear losing approval, recognition and have chronic feelings of worthlessness and failing.
Coyne’s Interpersonal Theory
This theory is a little more modern (1976) and states that a person’s negative behaviours cause others to reject them. For example, a person may seek continuous reassurance from those around them. As the frequency of these requests increase, the people to whom those request are made look negatively upon this person and avoid or reject them. This worsens the depressive symptoms and promotes the cycle to start again.
There are many remedies for treating the symptoms of Psychological depression. In future posts, I’ll explore them in more detail.
Although speaking with a therapist is the conventionally recommended path, many people have decided to work through their symptoms solo.
If you’re thinking about trying it on your own, one great resource I’d recommend is the book Feeling Good by David D. Burns.
If you’re interested in speaking with a therapist or even if you just need someone to lend an ear, 7cups.com has got you covered. – They offer free, anonymous and confidential online text chat with trained listeners, online therapists & counsellors.
Theory 3: Depression from Trauma
Not everyone experiences a childhood filled with positive memories. In fact, over 60% of adults report experiencing family difficulties or abuse. 3
Christine Marcelle Heim, Ph.D. wrote in a 2012 article: 4
“In a multicenter treatment trial, 686 patients with chronic depression were treated… More than a third of the sample reported parental loss before age 15; more than 40 percent physical abuse; 16 percent sexual abuse; and 10 percent neglect.”
There is a very strong correlation between childhood trauma and mental illness, but not everyone who experiences a traumatic experience goes on to become depressed. Medical professionals are actively studying the differences in genetics and the timing of traumatic events in relation to depression later in life.
More importantly, the type of treatment must line up with the cause of childhood adversity.
Different adversities require different treatments
Patients with childhood trauma related to abuse, violence, or neglect responded twice as well to psychotherapy without medication than patients with no childhood trauma who received psychotherapy and medication and three times as well as those with parental loss.
If you’re looking for help explaining to your friends and family about your depression, or if there is someone who you believe is depressed, the video below may be a great way to break the ice.
- Burton Prefaces his book by saying “I write of melancholy, by being busy to avoid melancholy. There is no greater cause of melancholy than idleness, no better cure than business.”
- Wikipedia: The theory argues that neurotransmitter imbalances within the brain are the main causes of psychiatric conditions and that these conditions can be improved with medication which corrects these imbalances.
- National Center for Mental Health Promotion and Youth Violence Prevention, “Childhood Trauma and Its Effect on Healthy Development,” July 2012(http://sshs.promoteprevent.org/sites/default/files/trauma_brief_in_final.pdf)
- Childhood Trauma: What Role Does It Play in Depression?