There is no single cause for depression. Many factors play a role including genetics, environment, life events, medical conditions, and the way people react to things that happen in their lives.
Genetics
Research shows that depression runs in families and that some people inherit genes that make it more likely for them to get depressed. Not everyone who has the genetic makeup for depression gets depressed, though. And many people who have no family history of depression have the condition. So although genes are one factor, they aren't the single cause of depression.
Life Events
The death of a family member, friend, or pet can go beyond normal grief and sometimes lead to depression. Other difficult life events, such as when parents divorce, separate, or remarry, can trigger depression. Even events like moving or changing schools can be emotionally challenging enough that a person becomes depressed.
Family and Social Environment
For some teens, a negative, stressful, or unhappy family atmosphere can affect their self-esteem and lead to depression. This can also include high-stress living situations such as poverty; homelessness; and violence in the family, relationships, or community.
Substance use and abuse also can cause chemical changes in the brain that affect mood — alcohol and some drugs are known to have depressant effects. The negative social and personal consequences of substance abuse also can lead to severe unhappiness and depression.
Medical Conditions
Certain medical conditions can affect hormone balance and therefore have an effect on mood. Some conditions, such as hypothyroidism, are known to cause a depressed mood in some people. When these medical conditions are diagnosed and treated by a doctor, the depression usually disappears.
For some teens, undiagnosed learning disabilities might block school success, hormonal changes might affect mood, or physical illness might present challenges or setbacks.
Depression involves the brain's delicate chemistry — specifically, it involves chemicals called neurotransmitters. These chemicals help send messages between nerve cells in the brain. Certain neurotransmitters regulate mood, and if they run low, people can become depressed, anxious, and stressed. Stress also can affect the balance of neurotransmitters and lead to depression.
Sometimes, a person may experience depression without being able to point to any particular sad or stressful event. People who have a genetic predisposition to depression may be more prone to the imbalance of neurotransmitter activity that is part of depression.
Medications that doctors use to treat depression work by helping to restore the proper balance of neurotransmitters.
For some people, depression can be intense and occur in bouts that last for weeks at a time. For others, depression can be less severe but can linger at a low level for years.
Doctors who treat depression distinguish between these two types of depression. They call the more severe, short-lasting type major depression, and the longer-lasting but less severe form dysthymia (pronounced: diss-thy-me-uh).
A third form of depression that doctors may diagnose is called adjustment disorder with depressed mood. This diagnosis refers to a depressive reaction to a specific life event (such as a death, divorce, or other loss), when adjusting to the loss takes longer than the normally expected timeframe or is more severe than expected and interferes with the person's daily activities.
Bipolar disorder (also sometimes called manic depressive illness) is another depressive condition that involves periods of major depression mixed with periods of mania. Mania is the term for abnormally high mood and extreme bursts of unusual activity or energy.
Symptoms that people have when they're depressed can include:
- depressed mood or sadness most of the time (for what may seem like no reason)
- lack of energy and feeling tired all the time
- inability to enjoy things that used to bring pleasure
- withdrawal from friends and family
- irritability, anger, or anxiety
- inability to concentrate
- significant weight loss or gain
- significant change in sleep patterns (inability to fall asleep, stay asleep, or get up in the morning)
- feelings of guilt or worthlessness
- aches and pains (with no known medical cause)
- pessimism and indifference (not caring about anything in the present or future)
- thoughts of death or suicide
When someone has five or more of these symptoms most of the time for 2 weeks or longer, that person is probably depressed.
Teens who are depressed may show other warning signs or symptoms, such as lack of interest or motivation, poor concentration, and low mental energy caused by depression. They also might have increased problems at school because of skipped classes.
Some teens with depression have other problems, too, and these can intensify feelings of worthlessness or inner pain. For example, people who cut themselves or who have eating disorders may have unrecognized depression that needs attention.
How Is Depression Different From Regular Sadness?
Everyone has some ups and downs, and sadness is a natural emotion. The normal stresses of life can lead anyone to feel sad every once in a while. Things like an argument with a friend, a breakup, doing poorly on a test, not being chosen for a team, or a best friend moving out of town can lead to feelings of sadness, hurt, disappointment, or grief. These reactions are usually brief and go away with a little time and care.
Depression is more than occasionally feeling blue, sad, or down in the dumps, though. Depression is a strong mood involving sadness, discouragement, despair, or hopelessness that lasts for weeks, months, or even longer. It interferes with a person's ability to participate in normal activities.
Depression affects a person's thoughts, outlook, and behavior as well as mood. In addition to a depressed mood, a person with depression can also feel tired, irritable, and notice changes in appetite.
When someone has depression, it can cloud everything. The world looks bleak and the person's thoughts reflect that hopelessness and helplessness. People with depression tend to have negative and self-critical thoughts. Sometimes, despite their true value, people with depression can feel worthless and unlovable.
Because of feelings of sadness and low energy, people with depression may pull away from those around them or from activities they once enjoyed. This usually makes them feel more lonely and isolated, making the depression and negative thinking worse.
Depression can be mild or severe. At its worst, depression can create such feelings of despair that a person thinks about suicide.
Depression can cause physical symptoms, too. Some people have an upset stomach, loss of appetite, weight gain or loss, headaches, and sleeping problems when they're depressed.
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