5 Top Causes of Depression
We don’t see many clients in their first moments of depression. In fact, most of the people who come to us for treatment have been experiencing depression for much of their lives, often since childhood or puberty. For them, depression has been an ever-present dark cloud, hovering over them. We’ve all heard of depression described as a “chemical imbalance,” but I believe the more important question is “What factors contribute to our brain chemistry becoming unbalanced?”
Fun fact, our brain chemistry is directly affected by our experiences and behaviors. That’s right, people are not born depressed due to chemical imbalances. Rather, we can be born with a genetic predisposition to depression, meaning we are at a higher risk of becoming depressed after certain experiences than someone else for whom depression doesn’t run in their family. In other words, you may be at a higher risk for developing depression at some point in your life, simply due to genetics, but this is not a guarantee that you will ever experience depression. Instead, research has shown that the things you do (or don’t do) as well as the things that happen to you (or don’t happen to you) have a direct impact on the chemistry in your brain that is responsible for controlling your mood, among other things.
If you’ve been feeling depressed lately and aren’t quite sure how to work your way out of it, we’d be glad to help. Our cognitive behavioral therapists offer therapy in Orlando and online throughout Florida, that focuses on helping our clients work through depression, anxiety, and trauma. Here are a few of the top five experiences and behaviors that we see most often related to depression:
1. Lack of basic physical self-care
This one is tricky because the more depressed you become, the more likely you are to stop taking care of yourself physically. However, this can also work in the reverse order. For example, if you get a new job that demands for you to be on-call at all hours, responding to emails, it’s likely to affect your physical self-care (in the form of lost sleep, movement, and social connection) simply because you are trying to keep up with the workload and your new employer’s expectations. Lapses in basic physical self-care that can contribute to depression include:
Not sleeping enough. It’s been well documented that getting less than 7 hours of sleep on a regular basis will start to affect your mood, your health, and your functioning.
Sleeping too much. For adults, getting more than 9 hours of sleep per day is considered excessive and can lower your mood by decreasing time spent engaged in other activities that help keep you feeling well, such as accomplishment, social connection, and exercise. (Sleeping too much can also be a result of #2 or #5, see below)
Not enough nutritious food intake. This is not about calories, but rather about the quality of food you eat. Insufficient caloric intake on a consistent basis can contribute to feelings of fatigue, trouble concentrating, and other physical effects that often mimic depression. Likewise, eating large quantities of non-nutritious foods can also have a negative effect on your mood. Sugar and simple carbohydrates, for example, can cause rapid spikes in blood sugar, and without proper protein, healthy fats, and fiber in your diet to help moderate your digestion, you’re likely to feel a “spike and crash” feeling that can leave you run down and needing a nap.
Not enough physical movement. Certainly, we’ve all heard the general health guidelines about exercising regularly for cardio health. However, at an even more basic level, thanks to modern technology and the work-from-home wave, we are moving less than we ever have. This can mean spending long periods of time in the same spot, which trigger fatigue, feelings of shut down, decreased blood flow and oxygenation, which all relate to decreased feelings of overall vitality. This can have a similar effect to sleeping too much.
2. Unresolved complicated grief
If you have experienced one or more significant losses in your life and have not been able to fully grieve those losses, then feelings of sadness and fatigue will linger. If you are not sure how to grieve or process feelings of healthy sadness, then any coping mechanisms you use will only serve to keep the grief at bay. Common coping mechanisms include:
sleeping more
staying busy with tasks or social plans
taking on more responsibilities than you can reasonably accomplish in the time you have
distracting yourself with devices such as scrolling through social media or binge watching
alcohol or other drugs
comfort eating or binge eating
The problem with these methods is that the grief is simply on hold - waiting for pop up the second you aren’t engaged in one of these “suppression methods.” In other words, the sadness and depression is always threatening to surface the second you slow down or sober up.
3. Unresolved trauma
Trauma contributes to depression in three major ways.
The first, we often blame ourselves for our traumatic experiences. We become angry that we did not fight or run away or listen to that feeling in our gut that said some thing wasn’t right before it was too late. This Monday morning quarterbacking that we do with trauma often leads to depression because we talk horribly to ourselves about what we could have or should have done differently to prevent the trauma from happening. This only adds insult to injury and makes us feel worse.
The second, is that trauma inherently changes the way that we see the world. Our brain constructs rules to keep us safe and hopefully prevent any future additional traumas from happening. In order to do this we get new beliefs after trauma that include things like trust no one, or never let your guard down. These trauma based rules, which are designed to keep us safe, are often inherently depressing or isolating.
The third, is that at the core of every trauma is usually feelings of sadness, grief, and hurt. In the multi-layered onion that is the emotional traumatic experience, these feelings are often hidden under layers of anger, guilt, and shame that must be worked through first. Until then, the sadness and hurt, as well as the self-compassion about what you have experienced remain inaccessible. This is why trauma recovery often involves a stage of grieving after you have resolved feelings of shame and guilt.
4. Avoiding conflict and trying to keep the peace
One of the most common experiences that contributes to depression is the difficulty feeling and communicating healthy anger in a constructive way. We are physiologically wired to feel frustrated or angry when our needs are not met, when we are mistreated, or when something feels unfair or unjust. If you have trouble tolerating healthy feelings of anger, then you likely have trouble with the skills that come from anger including:
assertiveness
communication and negotiation
conflict resolution
self advocacy
If you struggle with anger (and consequently these skills), then you are likely to go for long periods of time feeling that your needs are not being met. This may lead to feelings of helplessness or resentment and can often lead to staying in toxic situations where we feel like we are at the mercy of others and unable to change our circumstances - which is a recipe for depression.
5. Trouble dealing with healthy uncomfortable emotions
This is an expanded version of #2 because we experience healthy uncomfortable emotions in response to all kinds of stressors - not just grief. Fo example, if you are at risk of being laid off, if your marriage is falling apart, or if your child is chronically ill, all of these situations will bring up natural emotional pain. These feelings are not in and of themselves a mental health problem, as long as you work through them in a constructive way.
However, if you experience a heavy dose of painful emotions in response to a major life stressor and have the urge to numb out, this can lead to a pattern of avoidance. Numbing out often includes sleeping more, staying in bed, scrolling through social media, binge watching, or other types of addictive behaviors. Anytime you are awake and involved in life, there’s the risk of remembering what’s currently happening for you, the risk of the pain coming flooding back. It’s tempting to want a few hours or a few days off from it.
Unfortunately, when we numb out from healthy pain, the pain often spirals on us. For example, instead of feelings of grief and helplessness about having a child with chronic illness, if you seek to numb out from these feelings, you may start to notice more painful feelings pile on such as:
shame and guilt about disconnected from your family or shame about being a “bad parent”
anxiety about whether or not you will be able to recover from this experience
anger at yourself for not being “stronger" and “just dealing with it”
In this way, the negative feelings multiply. The more negative feelings pile up, the more depressed and down you feel, and the more exhausting it seems to think about getting up and fighting through them. This is what most people think of as depression - numb, exhausted, nothingness. Essentially it’s a depression that develops when we avoid or numb out healthy pain, either because we aren’t sure how to process it or it feels too big to handle alone.
How Can Therapy Help With Depression
The beginning of therapy is often about trying to connect the dots - figuring out exactly what you’re experiencing and how it started. With depression, these are some of the top contributing factors a therapist is on the lookout for. These causes also help guide treatment.
If you’re struggling with depression and believe one of more of these may be the cause for you, we offer therapy in Orlando and online throughout Florida that can help. We help clients assess how well they’re taking care of their most basic physical needs and try to troubleshoot a plan for slowly improving that. We provide a safe space for clients to process through major losses or traumas that may be keeping them stuck. For clients who struggle with avoiding conflict, we can help you acclimate to tolerating feelings of anger in a healthy way and converting these to useful communication. Lastly, we work with avoidance of all kinds, especially emotional avoidance, to increase clients’ ability to tolerate and process through healthy feelings of emotional pain.
We can help.
If you or someone you love is struggling with depression, please reach out. We offer depression treatment including CBT Therapy in Orlando and online throughout the state of Florida. Call today or send us your info and we’ll reach out for a free consultation to see if one of our therapists would be a good fit.
