Dumping Depression: Part 1 - What Really Causes Depression?
"Misery loves company."
-Unknown
I have no idea where this saying comes from or who invented it, but it seems to be at its truest in the field of mental health. Emotional illnesses and symptoms seem to come together, piling up on top of each other, like a nightmarish clown car full of acronyms - MDD, GAD, ADD, OCD, and the like. In major studies of mental health disorders, a key missing element in a book like DSM-5 are causes. Your therapist can tell you that you have depression, but may not be able to clearly say what caused it. Your psychiatrist might stamp your file with Generalized Anxiety Disorder, with no real explanation about where it came from. Nobody can tell you where this clown car from hell has come from, which can range from frustrating all the way over to infuriating!
Now, although most would hesitate to ascribe causes to these illnesses, many would gladly point out what we call "correlations and comorbidities". Think of it as the police arresting you as an accomplice to a crime because you are a known associate to the perpetrator and are often around them. It's the same here - few would venture to say "this caused your depression!", but there are a few things we often see riding around at the same time with depression. To take it further, these are the bad company depression likes to hang out with that might be peer pressuring or influencing it towards bad behavior.
Other Mental Health Issues
Going back to the image of the hellish clown car of acronyms, these clowns often ride around, seeking to attack individuals as a team. Many other illnesses can go along with depression. Sometimes they come from the existing thought patterns of chronic depression, or the daily struggles of living with other conditions can spawn depressive episodes. For example, some of us struggle with mood disorders like depression and anxiety because of unhealthy thought patterns that have developed, such as being perfectionistic, or excessively people-pleasing. On the other hand, some of us have been triggered by traumatic life events, such as a loss of someone, an injury, or major financial troubles. Here are some of the conditions that can go along with depression:
ANXIETY
Anxiety is one of the most common conditions that come together with depression. They are extremely similar in that they work almost the exact same way, but cause different types of disruption. They both exist in the world of our moods. Depression comes with a numb or irritated feeling, fatigue, and low energy. On the other hand, Anxiety keys us up, making us hyper-vigilant and ever worried. The symptoms are different, but our moods come from our thoughts. The same negative thinking patterns that drive depression also drive anxiety. We address this more in Dumping Depression Part 2- Dumping Our Negative Inner Voice. This is why both of these disorders are most often treated with Cognitive Behavioral Therapy, which examines our thought patterns and addresses them from a more rational point of view.
ADHD
ADHD might be an odd illness to connect to depression, but I think there can be a strong case for this. The disruption of ADHD is often that it creates a poor fit in the life of the person. Society requires a person with ADHD to sit still for hours at work or school, when this is not their brain chemistry. This can lead to a lifetime of criticism, poor grades, and poor performance at work, leading to negative belief about one's self and abilities. The poor fit between society and a person with diagnosed or undiagnosed ADHD or a "hunter-type", in a society that does not understand how you work, can lead to thought patterns that can cause depressive episodes. Living like this can over time cause feelings of worthlessness, guilt, and inferiority.
ALCOHOL & DRUG ADDICTION
This can be another chicken-or-egg situation as well. Did the addiction come before the depression, or vice-versa? Especially in cases of chronic and/or severe depression, we can sometimes feel driven to self-medicate with drugs and alcohol. Also, depending on the substances abused, depression can worsen, most notably in alcoholism since alcohol is a depressant. Thankfully, the same things that can improve alcoholism or drug addiction can also improve depression. We cover this more in Part 4.
EATING DISORDERS
Much like with alcohol & drug addiction, eating disorders can work both ways - either as a self-medication for depression, or as a trigger as one goes through the shame and guilt portions of the addiction cycle. Many of the same solutions continue to endure here - seeing a professional, staying engaged in positive, fulfilling activities, maintaining a focus on the present and living life one day at a time, and engaging in a healthy community such as a support group.
Emotional Habits
It is said that illnesses like depression are inherited, and our minds often jump to the ingrained DNA or biological signatures that we are unable to control. This is often true and important, but what we sometimes overlook is how traits are learned from our family of origin. This plays a large role in how we behave because we don't know any other way to be. Take for example, a mother's habit of keeping the window curtain closed in your house growing up; you don't see it as a big deal. You then grow up to feel most comfortable in a darkly lit space, but you don't realize how much sunlight affects your mood. Such a small thing like this combined with other small habits like poor diet, problematic relationship patterns and unhealthy coping skills can cause a big problem - Depression. Let's look at other small behaviors that might be undermining your mental health.
GUILT OR SHAMING
Being in an environment where one is constantly being made to feel guilty or ashamed may also be a factor for depressive episodes, or in the long term, chronic depressive disorders. In assessing patients for depression, one of the emotions we look for is guilt, along with shame, inferiority, and/or worthlessness. If someone - a parent, teacher, bully, boss, coworker, abuser, anyone - kept you under their control through guilt trips and humiliation, core beliefs will develop that will likely birth the emotions that come with depression. Depression thrives on the harsh or dejected inner voice, which fuels numbness, low mood, and even thoughts of self-harm or suicide. A negative inner voice fuels this, but that inner voice first came from a critical outer voice.
POOR BOUNDARIES & RELATIONSHIPS
This one's a chicken-or-the-egg issue straightaway. Did poor boundaries cause depression, do they stem from it, or both? Being in any kind of adverse or unpleasant situation can trigger episodes of depression. Often having poor boundaries is a learned behavior, living in an environment that constantly breaks healthy boundaries, teach you that you and you personal boundaries do not matter. This can cause one to end up in unhealthy situations in our lives over and over again, and in time causes us to develop negative beliefs about ourselves. This might lead to some depression, or other illnesses such as anxiety, or even Posttraumatic Stress Disorder in some situations.
The thought patterns and low mood of depression can also make it very difficult to set or maintain those healthy boundaries that keep your relationships healthy. Self-deprecating thoughts like "I'm worthless" or "I'm stupid" can leave us vulnerable to exploitation in our relationships.
Major Life Issues
Sometimes, we feel depressed, either for a time, or for the long-term, because something changed and we just can't deal. Maybe you lost your home, or lost a loved one who passed away, or maybe they're still alive but you don't speak to each other anymore. Maybe you or a loved one are facing a serious chronic illness, or even a potentially fatal one. There are a lot of changes that we don't control, and we don't welcome them. We naturally and understandably struggle to grapple with these issues. Sometimes however, the way we handle our grief over these difficult issues can cause us to get stuck in our emotions and our lives suddenly become so much more complicated. Difficulty adjusting to these types of major life changes can be a significant factor in developing depression.
DIFFICULT LIFE CIRCUMSTANCES
Depression is also strongly associated with difficult life circumstances. The struggles of poverty, divorce, abuse, or other family stressors create mental stresses that correlate strongly with depression. Vulnerable populations such as the poor are more likely to suffer from depression. Any kind of adverse circumstance - illness, disability, etc. comes with a higher likelihood for depression and other mental illnesses. Some awareness here can go a long way. As we deal with difficult issues, whether temporary or long-term, it may help to proactively get mental health services in order to smooth our transition or coping process.
How to Get Help
As stated in the previous blog, it can be difficult to get help because of the nature of depression and the route to getting help is hard to figure out even when you want it. Here are some ways to get help:
Psychology Today (US, Canada & UK) - Psychology Today has the largest list of therapists in the United States Canada, and the United Kingdom. Feel free to filter by your insurance, specific areas of treatment, and even what gender of clinician you would like to work with.
Talkspace - Talkspace is the leading site which offers counseling services over the internet. This may be helpful if you are uninsured, or have a high copay for mental health. A counselor can work with you via messages, and also through video chat.
Betterhelp - Betterhelp is another large online counseling site that offers you unlimited access to a counselor for a weekly fee. Sessions take place via messaging and also via video chat.
GoodTherapy (International) - Good Therapy is a large therapy directory with therapists available worldwide.
If you know any others that may be helpful, or services in other countries, please contact us and let us know!
Help for Suicidal Thoughts
Depression can be a debilitating illness, and we implore anyone dealing with it to take it seriously. If you are having thoughts of suicide, please call 1-800-273-8255 in the United States. It is available 24 hours a day, 7 days a week. Here are some international hotlines as well:
Thanks to the International Bipolar Foundation for this list!
Many things can cause depression, and we do not fully know what they are. These are some common things that come along with it. If you are dealing with any of these, or depression itself, get help. Call your suicide hotline if necessary. See a therapist. You can beat this, and you will.
Bonus: Use our Guidebook to reduce your triggers
At the root of the issues outlined in this blog are the ways we think about things and see ourselves.
While meditating and taking steps to meet your needs will help, perhaps you might feel that you need more help in order to make changes that stick. At Forward Ethos, we have seen this time and time again over thousands of therapy sessions with clients across the United States.
We have taken the techniques, tools, and skills that have transformed our clients’ lives since 2018 and distilled them into a powerful journal that will change your life in as little as 20 days. It also targets illnesses that stem from our thinking, such as anxiety and depression.
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