Discussion: an expansion

    Generally, the suggestion is that depression is a medical illness - some bio-neuro-chemical problem,
    without psychological causes (psychological: internal responses to external events and circumstances).

    However, all so-called "psychological problems" have some physical manifestations, and all physical
    illnesses have psychological components as well.
    * In fact, the chemical imbalances that occur during depression usually disappear when you complete
      therapy for depression, without taking any medications to correct the imbalance.
    * This suggests that the imbalance is the body's physical response to psychological depression, rather
      than the other way around - in most instances.
    * Some types of depression do seem to run in families, which suggests a biological vulnerability. This
      often seems to be the case with bipolar depression and, to a lesser degree, severe major depression.
    * Studies of families, in which members of each generation develop bipolar disorder, found that those
      with bipolar disorder have a somewhat different genetic makeup than those who are not diagnosed.
    * However, the reverse is not true. Not everybody with the genetic makeup that causes this
      vulnerability to bipolar disorder necessarily develops the disorder.
    * Additional factors, such as stress and other psychological factors, are involved in its onset as well.
    *Likewise, major depression also seems to occur, generation after generation, in some families, but
     not with a frequency that suggests clear biological causes. Additionally, it also occurs in people who
     have no family history of depression.

    So, while there may be some biological factors that contribute to depression, the indicators are that it
    is often a psychological/emotional reaction "disorder" - making the physio-biological aspect become a
    sort of chicken-egg situation (which came first?).

    A variety of psychological factors appear to play a role in vulnerability to these severe forms of
    depression. Most likely, psychological factors are completely responsible for other forms of mild and
    moderate depression, especially reactive depression.
    During treatment, Reactive depression is usually diagnosed as an adjustment disorder. People who
    have low self-esteem, who consistently view themselves and the world with pessimism, or who are
    readily overwhelmed by stress are more prone to depression.

    SOCIAL ENVIRONMENT - Culture (Learned Behaviour)
    Social learning factors are significant in the development of depression, as well as other psycho-
    logical problems. People learn both adaptive and maladaptive ways of managing stress and respond-
    ing to life problems within their family, educational, social and work environments. These environ-
    mental factors influence psychological development, and the way people try to resolve problems when
    they occur.

    Social learning factors also explain why psychological problems appear to occur more often in family
    members, from generation to generation. If a child grows up in a pessimistic environment, in which
    discouragement is common and encouragement is rare, that child will develop a vulnerability to
    depression as well.

    A serious loss, chronic illness, relationship problems, work stress, family crisis, financial setback, or
    any unwelcome life change can also trigger a depressive episode, understandably.

    The immediate social and intimate environments can also be the cause of the reaction. Also, certain
    events & holidays, such as Christmas can bring on a temporary depression. So will bereavement
    and loss.

    Some forms of depression are actually anger that is "masked" or suppressed.

    Very often, a combination of biological, psychological, and environmental factors are involved in the
    development of depressive disorders, as well as other psychological problems.

    As you can see, there are more non-physical "causes" listed here, than physical ones. Yet, commonly
    only the physical ones seem to be the ones focussed on by many therapists - who prescribe drugs that
    absolutely will do nothing for the non-physical causes (at best, they are symptom treatment only, in
    those instances. On the other hand, the physiological is not my field; mine deals with the "less explored
    and considered" causes. If that is what you are dealing with, I am available for assistance.
Depression - Dysphoria: enigma
Major Depressive Uni-polar "Disorder": Causes & Treatment
To return to the Introduction to Depression,
click/tap the icon at the right
Klaas Tuinman
Dawn Cove Abbey
Deerfield, (Yarmouth County) Nova Scotia, Canada - 2008
Revised Meaford, Ontario: 2019
    The general short introduction
    The reality is, as with many mental/emotional/spiritual reactions, that a variety of  factors may/
    will be involved. We have already seen, that it is not known exactly what causes depression.
    And because of that, generally the total number of things that are possible causes are not
    considered, and therefore, "treatment" and assistance often address the wrong possible
    "causes" - which results in "treatment" not working, or not working well.

    * Biological differences. People with depression appear to have physical changes in their
      brains: the significance of these changes is still uncertain. But eventually, we may discover the
      cause they point to.
    * Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that may well
      play a role in depression. Recent research indicates that changes in the function and effect of
      these neurotransmitters and how they interact with neurocircuits involved in maintaining
      mood stability, may play a significant role in depression and its treatment.
    * Hormones. Changes in the body's balance of hormones may be involved in causing or
      triggering depression. Hormone changes can result with pregnancy and during the weeks or
      months after delivery (postpartum) and from thyroid problems, menopause or a number of
      other conditions.
    * Inherited traits. Depression is more common in people whose blood relatives also have
      this condition. The search is on to find genes that may be involved in causing depression.

    * Reaction to life circumstances and events:  - and therefore often related to such   
      "conditions/emotions" as "Post-partum Blues (a combination of hormonal and emotional
      factors)", Grief, Guilt, Fear and suppressed anger, among others.
    * Similar to the manifestations on the Anxiety spectrum, Depression is a Reaction, called a
      mood "disorder"/reaction to life circumstances as indicated above (UNLESS it is directly caused
      by a physiological condition). It is one that is characterized by a persistent feeling of sadness,
      and loss of interest (in almost everything). It is also known  as "major depressive disorder"  or
      "clinical depression".
    * It permeates and affects virtually everything in life: how you feel, think and behave, and
      generally leads to a variety of emotional and physical problems. You may have trouble doing
      normal day-to-day activities, and sometimes you may feel as if life isn't worth living.
    * It is more than just a bout of the blues: depression isn't a weakness, and you can't
      simply "snap out" of  it. Depression may require long-term treatment. But don't get discouraged.
      Most people with depression feel better with the right medication, therapy (or both).
    * NOTE: "right" treatment requires the right diagnosis ... so here are other less frequently
      considered possible (probable) causes.

    Extended inventory of possible causes (there may be others yet . . .  this is open-ended:
    * It can be a result of a neuro-chemical problem, as a result of an illness, or some other rogue
      (unknown) biological imbalance, which has negatively affected the body's chemistry. And if
      that's the case, there are medications that can help; as can taking Vitamin D3, and Omega-6
      supplements, and getting out in the sunshine, or using a special lamp that simulates the sun.
    * But at other times, which are more common (and likely): it can also be a reaction to some-
      thing, things like: stress, certain events (such as the death of a loved one, or a pet - see
    Grief/Bereavement, and certain upsetting or painful circumstances. It can also be due to
    social (and more intimate) environments in people's lives (see "Environment" below).

    The Not Commonly Considered or Explored ones: but very relevant in many cases.

    * Indecision: the "hidden"one. This is one that is often overlooked -or not mentioned
    - because it isn't generally considered by many health-care providers. That "hidden" cause is,
    indecision. Indecision resulting from being faced with actually knowing what you are reacting
    to, and knowing  what you can do about it, BUT, there are two (or more) options you need to
    choose between, and you don't  like any of them. And consequently you hover between them,
    without making a decision or  choice. It could be that they contradict your values, morals,
    ethics, etc., or because of more mundane, but important reasons, you are unable to do so,
    perhaps for financial reasons, or whatever (which would result in feeling trapped). It is when
    they avoid the choice or defer it, that the problem arises - for some reason, human emotional-
    mental functions do not handle indecision well - especially if on a prolonged basis - and the
    condition we know as depression often results.  That inability to choose, whilst knowing what
    the right choice to make is, creates an inner dis-balance, and our minds do not handle that
    well; it creates what is called cognitive dissonance.

    * Cognitive dissonance and the Double Bind: is the mental discomfort (psychological
    stress) experienced by a person who is simultaneously faced with having to somehow (balance/
    juggle), hold two or more contradictory beliefs, ideas, or values, in a way that makes sense -
    except that no matter how hard they try - it is impossible to reconcile the two - and so a major
    uncertainty results. And we humans do not handle "uncertainty" well - always trying to "second-
    guess" the situation, or reality: "what, or which one, to believe".

    Cognitive dissonance is the resulting consequence of having to chose between performing two
    "actions" that contradict personal beliefs, ideals, and values; it also occurs when confronted with
    new information that contradicts those beliefs, ideals, and values. It is also known as being in a
    Double Bind situation where a person is confronted with two irreconcilable demands, or a choice
    between two undesirable courses of action.

    *The Double Bind: Originally, it referred to a no-win kind of communication that Gregory
    Bateson and his colleagues believed was a contributing factor in schizophrenia (but it can be a
    contributing factor in depression, as well. One example of double bind communication is a
    mother giving her child the message: "Be  spontaneous." If the child acts spontaneously, s/he
    is not acting spontaneously because s/he is following his mother's direction. This leads to an
    inner cognitive dissonance.

    * Similarly, if a child's father continually said, "I love you, and cherish you" to the child, but then
    was constantly verbally (and/or physically) abusive to that child, the child would be confused by
    the actions and words not "adding up"- it creates a Cognitive-Emotive contradiction that the child
    is unable to ever reconcile - and the effects of that often stay through life to interfere with
    happiness and joy, until, or unless dealt with at some point.

    * And that is a no-win situation for the child. If a child is subjected to this kind of communication
    over a long  period of time, it's easy to see how he could become thoroughly confused - with
    depression as a strong possible consequence. It is virtually impossible for humans to be able to
    "balance" two contradictory states, actions etc in a positive, constructive and wholesome way.

    * There is a Zen story that is a good illustration of the double bind and also of a unique solution.
    A Zen master says to his pupils: "If you say this stick is real, I will beat you. If you say this stick
    is not real, I  will  beat you. If you say nothing, I will  beat you." There seems to be no way out.
    One pupil, however, found a solution by changing the level of communication. He walked up to
    the teacher, grabbed the stick, and broke it. Thus "breaking" the bind.

    * The double bind concept is applicable to many of our life situations - and in instances of mental/
    emotional challenges (dis-ease), not only Zen teachings.

    * If you wish to explore this (Double Bind-Cognitive Dissonance) further, there is a link to
    another page at the bottom of this one (on another site).

    Anomie/Alienation: Normlessness
    * Anomie is a "condition in which society provides little moral guidance to individuals".[1] It is
    the breakdown of social bonds between an individual and the community, e.g., under unruly
    scenarios resulting in fragmentation of social identity and rejection of self-regulatory values. It is
    also known as "normlessness". This concept was introduced by Emile Durkheim in his classic study
    on Suicide.

    * "Normlessness" refers to a state of confusion and inner disorientation that occurs when it feels/
    seems like nothing is connected, nothing is "logical, nothing is ethical/moral - that every thing is
    a chaotic, random, made-up-on-spur-of-the-moment hodge-podge. When that occurs, humans all
    have negativereactions/responses - one of which is depression- and a state of feeling "alienated".
    * Hopelessness: (having given up, or lost, hope). Sometimes, when our life circumstances have
    changed drastically, or are faced with a seemingly hopeless situation, that it's sheer, seemingly
    overwhelming dimension results in feeling no hope, and the result of that is very similar to
    Anomie/Normlessness above.

#1: Get active. Dealing
with depression requires action:
your participation. Yet, taking
action when you’re depressed
is  hard.

Sometimes, just thinking about
the things you should, or could,
do to feel better, like exercising
or spending time with friends,
can seem, and feel, exhausting
or impossible to
actually get in gear.
That's the dilemma and enigma of Depression: the things that help the most being the things that are the
hardest to do. But remember, there's a huge difference between difficult and impossible.
  • It takes will-power (often a tremendous amount), and a strong desire to heal, and while you may not have
    much energy, you can draw on all your reserves: enough to take a walk around the block, or pick up the
    phone to call a loved one.

Baby Steps
Taking the first step is always the hardest. But going for a walk or getting up and dancing to your favorite music,
for example, is something you can do right now. It can substantially boost your mood and energy for several
hours. That's long enough to put recovery step two into action; something like preparing a mood-boosting meal,
or arranging to meet an old friend.

There’s a reason that most therapists suggest taking it slow when trying to treat depression. If you feel good one
day, and decide to try and start a new venture, or make a new friend, and you don't succeed, it could be a
powerful setback in overcoming depression.

Instead, try things out slowly, and experiment with change one step at a time (save the leaps for when you’re
feeling fully recovered!).

When you do take steps into your renewed future, trying out new behavior strategies or relationship skills,  
reward yourself for your successes. We're all quick to compliment others for doing something nice, but not
ourselves. Give yourself a compliment and a reward for accomplishing some goal you have set for yourself in
your depression recovery.

Avoid solitude - even though retreating "into the cave" will be your first inclination.

Avoid dark rooms - open the curtains, have lights on, go outside - a dark environment feeds and encourages
dark, depressive, and defeatist thoughts and emotions/feelings.

Stay Connected:
  • Talk to one person about your feelings
  • Help someone else by volunteering
  • Have lunch or coffee with a friend
  • Ask a loved one to check in with you regularly
  • Accompany someone to the movies, a concert, or a small get-together
  • Call or email an old friend
  • Go for a walk with a workout buddy
  • Schedule a weekly dinner date
  • Confide in a clergy member, teacher, or sports coach

  • Make face-time a priority. Phone calls, social media, and texting are great ways to stay in touch, but
    they don’t replace good old-fashioned in-person quality time.  The simple act of talking to someone face to
    face about how you feel can play a big role in relieving depression and keeping it away.

  • Try to keep up with social activities even if you don’t feel like it. Often when you’re depressed, it feels
    more comfortable to retreat into your shell, but being around other people will make you feel less
    depressed. Meet new people by taking a class or joining a club.

  • Find ways to support others. It’s nice to receive support, but research shows you get an even bigger
    mood boost from providing support yourself. So find ways—both big and small—to help others: volunteer,
    be a listening ear for a friend, do something nice for somebody.

  • Care for a pet. While nothing can replace the human connection, pets can bring joy and companionship
    into your life and help you feel less isolated. Caring for a pet can also get you outside of yourself and give
    you a sense of being needed—both powerful antidotes to depression. Take a dog for a walk. If don’t own a
    dog, you can volunteer to walk homeless dogs for an animal shelter or rescue group. You’ll not only be
    helping yourself but also be helping to socialize and exercise the dogs, making them more adoptable.

  • Join a support group for depression. Being with others dealing with depression can go a long way in
    reducing your sense of isolation. You can also encourage each other, give and receive advice on how to
    cope, and share your experiences.

  • Exercise is something you can do right now to boost your mood. Start Exercising and Stick to It:
    Creating an Enjoyable Exercise Routine. Pair up with an exercise partner. Not only does working out with
    others enable you to spend time socializing, it can also help to keep you motivated. Try joining a running
    club, taking a water aerobics or dance class, seeking out tennis partners, or enrolling in a soccer or
    volleyball league.

  • Eat a healthy, depression-fighting diet. Minimize sugar and refined carbs.

  • Get a daily dose of sunlight. Sunlight can help boost serotonin levels and improve your mood.
    Whenever possible, get outside during daylight hours and expose yourself to the sun for at least 15 minutes
    a day. Remove sunglasses (but never stare directly at the sun) and use sunscreen as needed.

  • Challenge negative thinking. Do you feel like you’re powerless or weak? That bad things happen and
    there’s not much you can do about  it? That your situation is hopeless? Depression puts a negative spin on
    everything, including the way you see yourself and your expectations for the future.

  • When these types of thoughts overwhelm you, it’s important to remember that this is a symptom of your
    depression and these irrational, pessimistic attitudes—known as cognitive distortions—aren’t realistic. When
    you really examine them they don’t hold up. But even so, they can be tough to give up. You can’t break out
    of this pessimistic mind frame by telling yourself to “just think positive.” Often, it’s part of a lifelong pattern
    of thinking that’s become so automatic you’re not even completely aware of it. Rather, the trick is to identify
    the type of negative thoughts that are fueling your depression, and replace them with a more balanced way
    of thinking.

Let go of Negative, unrealistic ways of thinking that fuel depression. All-or-nothing thinking – Looking at
things in black-or-white categories, with no middle ground (
“If I fall short of perfection, I’m    a total failure.”)
  • Overgeneralization – Generalizing from a single negative experience, expecting it to hold true forever (“I  
    can’t do anything right.”)
  • The mental filter – Ignoring positive events and focusing on the negative. Noticing the one thing that went
    wrong, rather than all the things that went right.
  • Diminishing the positive – Coming up with reasons why positive events don’t count (“She said she had a
    good time on our date, but I think she was just being nice.”)
  • Jumping to conclusions – Making negative interpretations without actual evidence. You act like a mind
    reader (“He must think I’m pathetic”) or a fortune teller (“I’ll be stuck in this  dead-end job forever.”)
  • Emotional reasoning – Believing that the way you feel reflects reality (“I feel like such a loser. I really am no
  • ‘Shoulds’ and ‘should-nots’ – Holding yourself to a strict list of what you should and shouldn’t do, and
    beating yourself up if you don’t live up to your rules.
  • Deal with the "hidden causes".
Other Depression Treatment:
  • Medication
  • Lifestyle Changes
  • Therapy

If you’ve taken self-help steps and made positive lifestyle changes and still find your depression getting worse,
seek professional help.
Needing additional help does not mean that you are weak.

Sometimes the negative thinking in depression can make you feel like you’re a lost cause: you aren't                    
- depression can be treated and you can feel better!

Here is the link to the Double Bind article mentioned above. You'll have to copy it from here and paste it into  
your browser: it won't load directly from here:
Klaas Tuinman M.A.
Life Self-Empowerment Facilitation
at Dawn Cove Abbey
Comments and Questions are welcomed