Lately, there’s one illness that’s taking hold and doesn’t seem to give us pause: depression. The World Health Organization (WHO) estimates that at least 322 million people suffer from it in the world, 18% more than a decade ago. Also known as major depressive disorder, it is characterized by low mood, decreased interest, impaired cognitive function, and problems with sleep or appetite. In addition, it is recurrent and costly, with a tendency to become chronic, and generate suffering and disability.
Do we know what is the reason for this? Unfortunately not. However, there are enough studies on its risk factors, i.e. characteristics and conditions that increase the chances that we fall into its clutches.
Some, as common sense dictates, relate to dramatic life events, such as the death of a loved one or the diagnosis of a serious illness. However, there are many other risk factors for depression that are not as well known, although they are still important.
We refer to sociological factors, genetic and neurological factors, personal factors, adverse experiences and comorbidities.
Socio-demographic factors: twice as many depressed women
Perhaps the most consistent and well-known risk factor for depression within sociodemographic factors is gender. Globally, regardless of country or culture, women are twice as likely to experience depression after puberty than men.
However, other risk factors for depression have also been found, such as age, marital status, educational level, or race. Specifically, this disorder occurs more frequently in young adults; single, separated or divorced people; and among people of lower educational level and white race.
It has also been found that depression is more common among low-income people, unemployed people and residents of urban areas.
Genetic factors: the tendency to depression is inherited
First-degree relatives of patients with depression show an almost threefold increased risk of developing this disorder. Studies suggest that between 26% and 42% of the variation in depression is due to genetic influences. There are also indications that this heritability is more pronounced in depressions of early onset and recurrent course.
Nevertheless, no specific gene or set of genes has been found to be reliably associated with depression or involved in parental transmission … it is very heterogeneous.
Neurological factors: the amygdala becomes hyperactive
In parallel, neuronal abnormalities in certain brain regions have been reported in adults. Structural abnormalities have been found primarily in the gray matter volumes of the hippocampus, amygdala, anterior cingulate cortex, and dorsolateral prefrontal cortex.
Depressing us also changes neuronal function. Specifically, brain activation in subconscious emotion-processing areas is increased, such as the amygdala and limbic circuits, combined with attenuated activation in areas of cognitive control.
It doesn’t just happen in adults. Similar abnormalities in neuronal function and structure have been identified even before the onset of the depressive episode in children of depressed parents. And this leads us to suspect that they make us more vulnerable to this disorder.
Personal factors: introversion and excessive self-criticism
There is evidence that a tendency to experience negative emotions (fear, anger, sadness, anxiety) as well as mood swings and negative thoughts leads to a higher risk of developing a depressive state. This is what is known as neuroticism.
On the other hand, people who score high on introversion have more cases of depression. This refers to subjects who prefer solitary activities, focusing more on their thoughts, feelings, and moods, than exploring external stimuli.
Research also suggests a connection between depressive disorder and lower scores. ConscientiousnessCharacteristic of individuals without motives, informal, lazy, careless, undisciplined and with low will.
Excessive self-criticism (inclination to feelings of guilt and failure resulting from unrealistically high expectations of oneself) and dependence/sociality (feelings of helplessness and fear of abandonment as a result of high emotional dependence on others).
Another approach that promotes depression is what is known as the negative attribution style. It is the tendency to ascribe the negative consequences of one’s experiences to internal, static and global reasons. For example, “I didn’t get a job because I’m worthless, I’ve always been there in all aspects of my life”, and similar thoughts.
Something similar happens with rumination, which is defined as repetitive thinking that focuses on depressive symptoms and their effects, causes, and meaning to the person experiencing them.
Finally, a lack of personal resources (social skills, appropriate problem-solving strategies or coping skills in stressful situations) is also related to a higher risk of depressive symptoms.
adverse experience
More than 40 years of research has documented the role played by serious life events At the onset of depression. Depending on the type of sample under study, approximately 50% to 80% of people with depression reported an acute and serious life event prior to the onset of the disorder.
Based on a conservative estimate, we can establish that people with depression are 2.5 times more likely to experience a serious life event before the start of life than those who do not. Commonly life-threatening health problems, isolation and bereavement, risk of violence, job loss and financial insecurity.
It is equally important to consider cataclysmic events or incidents. That is, sudden, single, powerful events that affect large numbers of people, often outside the control of individuals or groups, and are universally considered stressful. Like the Covid-19 pandemic.
Exposure to negative events in childhood also puts us at risk for depression as we grow older. These incidents include physical and sexual abuse, psychological neglect (or abandonment), exposure to domestic violence, mental illness of a parent, and criminality.
People with a history of childhood trauma (especially being bullied and abused or emotionally neglected during childhood) have more than double the risk of developing depression.
morbidity
Perhaps one of the most surprising aspects of depression is that it often accompanies other mental disorders. Specifically, anxiety disorders, substance disorders, eating disorders, and sleep problems.
On the other hand, chronic or serious medical illness is a risk factor for depression. In addition, an association has been found between depression and a large number of physical diseases: acute myocardial infarction, asthma, cancer, cardiac arrhythmias, chronic coronary syndrome, chronic obstructive pulmonary disease, congestive heart failure, certain neurological diseases such as Alzheimer’s or epilepsy. , thyroid problems, diabetes, obesity, some pathologies of the digestive system, high blood pressure, osteoarthritis, osteoporosis, kidney failure, rheumatoid arthritis, stroke … not to forget fibromyalgia and chronic fatigue.
Taking all of these factors into account can help prevent depression, but it can also help you understand it better. And perhaps this will allow us to stop his feet in his unstoppable progress.
Fernando Lino Vazquez Gonzalezo Professor of Clinical Psychology, University of Santiago de Compostela
This article is originally from . was published on Conversation, here you can read the original,
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