Nursing Teaching on Triggers and Causes of Depression

 Patient/caregiver was instructed that triggers and causes of depression can be widely varied. Many a times, no defined triggers could be clearly identified. A variety of genetic and other biological factors, as discussed below, could be playing a key role in the onset of depression symptoms. Some of the triggers and cause include:
  1. Brain chemistry: Neurotransmitters like serotonin, dopamine, and norepinephrine are naturally occurring chemicals in the brain, affecting an individual’s mood, thought process, sleep, appetite, and behavior. A fine balance between these chemicals in the brain is believed to play a key role in normal, stable, and healthy brain function. Factors like neuronal degeneration, intake of medications having their primary action on the brain, excess intake of alcohol etc., can lead to altered levels of these neurotransmitters in the brain. This can result in deranged mental and mood stability, contributing to onset of depression symptoms.
  2. Hormones: Hormonal balance, especially with female sexual hormones, such as, estrogen and progesterone, and thyroid hormone plays a significant role in maintaining healthy mental state and body metabolism. Changes in hormone levels in females with altered thyroid function and during monthly menstrual cycles, immediate post-partum period, and menopause can lead to altered body metabolism and hormonal imbalance, which can contribute to onset of depression symptoms.
  3. Personality traits: Individuals with low self-esteem can present with poor tolerance to stress. Experience of even minimal stressful situations by these individuals can turn overwhelming and hopeless, thus paving the way for onset of depression.
  4. Chronic medical conditions: Individuals with history of chronic unresolved physical or emotional pain, amputation of limb, neuropathy, cancers, poor response to treatment for various medical conditions, stroke with compromised ambulation & activity, wheelchair dependence, bedbound status, and increased caregiver dependence can significantly influence the affected individual’s response to stressful situations. This change in an individual’s response to stressful situations can trigger the onset of depression symptoms.
  5. Family history: While no specific gene has been identified precisely with causing depression, genetic and familial studies have offered significant links with pathophysiology of depression. Depression was noted to be increasingly common in individuals having family history of one or the other mood disorders.
  6. Substance abuse: Addiction and abuse of alcohol and/or other illicit drugs, such as, heroin, marijuana, and methamphetamine is believed to cause significant changes in the brain chemistry. This can lead to altered brain function and individuals can manifest symptoms of delirium, panic, depression, and psychosis.
  7. History of trauma: Experiencing traumatic situations, such as, physical or mental abuse, loss of livelihood, neglect, separation from parents/partner/or other loved ones, divorce, and death of a loved one etc., can significantly influence the affected individual’s response to and ability to handle stress. This change in an individual’s response to stressful situations can set the path for onset of depression symptoms.