So, although the reverse of these characteristic is not indicative of depression, their expression within the context of grief suggests the lack of clinical depression.
With the fundamentals of depression outlined, it is reasonable to wonder why such symptoms and behaviors manifest themselves in certain people and why they do not in others. Many different researchers coming from many different scientific backgrounds -- from psychology to biochemistry -- have investigated the fundamentals of depression, and each have constructed models as to what its underlying causes are. Each of these investigations has attempted to explain the causes and symptoms of depression and has offered treatment possibilities.
The psychological models of depression have focused their attention on failed early attachment, inability to obtain desired rewards, impaired social relations, and distorted thinking." This approach to depression has yielded some valuable information regarding the disorder; yet, much of the results make it unclear as to whether these aspects of depression are actually the causes or outward expressions of depression. Researchers and practitioners who adhere to this credo believe, "Depression is not a genetic fault of a mysterious illness which descends on us. It is something which we create for ourselves, and just as we create it, so we can dismantle it." However, people who understand depression in this way have difficulty explaining how certain groups of people experience higher rates of depression than others -- this implies some sort of predisposition towards clinical depression in certain people. Studies have also shown that genetic causes of depression are quite plausible: "It has been found that when one identical twin becomes depressed the other will also develop clinical depression approximately 76% of the time. When identical twins are raised apart from each other, they will both become depressed about 67% of the time."
Recognizing the possible shortcomings of purely psychoanalytical methodologies pertaining to depression has caused individuals in the fields of biology and biochemistry to investigate the illness. As a result "considerable gains have been made in viewing depression within the context of a biological framework. From this perspective, diagnostic tests and medications have emerged to counter the negative consequences of depression." These sorts of advancements have come from an evaluation of depression that focuses upon genetic vulnerabilities as well as the observable chemical changes that occur in the brain and can be associated with different moods. Generally, depression should be attacked from all directions; as is the case with most genetic disorders, the actual manifestation of clinical depression is most likely interplay between genetic predisposition and environmental factors. Consequently, both evaluations of the illness retain much of their validity, but taken together, they merge to produce the most accurate policy for approaching depression that can reasonably be hoped for.
From the biological point-of-view, we all are at some risk for depression. However, "Women are diagnosed and treated for major depression more often than men. In the U.S., a woman is about twice as likely as a man to be diagnosed with depression." Prior to adolescence, both genders tend to experience symptoms of depression equally, but in adulthood women have about a 25% chance of experiencing bouts of depression, whereas men have about a 12% chance. From the psychological point-of-view, this may be because women simply have more stressful lives in our society, and as a result, react more adversely to the environment. Statistically, this may simply be because more women seek help regarding their depression than do men. However, the difference may also come from men's greater usage of alcohol or drugs to stifle the effects of depression. Or biologically, women may simply be more prone to depression because of their particular hormonal makeup.
Additional risk factors are both environmental and innate. For example, a correlation between depression and relatives with depression has been found. Also, those living in unhappy marriages are also more likely to exhibit symptoms of depression. Moreover, depression, although affecting people of virtually any age, tends to first appear between 20 and 50. Mania usually appears earlier in life -- adolescence. People with creative or critical personalities are at a higher risk for depression as well. "Some people suffering from depression have been found to have different levels of chemicals involved in brain function." All of these frequencies tend to suggest that both the psychoanalytical and biological models of depression hold some truth, and can be treated from either or both angles.
Just as the form and symptoms of depression occur on a continuous spectrum, the methods of treatment tend vary as well. For depression, there is no one cure, either medically or holistically. Many people interpret depression as a need for people to develop a spiritual pathway to a more valuable existence. As a result, thousands of self-help books on the topic have been published with astonishing success. Others choose to employ medications to battle the biochemical causes of depression. Still, "There is no one medication that works for everyone -- even for people who seem to have the same symptoms." This is another obvious consequence of the wide variability regarding human beings and emotions. Overall, the drugs commonly prescribed fit into three primary groups:
Selective serotonin drugs: Prozac, Zoloft, Paxil, Celestra, and Serozone.
Selective norepinephrine drugs: Vestra.
Mixed-action drugs: Effexor, Wellbutrin, Remeron.
These drugs, though clinically very useful in reducing the symptoms of depression, are not cures in and of themselves; no one drug should be expected to treat all aspects of depression.
Centrally, the familial and close-friend environment is at the core of depression and can help to remedy it as well. Within the family structure, numerous associations have been found between certain characteristics of the family unit and individual depression. If there are significant losses -- like that of a parent -- individuals in a given family are likely to suffer from depression. Also, general trends like miscommunication, boundaries between family members, children that are forced to act as parents, the presence of physically ill family members, large generational gaps, power struggles, social status, and recurrent overreactions have all been identified as family-related causes or magnifiers of clinical depression. Such a wide variety of trends makes the psychoanalytical approach to treating depression just as valuable as the biological approach. In short, the immediate social structure of the individual experiencing depression routinely needs to be reorganized in order to facilitate recovery. Otherwise, one member of the family who is clinically depressed is likely to create an environmental situation where more members of the family become depressed. Essentially, depression is far more widespread, far more damaging, and far more treatable than most people perceive it to be. Enduring one's mental well-being demands some understanding of depression in order to treat it, avoid its external risks, or help those close to you.
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