Elena Smith
Professor John Wells
English 112
25 February 2015

Many individuals would argue that there are many causes for depression. Before getting into some of the contributing factors, many statistics show us that depression is hereditary and if your mother and father suffered from depression, then you yourself may find that you are more likely to be diagnosed as well ( Berger, Joshua L. 5).
Clinical depression, also known as major depression or depression is defined as a mood disorder that may occur only once in an individual’s lifetime or in groups of episodes that typically last anywhere from 9 to 16 months ( Berger, Joshua L. 8). Statistics show that depression is hereditary and can be passed down from generation to generation.. This is an argumentative topic that I feel must be brought into the open as not many people who suffer from it realize that they are actually going through it and just how serious it can be. Those who are fortunate to have people to talk to have an opportunity to help themselves, but there are many who do not even know of the existence of this illness. With this paper, I aim to show how depression differs from the sadness or gloom everyone goes through at some periods in their lives. Along with that, I also aim to argue that depression is not at all uncommon and as extraordinary as people feel and think it to be, as statistics argue that 1 out of 4 individuals will suffer from depression at some point in their life (Barglow, Peter, M.D. 12).
Many would argue that depression is not truly an illness, but it indeed is and should not be taken lightly. Proper treatment is critical to these individuals who are suffering. It is not a phase of some sort, which one can pass through, or get rid of without taking the appropriate measures. Depression is a serious illness, since it can have harmful effects on a person’s life; the way a person eats, sleeps, and feels about themselves (Barglow, Peter, M.D. 16). If depression is not treated, symptoms could last for weeks; months, or even years and this, without a doubt, would have detrimental effects to one’s mental and physical health. Another false view about depression is that if it is severe, it has no treatment. In contrast, statistics show that 80% of all reported cases have received effective treatment (Tomblin 82). Numerous studies continue to show that depression is in fact very much hereditary.
There are many factors, which do not directly cause depression but may trigger it (Barglow, Peter, M.D.6). For instance, a stressful event or period in one’s life such as death of a loved one or the loss of one’s job may be the onset of a depression. Aside from events, medications or withdrawal from them could also trigger depression. Also, AIDS, endocrine disorders, head injury, neurological disorders, infections, emotion or physical trauma and postpartum depression are all examples of medical or physiological causes of depression.
Typically, the first episode of depression is a result of a trigger such as a stressful event but the following episodes may occur without a stress event to trigger them. Thus, individuals can ask the question whether depression is a genetic predisposition that is then triggered by environmental factors. Many, including doctors and researchers would argue that this is in fact the case. The question is rather difficult to answer since studies have s been known to support both the environmental and biological perspectives as well.
Genetic research has also been able to show support that biological elements may play a strong role in depression. Close-blooded relatives of people with depressive disorders were found to be more vulnerable to depression in comparison to members of the general population. For example, studies on identical twins, who share the same genetic makeup and fraternal twins, who do not share the exact genetic makeup support the view that biology is a big factor in the causes of depression. Some types of depression run in families and those who get ill have a different genetic makeup in comparison to those who do not get ill. But then, it also turns out that people with this particular genetic makeup do not necessarily acquire the illness. Thus, this is where external factors such as stress step in. In other cases, major depression may occur to those who "inherit" it but then there are those who fall into depression without having a family history of depression.
Other than such environmental or external triggers, the root cause of depression is a chemical imbalance in the brain involving the neurotransmitters dopamine, norepinephrine, and serotonin. When there are low levels of these brain chemicals, normal brain transmission of signals by the nerve cells is prevented. In the most primitive part of the brain, the brainstem, there lies a cluster of serotonin neurons. This neurotransmitter is responsible for controlling the important physiological aspects of the body. Included among these aspects are motor activity, cardiovascular activity, respiration, and control of body temperature.
Thus, this imbalance causes disturbances in brain circuits and is the main reason why depression can be such a debilitating disorder. There has been extensive research done in the past 20 years by genetic researchers in order to identify the genes that cause depression. At present, these genes have not been identified and one reason may be that several genes contribute to the problem. This means that each gene makes a small contribution and is therefore, hard to spot. Another biological cause of depression is in cases of hormonal abnormalities. When given a number of substances that normally induce the release of growth hormones, depressed patients did not respond positively.
Although there is no doubt that many studies give strong evidence towards biological causes of depression, there are many cases where the chemical imbalances in the brain have disappeared when psychotherapy are completed without the intake of any medications. This suggests that the reverse might be true in which the psychological depression is causing the body to respond physically rather than these imbalances causing the psychological depression.
Depression may result in the inability of a person to take pleasure in anything as well as be unable to perform even the most ordinary tasks. Depressed individuals, in fact two-thirds of them, often think of committing suicide. These individuals feel guilty as well as feeling worthless. Clear thinking is diminished and in place, anxiety, lack of energy and enthusiasm take place. Depression can shut down the survival instinct or temporarily suppress it. Suicide and self-harm are ways to escape from mental pain for depressed individuals. In comparison to "normal" individuals who have suicidal tendencies due to a crisis of some sort, depressed individuals may not care to plan and are willing to attempt more painful and immediate means, such as jumping out of a window. As one loses the motivation to do anything, health deteriorates as sleep and eating disorders arise. Like other devastating illnesses, depression has its stigma attached to it and thus, the patient feels weak and guilty due to his depressed state.
330 million people worldwide suffer from depression of which only a few will receive proper treatment or attention. It is estimated that by the year 2020 major depression will be the world's second most debilitating disease, surpassed only by cardiovascular disease. Depression occurs twice as often in women as it does in men. Many factors such as menstruation, pregnancy, miscarriage and menopause may be reasons for depression in women. With additional responsibilities such as taking care of children and going to work or taking care of aging parents, women are highly susceptible to depression.
First and foremost, detection and measures towards treatment are important when depression occurs. Showing the major symptoms such as lack of motivation or enthusiasm for things previously enjoyed, are a sign. Depression should be treated as a disease and not as an everyday, regular emotion (Taliaferro, Lindsay A,M.S., M.P.H.10). A psychiatrist is important in evaluating the patient as well as someone who will listen to the patient. Anti-depressant drugs can also help make psychotherapy more effective (Taliaferro, Lindsay A,M.S., M.P.H.12). It is especially beneficial for those who are too depressed to speak since their symptoms improve after taking medications such as.Prozac, or fluoxetine, is the most widely prescribed anti-depressant which increases the supply of serotonin to the brain.
Electroshock (ECT or Electroconvulsive Therapy), although having a notorious reputation, is a much better option today than ever. The voltages used today are much lower, safer, and patients are sedated prior to receiving ECT so their muscles will not spasm. ECT and anti-depressant drugs both affect the neurotransmitters in the brain as a way to treat depression.

A study done recently by Health Magazine in April of this year found that chronic stress contributes to depression, which led researchers to believe that continuous stress over a long period of time "hard wires" the brain into operating in stress mode all the time, triggering depression (Simon, Gregory E., Michael Von Korff, and Elizabeth Lin.) . This is a prime example of the confusing principal behind what causes depression. Stress can be considered a symptom, or the result of depression, but this study showed that it actually caused depression. Therefore, it seems that no matter how depression stems, it is important to take notice of the fact that psychological and physical problems thrive on each other and grow. This is why I’m arguing that a combination of physical and psychological intervention seems most effective for most patients.
Although we have gathered much evidence to support all the causes of depression, we are left with being unsure to what extent the three causes, genetic, chemical and hormonal play or fit together. Also, the evidence that these causes do not always fit together leaves us with more questions. Thus, in the meantime, we must gather as much evidence in order to come up with effective treatment with the least possible side-effects and prolonged positive effects. Again, arguing that a combination of medication and therapy seems to be the most helpful according to research. Although most sufferers of depression can be helped, they are not aware of this and consequently, many do not seek treatment. Raising more awareness on depression, should be another goal in order to fight depression. The first and foremost step into treating depression is recognizing its symptoms and realizing that this disease can happen to anyone, regardless of his or her background.

Work Cited
Taliaferro, Lindsay A,M.S., M.P.H., et al. "Associations between Physical Activity and Reduced Rates of Hopelessness, Depression, and Suicidal Behavior among College Students." Journal of American College Health 57.4 (2009): 427-36.ProQuest. Web. 12 February. 2015.

Miller, Elissa J, M.D., M.P.H., and Henry Chung M.D. "A Literature Review of Studies of Depression and Treatment Outcomes among U.S. College Students since 1990."P 60.9 (2009): 1257-60. ProQuest. Web. 12 Feb. 2015.

Simon, Gregory E., Michael Von Korff, and Elizabeth Lin. "Clinical and Functional Outcomes of Depression Treatment in Patients with and without Chronic Medical Illness." Psychological medicine 35.2 (2005): 271-9. ProQuest. Web. 11 Feb. 2015.

Barglow, Peter, M.D. "Numbing After Rape, and Depth of Therapy." American Journal of Psychotherapy 68.1 (2014): 117-39.ProQuest. Web. 12 Feb. 2015.

Berger, Joshua L., et al. "Effects of Gender, Diagnostic Labels, and Causal Theories on Willingness to Report Symptoms of Depression." Journal of Social and Clinical Psychology 31.5 (2012): 439-57. ProQuest. Web. 12 Feb. 2015.