Is depression hereditary?
Yes and no. There is evidence that genes do play an important role in the development of depression. There are many types of depression, and genetic factors play a larger role in heavy depression.
However, genes are not the only factor that affects the onset of depression. It is like the outbreak of war is not only because of economic decisions. Moreover, even if there is a genetic possibility, it is not the inheritance of the disease of depression, but the inheritance of the quality of the onset of the disease. In other words, even if you have the “gene” for depression in your family, you will not necessarily have a depressive episode.
Also, if one of your parents or relatives has had depression and you have it, it does not mean that you have inherited the gene for depression. The medical community determines that the evidence for inheritance lies in genetic testing, not in whether there has ever been a depressive person in such a family. However, it has not been determined what genes are inherited for depression, so the inheritance of depression is still a medical hypothesis that has yet to be proven.
Why do you get depression?
This is still a medical puzzle.
To date, the medical and clinical psychology communities have not yet determined what the cause of depression is.
In general, the professional community is of the opinion that.
(1) Depression is a syndrome, just like fever, which can be caused by various causes, and different types of depression have different pathogenesis;
(2) There are four major factors that have a significant impact on the onset of depression: genetic, psychological, social, and neurotransmitter alterations in the brain. Among them, the alteration of neurotransmitters in the brain is the most direct pathogenic factor, because both genetic and psychological and social factors can alter the neurotransmitters in the brain and thus cause the manifestation of depression. Correspondingly, both psychotherapy and medication alter the neurotransmitters in the brain, thus treating depression.
Why do you need medication for depression, but not purely psychological treatment?
Why do some people take medication when they can get better without it? Because the process is too painful.
Depression is the same.
Without medication, mild depression can be relieved by psychotherapy, but the process is too painful. Moreover, work and life are affected during the process, and the time of psychotherapy will be longer.
Therefore, even from the economic point of view, it is advantageous to take medication while doing psychotherapy.
In the case of heavy depression, medication is necessary because of the high risk of suicide.
The idea of depression as a purely psychological illness or as a purely physical illness is a centuries-old backward idea.
Why does depression sometimes come back during the course of psychotherapy?
In the course of psychotherapy, depression will initially appear to get better. But this is a clinical illusion called “empathic improvement”.
This improvement occurs because the client develops an emotional attachment to the doctor and temporarily hides or ignores internal conflicts and pain. As the treatment progresses, these hidden parts come out again, thus creating the illusion that the depression has recovered and relapsed.
Therefore, psychotherapy usually requires several sessions of treatment. Even a short course of psychotherapy requires 15-20 sessions of meetings.
Most of the cases that are cured in three or five sessions are “empathic improvement”.
Can depression be cured?
This is like asking whether a cold can be cured.
With early detection, timely treatment, and an adequate course of psychological and pharmacological treatment (about 2-3 years), about two-thirds of depressed patients can be cured or significantly improved. The chance of relapse is minimal if mental health care is taken care of in later life.
However, a very small percentage of depressed patients have little effect after treatment or the effect is maintained for a very short time.
Many depressed patients’ relapse is actually self-inflicted, and they do not follow medical advice to stop, reduce or increase medication, do not follow up regularly, withdraw from psychotherapy just after the effect, do not pay attention to mental health care in daily life and so on.
Depression is a part of our normal emotions, and people who are not depressed at all are not normal.
What does depressive neurosis mean?
Many depressed people in psychotherapy have depressive neurosis, not heavy depression.
The etiology of depressive neurosis often has a psychosocial component that is related to the personality deviation of the counselor.
The main manifestations are a marked decrease in interest in daily activities and recreation, experiencing no pleasure; pessimism and disappointment about the future, but not despair; feeling down, lack of motivation and enthusiasm, seemingly not wanting to do anything, and not wanting to move; a decline in self-evaluation,, often low self-esteem, self-blame, guilt; feeling that life lacks meaning and value, and even attempting suicide, but in the specific implementation, it is a lot of concerns; often accompanied by anxiety and somatic discomfort.
The most prominent feature is the internal conflict and ambivalence. Psychotherapy combined with medication is the most effective treatment.
What is reactive depression?
Reactive depression is a state of depression caused by stressors such as strong mental stimuli or persistent mental tension.
After a life event such as traffic accident, divorce, widowhood, unemployment, natural disaster, long-term bad competition, etc., it can make a person suffer from reactive depression. It is different from normal people who show sadness, distress, discouragement, etc. Normal people’s sadness tends to return to normal quickly after a short period of venting; whereas reactive depression is different, it is based on the onset of unconquered psychological conflicts, depression is severe and lasts for a long time, and its severity must reach to make its psychological function decline or social function be impaired in order to be diagnosed.
Treatment is mainly psychotherapy with antidepressant medication.
Do antidepressants make people dull and addictive?
Commonly used antidepressants are classified as tricyclic, tetracyclic, SSRI and SNRI drugs.
All medications have similar efficacy in treating depression, and all have side effects.
The tricyclic and tetracyclic classes (chlorpromazine, amitriptyline, and maprotiline) are characterized by cheap prices and side effects.
SSRIs and SNRIs (fluoxetine, paroxetine, citalopram, venlafaxine, etc.) are newly developed drugs that are characterized by high price and low side effects.
There are two reasons for the “dulling” of psychiatric patients: one is the manifestation of the condition itself, such as slow thinking, reduced activity and depressive pseudo-dementia in patients with major depressive disorder, which is precisely an indication of inadequate drug treatment rather than drug-induced side effects; the other is the cone of antipsychotic drugs (e.g., sulpiride). In general, antidepressants do not cause such side effects.
All antidepressants are not “addictive” and produce physical dependence. However, people with dependence characteristics will develop psychological dependence on all drugs, and psychological dependence is mainly solved by psychotherapy.
The main side effects of antidepressants are flushing, rapid heartbeat, constipation, nausea, insomnia, anxiety, dizziness, dry mouth, decreased or hyperactive sexual function, etc. Generally, most of the side effects will decrease or disappear with prolonged medication use.
What is meant by secondary depression?
Many diseases such as influenza, AIDS, hepatitis, cancer, hypothyroidism, cerebral atherosclerosis, epilepsy, etc., and the use of many drugs such as reserpine, chlorpromazine, haloperidol, methyldopa, propranolol, oral contraceptives, hormones, and adiponectin can also be followed by depression, as secondary depression. The latter is also known as pharmacogenic depression.
In fact, secondary depression is very common, occurring in about one-third of hospitalized patients, except that our country’s standard of living and level of medical care does not yet allow for routine psychological intervention for these patients.
Can middle-aged and elderly people also get depression?
Yes. Although depression mainly develops during young adulthood.
Menopausal depression is a very common type of depression in middle-aged and older adults. Previously, for various reasons within the medical community, many doctors did not know much about psychiatry. So many menopausal depressions were diagnosed as neurasthenia or menopausal syndrome.
At the age of 45-55 years old for women and 50-60 years old for men, people have greater physiological and psychological changes, lower physiological immune function, gradual decline in the function of the neuroendocrine system and lower hormone levels, which often bring a series of physical illnesses and emotional changes, and psychological pressure from work, study, family, marriage and all aspects of society.
Therefore, depression is more likely to occur during this period.
Menopausal depression usually starts slowly, develops gradually, and has a long course. At the beginning, it is mostly characterized by insomnia, fatigue, dizziness, headache, irritability and other physical discomfort, and then patients are often depressed, anxious, pessimistic and negative, compared with the present, slow thinking, slow reaction, feeling low energy, not being able to do things, not being interested in things they usually like, especially easy fatigue, which cannot be relieved even after rest. Some people may feel that they are a “waste of time who can only eat but not do anything.”
Treatment of menopausal depression is mainly medication combined with short-term supportive psychotherapy.
Geriatric depression is also a common type of depression in the elderly. As our country enters an aging nation, this problem is also more prominent.
Patients often feel a sense of loss of being abandoned by society, loneliness and isolation, low self-esteem, a sense of impending death, and a burning of all thoughts. Many people start to go to general hospitals with various complaints of physical discomfort, and the patients’ complaints do not match with the clinical physical examination results, and various treatment methods cannot obtain obvious results. In fact, this is the result of elderly people not knowing how to express their emotions, and it is possible to find out depression as long as doctors ask more questions about emotions.
The treatment of depression in the elderly is better with medication combined with family therapy.
Girls are not depressed because they are not sexually developed yet!
In general, more depressed people are women than men. The rate of depression in adult women is about twice as high as in adult men. Interestingly, however, studies have found that before puberty, boys are more likely to be depressed than girls. Once they reach puberty, the rate of depression is more than twice as high in girls as it is in boys.
Why is this?
In addition to sex hormones, psychological factors play a big role.
Susan Gore of the University of Massachusetts found that depressed adolescent girls tend to be overly concerned and overly involved in the emotional problems of their mothers in the family, while boys are not as sensitive to family problems. On the other hand, depressed mothers tend to confide in girls rather than boys. Perhaps this is one reason why girls are prone to depression.
On the other hand, Joan Girgus of Princeton University found that a preoccupation with body image also contributed to girls’ depression.
Nolen-Hoeksena and Girgus found that girls’ personalities are more likely to be emotionally dependent on relationships, less certain and more reactive than boys. Therefore, during adolescence, when girls have to face many sudden changes, such as interactions with men, physical changes, emergence of sexuality, and restricted social activities, they often do not know how to deal with them proactively and become frustrated and thus depressed.
Masculinity in society also reinforces girls’ depression. For example, many societies require a passive image of women, women are more vulnerable to sexual assault and discrimination, etc.
Therefore, as girls grow up, the risk of depression increases.
Can psychologists get depressed too?
Of course, and psychologists also have a much higher rate of depression than the rest of the population.
There are several reasons for this: first, many depressed patients or people with their own psychological problems are prone to choose the profession of psychotherapy; second, psychologists are exposed to bad moods for a long time and are easily involved; third, the profession of psychologist is not well respected by society and is easily discriminated against, so it can cause a sense of inferiority among psychologists.
Therefore, in general, psychologists themselves should focus on mental health care and receive supervision from time to time (part of supervision is that psychologists themselves receive psychotherapy).
Not being depressed ≠ being happy
What does it mean to be happy? Is it having a lot of money? Is it having a lot of people who appreciate you? Is it having good looks? Is it having a smart mind? Is it having a PhD? Do you have a car and a house? Do you always feel lucky? Is it a simple attitude to life? Is it that you believe that you are happy because you are happy? Is it having your wishes fulfilled? Is it that many people love you? Is it that you can control a lot of people? Is it that you can do whatever you want? Is it helping others? Is it being alone and contemplating? ……
Many external events do not affect your happiness, and after a few months the happiness level of a lottery winner is no different from that of anyone else, and the happiness level of disabled people is not much lower than that of the general population.
Some psychotherapists (such as Meyers) believe that being happy means living a full, meaningful, and enjoyable life. How about you, do you think so too? Or not?
Some philosophers believe that happiness means the satisfaction of desires. Do you think so too? Or not?
Other philosophers believe that happiness means the elimination of desires. Do you think so too? Or not?
So, what do you think is the relationship between happiness and depression? As long as you are unhappy, you will be depressed? As long as you are depressed, you will not be happy?
It seems that many people think so. However, psychologists have found that the opposite of depression is not happiness. For example, studies have found that, in general, more women are depressed than men. If the opposite of depression is happiness, then men should be happier than women. However, tests have found that this is not the case. The level of happiness was the same for men and women.
This proves that the opposite of depression is not happiness.
Maybe you have already experienced it. When you get rid of depression, you don’t get happy, you just feel that the pain is eliminated.
Yes, happiness and depression are not contradictory. They can exist at the same time. Pain and happiness. Just like you can love and hate someone at the same time.
You can’t be tense and relaxed at the same time. But you can indeed be depressed and happy at the same time.
Why are our joys so short-lived? Why can’t we afford not to have too much intense joy in our lives?
Because we have fantasies like a child.
Our illusions about life are.
First, that my life should be safe, that death, car accidents, accidents, layoffs, and other losses will not happen in my life;
Second, people will care about me and love me, just like my parents did to me.
Third, my life should be carefree, just like a child in a cradle.
Fourth, people would respect me, just like my relatives.
These fantasies keep us from accepting the natural laws of society.
When life tells us that our fantasies won’t come true, we say, “I don’t like it.”
It is this attitude that keeps us from having a relationship with stable happiness rather than what actually happens.
The death of a parent, for example, can make a person unhappy and depressed because he has a fantasy: “Mother shouldn’t have died so early.” But if his thought is, “Everyone dies, so does the mother, everyone can have an accident, so does the mother.” He wouldn’t have been so depressed.
Is the world supposed to change because of our fantasies?
True, stable, long-term happiness is built on a foundation, and that foundation is that we take on the trauma that life brings us. Whatever happens, accept that this is the way it is. Remember, accept the facts and improve the future.