According to the World Health Organisation, depression is the world’s fourth leading cause of burden of disease currently. In Singapore, the 2010 Singapore National Mental Health Survey reported a 6.3% lifetime prevalence of depression in the Singapore adult population. Depression is a major health problem which impairs psychosocial and occupational functioning, and is associated with significant morbidity and mortality. Depressive symptoms include loss of interest, sadness, and feelings of low self-worth. It has been estimated that there are about 121 million people worldwide suffering from depression (World Health Organization, 2012).
Also according to the World Health Organisation, health is defined as “a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity”. What it simply means is that there are three domains we must look at for in holistic health. These three domains are the physical (biological), mental (psychological) and social aspects of an individual’s health. We call this the biopsychosocial model of health and illness. In all illnesses (and that includes depression) the three domains probably overlap with each other during an episode which is why using treatment approaches based on the biopsychosocial model have the most success.
Using the biopsychosocial model, let’s take a look at what are some possible factors that may contribute to having Depression.
Some people may be more susceptible to depression given their biological factors and genetics, which places them more at risk. Depression can make a person more vulnerable to developing a range of physical disorders. Similarly, a person who has a physical disorder is often more likely to develop depression. Genetic factors can have a lot to do with the way the neurotransmitter, serotonin is balanced in the brain. Serotonin is crucial because it plays a fundamental role in regulating vital biological functions such as the quality of sleep, concentration, memory and appetite. Some researchers believe that when people become extremely sad, the level of serotonin in the brain becomes imbalanced, and the primary function of serotonin levels is compromised. Those who have a family history of depression also have an increased chance of getting depression themselves. Having said that, genetic influence is only partially responsible for causing depression.
An increased likelihood of getting depressive symptoms can also happen as a result of a history of having too many negative life events or prolonged life stress. One extremely common cause is working or studying in a stressful environment. Many people spend a large chunk of time at school or at work. Sometimes the work environment can be an extremely stressful, due to a negligent supervisor, unsupportive coworkers, heavy workloads, demanding deadlines, and unforgiving customers, amongst other things. Unfortunately, when stress levels gets too high, it often causes people to be unhappy with their job. If this dissatisfaction continues on for too long, it can turn into extreme sadness. Another common culprit for the onset of depressive symptoms is the experiencing of prolonged mental and physical abuse as a child. It has been observed that people who were victims of mental and physical abuse in childhood, tend to exhibit significantly higher rates of depression, as compared to those who were loved, and respectfully treated when they were growing up.
People can also become depressed as a result of social factors such as: experiencing traumatic situations, early separation, lack of social support, or harassment (bullying). This third factor relates to experiencing a current major traumatic life event, some of which can be thought of as “the straw that broke the camel’s back”. Have you ever lost a loved one, been cyberbullied or been fired from a job? At first, it may be difficult to understand the reason why these events may lead to extreme sadness, but it is pretty straightforward. A sudden loss of a loved one, being cyberbullied, or being fired from a job have something in common, they all bring about a mixture of grief, anger, guilt, and anxiety. They also involve the idea of losing something. Sometimes people are not equipped with the information that is needed in order to cope with these current emotionally difficult times, and that is when people become depressed and sometimes turn to suicidal ideation.
Note that the above three factor do and will overlap in most cases. Which leads to my final point. That all of us are vulnerable to depression, some more than others. The reasons could be because of the difference in our individual biological threshold for negative events; the way we perceive and respond to negative events; and our personal coping mechanism and abilities.