Mary isn't sleeping too well these days. She usually wakes up early in the morning and then can't get back to sleep.
Mary isn't eating too well either. She finds she's just not hungry and so is losing weight.
Her husband noticed that she sits around the house most of the day and does very little. She doesn't get out to visit friends as much as she used to, and their sex life has really gone downhill.
Needless to say, he's worried and hurt, and wonders if there is anything he's done or failed to do that has affected their marriage. And when he's really honest with himself, he wonders if she still loves him.
Mary would probably describe her mood as blue, or low, or sad. She finds herself crying often but doesn't know why. She is often tired, and can't make the simplest decisions, and so sits and does nothing. She is really quite disgusted with herself for being the way she is, and thinks of herself as a pretty worthless, useless person.
What is most discouraging for Mary is that she can't see any hope for change or improvement. She doubts if she'll ever feel better and that doubt makes her feel even worse.
In short, Mary displays many signs of clinical depression: sleep difficulties, appetite and weight loss, motor retardation, withdrawal from social contact, reduced sex drive, depressed mood, chronic fatigue, indecisiveness, self-blame and a pessimistic outlook for the future.
Depression is becoming the number one mental health problem in the United States today. It has been estimated that fifteen percent of the adult population suffers from some degree of clinical depression. Not only can depression be extremely uncomfortable for the person who suffers from it, it can also strain his relationship with his family as Mary's example shows.
We don't yet know exactly what causes depression. There are as many theories about the causes of depression as there are theorists writing about it. The truth of the matter is that there is no such thing as one type of depression - just as there is no such thing as one type of cancer - and so there is no single cause of depression.
My own approach is to look at depression from three different levels - biochemical, psychological and psychosocial - which act singly or in combination to produce depression.
Biochemical. Some people suffer recurrent bouts of depressions for no apparent reason. They may have every good thing life has to offer - family, friends, job and economic comfort - yet are still depressed.
Since many of these people have a history of depression in their families and respond favorably to anti-depressive medications, it is assumed their depressive episodes are caused by genetic, dietary, physiological or biochemical factors.
Psychological. Depression may be caused by what the person is thinking or experiencing inside himself: hurt, guilt, fear, self-doubt, low self-esteem, and/or a sense of hopelessness. What someone thinks or imagines can affect his mood, so that depressing, pessimistic thoughts can make people depressed. Quite often the depressed person blames, criticizes and condemns himself for things - real or imagined - he has done or failed to do, even to the point of condemning himself for being depressed! Since he considers himself to be bad, worthless and useless, and sees no hope for his future, he literally talks himself into a depression.
Psychosocial. Depression can also be the result of some clearly identifiable, external loss or setback as when someone loses his job or becomes divorced. Or depression can be caused by serious marital or family problems. Usually in these cases, the depression can be lifted if the problems that cause it can be alleviated.
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