Young adults’ views about what causes depression

Scientists do not know exactly what causes depression, but they believe a variety of factors contribute to it. These include brain chemistry, genetic predispositions, life circumstances, hormones, substance abuse and certain illnesses. In many cases depression may be caused by a combination of factors.

People we interviewed offered many explanations for their own depression. A few people said they didn’t know what caused it, or that they wished an expert could give them solid reasons. One said she thinks depression may just have to “with who we are fundamentally as people.” A number of people thought depression was caused by multiple, inter-connected factors. As Crystal put it, “My depression is complicated. I mean everyone’s depression is a little bit complicated and individualized.” Elizabeth had a similar view of hers as “…a combination of environmental factors, circumstantial factors, and biological factors too.”

Having depression run in his family doesn't mean, for Joey, that he has to be depressed. The conditions for depression have to also arise in his life.
Interview Transcript

I do think that there’s a tendency for depression in my family but at the same time, I don’t think like, that that’s enough just to get it. Like I feel like that there’s a lot more going on than just that your family has it, like you might be like wired in a way where you’re susceptible to it but unless like, the conditions kind of arise or you know, like me, you just let the conditions arise. Then I, yeah, I don’t really see that happening. Like I don’t feel like I would have a kid or be worried about having a kid that just like, you know, for no reasons is like, depressed. Because I mean, I don’t know. Even for people with like really hardcore depression, I feel like there’s like a reason for it… and like, I didn’t believe that at first because it’s like, when I was doing mild amounts of like depression research they’re like, why are you depressed? And I’m like, people don’t have reasons for being depressed, you’re just depressed and it’s like, really? Like, ’cause if you can get over it, then wouldn’t there be a reason for that, like. And yeah, looking back it’s like ok yeah, I definitely had some reasons. Of course you would be depressed if you didn’t do anything all day for, besides like go to some job you hated, like, and spend the rest of your time like, drinking in your room, like. How else could that have gone?

DEP Joey
Profile Info
Age at interview: 28
Sex: M
Age at diagnosis: 26

Background: Joey lives in an apartment in an artists’ building in an urban area near where he had gone to college. He works part time in retail stores and is a musician. He is White.

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Jason thinks that a susceptibility to depression that he may have inherited from his mother combine with specific 'trigger factors' in his life to cause his recent struggles.
Interview Transcript

So, personally I think it might be because, like my mom suffered from it. So, I think there’s some genetic component, or at least, you know the, you know maybe the environment part could be like because you’re exposed to it. And, you know maybe that affected her life, that affected you. And then I think, first of all it’s, I think that affects your susceptibility. And then I think it’s more about all those trigger factors. Because I think, at least for me, I think it’s a lot due to a lot of bad things happening together that almost like, break you. So, I think you know maybe some things that test your sense of perseverance or sense of resilience, and tolerance and so on, so. I think when a lot of those trigger factors come together and you can’t handle it. I think, so to me, it’s like, it’s, it’s you know, it’s a different feeling from being stressed, or unhappy. So I think in my impression it’s almost like, you know, you get stretched when you are feeling stress from different trigger points and at some point you just, like, snap. And I think that’s when you, you know, go from, like, just being stressed or unhappy to, like, being depressed, but that’s just my own understanding.

DEP Jason
Profile Info
Age at interview: 25
Sex: M
Age at diagnosis: 22

Background: Jason is from a large city in Asia, but is living in the U.S. while he completes his college education. He lives in a dormitory room and plans to return to his country of origin after graduation.

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Common descriptions most people offered about causes of depression fall into 3 categories:

Biological explanations

Many of the people we spoke to said they thought hormones, a chemical imbalance, and/or genetics play a large role in causing depression. Violet noted that she always believed depression had “something to do with hormones… [and was not] something you caught, obviously.” Crystal said she thinks part of her depression came from biological changes in her young adult years, and that she could have “tackled it a little bit earlier” if she or her family had been more on the lookout for this. A number of people talked about how understanding depression as a biological issue made it easier not to blame themselves.

Sally says a lot of people don't realize depression is a real thing—a chemical imbalance you can't just make yourself correct.
Interview Transcript

Well, like I said earlier, like even my boyfriend who sees my behavior every day, he still doesn’t understand like, what depression even is. People are, a lot of people are like, oh like you’re sad snap out of it you know, like they don’t understand that depression is a real thing. You know most people, everyone experiences some kind of depression at one point or another, but those people who have like, I wouldn’t say chronic, but depression may feel for many years or you know uncontrollably you know like for me like definitely a chemical imbalance. You know, it’s different, it’s different than like bereavement, experiencing death in your family, different than like you know feeling sad because your boyfriend broke up with you or something like that. Like, it’s that but like, twenty times worse.

DEP Sally
Profile Info
Age at interview: 25
Sex: F
Age at diagnosis: 19

Background: Sally lives with her boyfriend, dog and cat in an apartment in a suburb. She is in graduate school part time and works as a researcher. She is Middle Eastern/Egyptian.

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Genetics – that is, traits or susceptibilities passed down through biological families – was also named by many as a cause of depression. Marty thinks his depression was passed on through his mother’s side of the family; his siblings are not affected, but he “drew the short straw.” Maya said she thinks there is a genetic component to depression that “dictates sort of your set point for happiness.”

Life circumstances were generally pretty good for Casey, so he thinks genetics and biology are likely explanations for his depression.
Interview Transcript

I have always assumed possibly because it’s, it feels better as an explanation for me but also possibly because I think it’s probably true, that it’s like genetic and like naturally occurring, because I think it just doesn’t, for me at least it doesn’t make sense the way I some, the way that when I’m feeling depressed that I like react to… I think depression doesn’t make sense as a reaction to my external circumstances, because I’m generally pretty lucky nothing terrible has happened to me.

DEP Casey
Profile Info
Age at interview: 22
Age at diagnosis: 15

Background: Casey grew up in a rural place but now lives in a city with a roommate. He recently graduated from college and is considering graduate school while also looking for work. He is White.

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Several people pointed out that their family’s history with depression had been hidden from them. One reason people gave for this secrecy is that depression is stigmatized in their culture, and therefore it is not spoken about much or at all. Another is that their parents wanted to protect them from knowing about this history, or were simply trying to conceal their own depression.

Only when her father was on his deathbed did Myra find out that there was depression on her father's side of the family, and that her father had his own struggles with depression.
Interview Transcript

We didn’t know, we didn’t know that he was, that his side of the family was prone to cancer and depression until he was on his deathbed, so.

Oh, so there was depression in his family then?

Yeah, we, we just had no idea.

But not him?

Yeah.

He wasn’t depressed, or was he?

He was, yeah. Mmm-hmm. After the back surgery, I noticed he — it was kind of just even less going out. It, even less just, you know, doing things that made him happy. It was more so just taking care of the family and just pushing forward and always, you know, always greeting us with a smile and always saying, well, why, why is it the people are giving in to, to, to what they, you know, what they feeling on the inside? Why, why can’t you just smile and be happy, you know?

Well, like I said, he was, he was really good at just, just putting on a happy face and as I got older, I noticed it was even less, you know, even less going out than he already was. It was just, it turned more so to just taking care of the family and, you know, hiding whatever, whatever pain he was going through, physical, emotional, things like that. So I mean, like I said earlier, we had no idea that cancer and depression ran on his side of the family until he was on his deathbed. So, yeah, it’s just sad and a shock to find out all around.

DEP Myra
Profile Info
Age at interview: 28
Sex: F
Age at diagnosis: 27

Background: Myra is a musician works as an aide to older adults. She lives with her fiancé. She is African American.

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Colin was relieved when his parents finally told him depression runs in his family.

And, we went out to eat and stuff and we had just a very calm, like, surprisingly calm levelheaded talk. And, so much got revealed in this conversation. And, I was baffled. Like, since I was, started having bad depressive symptoms, around maybe, I don’t know, puberty, like 14, 13, I had felt so guilty because I literally have so few things in my life that, I’m sure like a lot of people say this, so few things I feel that warrant this type of just intense sadness and enmity for the world. And, I felt so guilty my whole life about feeling the way I do, like, I’m somehow causing this and bringing it on myself, and like I’m doing something wrong, it’s my fault that I feel this way all the time. And, I’ve asked them straightforward before about, because I’ve had to fill out so many like therapist documents or psychiatry appointments, I’ve been at [hospital name] before for OCD. So, I had a long screening process for that as well where they ask about family history. And, they never have anything to report, because my parents say that there’s nothing to report, which is another reason I felt like I’m an isolated incident.

And then, it all comes out at this meal that there’s so much depression and mental health issues on both sides of my family. And I have no, I, they said that they were keeping this from me because they thought it would bother me or worry me. But, it just made me feel so much better when I learned that it wasn’t my own doing. And, they told me about, I have one grandparent who’s still alive. And that she had attempted suicide twice. And my mom has a large family; she’s one of 15 kids. And, she said at least seven of her siblings are antidepressant. And, my father said my uncle has obsessive compulsive disorder. And, all this stuff started coming out. And, I was just taken aback. Oh man, it was just, I don’t know, it was, I felt very good about all this. And they were just like I didn’t want you to hear that. Like, do you really want to hear something that dark like your own grandmother tried to kill herself? I said, yes, like, please tell me that. I would have loved to hear that. That would’ve been so relieving to me as a younger kid. They didn’t understand that. But, after that conversation, they went home, I felt better.

DEP Colin
Profile Info
Age at interview: 20
Sex: M
Age at diagnosis: 18

Background: Colin works at the college he attends and lives with a roommate. He takes medications and sees a therapist. He is White.

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Childhood and family issues

Many people described chaotic, difficult, or abusive living situations in childhood as a significant cause of their depression. As Brendan puts it, these “background… stresses in my life… might have contributed to my depression from an early age.” Specific stresses people described include not having a father figure, divorce, moving often, having an unstable household, being in foster care, being neglected and left home alone, and having parents who were themselves depressed or struggling with substance abuse. People also described “being poor in America” as a contributing factor. (National data from 2014 shows that people who live in poverty are more than twice as likely to have depression as people at or above the poverty level*.)

Devin thinks his depression comes at least in part from being neglected by his parents.
Interview Transcript

You know there, there wasn’t very much hugging or often saying, “I love you,” that you would think a mother would. And to me, I was the second child. It seemed like it happened more to me. I don’t know if that was just my perception of it, but that’s just how it’s always been, my mother never really said, “I love you,” which caused a huge impact on me because that was, that was harsh being a young kid not, not hearing a parent say I love you or hug you or…you know, it was just that I lived in that house. And you know I, probably like when I was two my mother and father got divorced so I would see my father on weekends and then the rest of the week I would be with my mother.

…no, that would definitely have to be it, it would definitely stem from my father and my mother. My mother being neglectful, my father no matter what I did, it was, it was not good enough, it was wrong.

DEP Devin
Profile Info
Age at interview: 21
Sex: M
Age at diagnosis: 16

Background: Devin lives with his girlfriend and other roommates in a city he recently moved to from another part of the country. He has a part-time job in a store. He is White.

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Sierra Rose says if you are in a bad living environment it is hard to be mentally healthy.
Interview Transcript

If you’re not in a good living environment, you’re not going to be good mentally or emotionally and most of my life I haven’t been in good living environments and it shows. Once I moved out of my mom’s place which was a bad environment, I got better and then that environment turned sour and I got way bad again and then I got out of that and into what I thought was another good environment and then that turned bad and it’s, it’s very situational, and I…

DEP Sierra Rose
Profile Info
Age at interview: 18
Sex: F
Age at diagnosis: 11

Background: Sierra Rose lives in an apartment with her boyfriend, another roommate, and three beloved cats. She spent a week in the hospital shortly before her interview, and was continuing with out-patient care but struggling to pay for some of it. She is Italian and Jewish.

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Changes in society

People also experienced modern life as contributing to depression. Maya notes that social media create a false impression that everyone is always “purely at their best,” and makes it much harder to “show ourselves when we are struggling.” Joey wonders if “insane modern society” has been resulting in larger numbers of depressed people.

Lots of screen time and less face-to-face communication seem to Sierra Rose to be causing increased rates of depression among young people.
Interview Transcript

I don’t like all of the technological advances that we have, I think it contributes to a lot of the problems that as a society we have. Eating disorders and depression and all of the advances we have just bring on a whole new set of problems that we don’t know how to fix. I mean suicide rates have gone up so much because and if you look at it, it correlates with the advancement of technology and the lessening of respect in children and the lessening of face to face personal communication. It’s all done over text or email or video chat or you know Facebook, there is no face. So many people don’t know how to have a conversation, sit down face to face without sitting there with their phone to be scrolling through or you know watching TV or anything like that and it’s…I think that’s the main cause of the majority of our issues nowadays, mental illnesses included. I’m not saying that, you know, it isn’t or wasn’t a problem back then just saying that it’s gotten greater as time goes on. And it’s so hard now because you have people glorifying depression and glorifying self-harm and eating disorders and it’s like why, why would you choose to live like this? It’s appalling.

DEP Sierra Rose
Profile Info
Age at interview: 18
Sex: F
Age at diagnosis: 11

Background: Sierra Rose lives in an apartment with her boyfriend, another roommate, and three beloved cats. She spent a week in the hospital shortly before her interview, and was continuing with out-patient care but struggling to pay for some of it. She is Italian and Jewish.

Click here to view Sierra Rose's profile page
Crystal says the world is going at a faster and faster pace, which creates struggles for people with a slower personal clock.
Interview Transcript

As a young adult at least now, in this day and age the world is getting more competitive, life goes at a faster pace. I mean unfortunately we live in a society where people tend to be really in a hurry to do things. So you know often times it’s like you know, you really shouldn’t be taking a break right now because you could be spending your time doing this, you could be so much more effective. But how you know, if we switch back 100, 200 years earlier, life was a little bit slower and people took their time with things and you know. So advice that I’d give to people to follow as much as you can is, take yourself outside of this day and age and imagine that you have all the time in the world and just follow your own personal clock. Because time is a really great resource in dealing with depression, it’s a difficult one because often time it forces us to, you know lose time.

DEP Crystal
Profile Info
Age at interview: 20
Sex: F
Age at diagnosis: 15

Background: Crystal is an African American college student. She works campus jobs during the year and internships in the summers.

Click here to view Crystal's profile page

(See also ‘Depression, medication and treatment choices’, ‘Depression and relationships’, ‘Depression and feeling different when young’.)

References

* Pratt, Laura, and Debra Brody. “Depression in the U.S. Household Population, 2009-2012.” National Center for Health Statistics Data Brief 172 (2014).

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