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What Are the 4 Main Causes of Depression?

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What Are the 4 Main Causes of Depression?

Depression is a mood disorder that can affect anyone, regardless of age, economic status, or ethnicity. Almost 5% of U.S. adults report regular feelings of depression. (1) Higher rates of depression have been linked to old age (2) and difficult socio-economic conditions (3), but there is no single cause. 

People experience symptoms of depression for a whole range of reasons. Sometimes it is triggered by a particularly upsetting event or stressful period in their lives, such as:

  • The loss of a family member or close friend
  • Feeling underappreciated or redundant at work
  • Going through a divorce
  • Living with debt
  • Serious illness
  • Giving birth (in the case of post-natal depression)

Depression often occurs after a series of multiple traumatic events leads to prolonged excessive stress. For example, falling ill during a time of financial struggle can compound stress and lead to the often-cited ‘downward spiral’ of events that result in depression. 

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When patients with depression symptoms are feeling low, they often withdraw from family and friends. This leads to loneliness and a breakdown in their support system, exacerbating symptoms and making depression worse in the long run.

Below are the four most common causes of depression.

Family History

A person is more likely to develop depression if there is a history of it in their family. Researchers found a specific gene in more than 800 families with depression, suggesting that as many as 40 percent of patients’ depression is genetic. (4) However, depression is a complex and varied disease, and environmental factors also play a significant role, e.g., shared socio-economic factors among family members. (5)


Research has found that certain personality traits are correlated with depression. (6) These include low self-esteem, neuroticism, introversion and being overly self-critical. 

The structure of the human personality is complex and can stem from environmental and genetic factors. The chemical makeup of the brain influences moods, which is why proven treatments for depression such as SSRI medications and transcranial magnetic stimulation (TMS) target brain activity.

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Substance Abuse

Overindulgence in alcohol and drugs is a common coping mechanism for people going through difficult times, but these substances have an adverse effect on our brain chemistry, often worsening symptoms of depression and making recovery more difficult. (7)


Medical issues such as chronic or life-threatening illnesses (e.g., cancer) can also trigger depressive symptoms. Serious head injuries have been linked to mood swings and reduced emotional regulation. Depression is also associated with hypothyroidism (underactive thyroid).

There’s No One-Size-Fits-All Solution for Depression

Ultimately, there are as many reasons behind depression as there are people with depression; virtually any factor of someone’s life can be the cause. Whatever the circumstances, if you think you might be experiencing symptoms of depression, it’s important to seek help as soon as possible. Delays in seeking medical assistance can lead to worsening symptoms.

To make an appointment with a licensed healthcare professional at Madison Avenue TMS & Psychiatry, contact us online or call (212) 731-2033.

  1. Early Release of Selected Estimates Based on Data From the 2019 National Health Interview Survey. National Center for Health Statistics. 2020. (Accessed Feb 10, 2023).
  2. Older Americans 2020: Key indicators of well-being. Federal Interagency Forum on Aging Related Statistics. 2020. (Accessed Feb 10, 2023).
  3. Machlitt-Northen, S., Keers, R., Munroe, P.B. et al. Polygenic risk scores for schizophrenia and major depression are associated with socio-economic indicators of adversity in two British community samples. Transl Psychiatry 2022;12, 477. (Accessed Feb 10, 2023).
  4. Is Depression Genetic? Healthline. April 5, 2021. (Accessed Feb 13, 2023).
  5. Sullivan PF, Neale MC, Kendler KS. Genetic epidemiology of major depression: review and meta-analysis. Am J Psychiatry. 2000;157(10). (Accessed Feb 10, 2023).
  6. Denkova, E., Dolcos, S., & Dolcos, F. Reliving emotional personal memories: Affective biases linked to personality and sex-related differences. Emotion, 2012;12(3), 515–528. (Accessed Feb 10, 2023).
  7. Quello SB, Brady KT, Sonne SC. Mood disorders and substance use disorder: a complex comorbidity. Sci Pract Perspect. 2005;Dec;3(1):13-21. (Accessed Feb 10, 2023). 
Dr. Woo has been seeing patients in private practice since 2002, always with the goals of combining evidence-based medicine with psychodynamic psychotherapy and collaborating with other mental health professionals to ensure the best possible outcomes for his patients. He has been certified to administer TMS at his practice since 2017. His greatest clinical interests include helping patients suffering from depression, anxiety, and obsessive compulsive disorder.

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