Depression: Its Causes and Symptoms

Jeffrey Kaye, Ph.D.
844 California Street, San Francisco, CA 94108

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Depression is a common disorder, affecting about three to four percent of the adult population at any one time. Lifetime prevalence rates are estimated to be around 20 percent. A variety of treatments are available. Don't feel hopeless if the first or even the second approach doesn't work. Psychotherapy is one of the standard treatments for depression. Depression is an emotional condition with cognitive and social/interpersonal repercussions. It can accompany any number of other psychiatric conditions, among them anxiety and panic disorders, eating disorders, substance abuse, and many others. Depression often starts out as a reasonable response to a life stressor, but the condition then becomes overwhelming. It can be reversed.

Click on one of the links below:
I want to know more about the symptoms of Depression.

I want to know why I or others get Depression.

I want to take the Depression questionnaire/evaluation.
(An alternate on-line depression assessment can be found at the website of the California Psychology Network. Please feel free to try out the CPN Online Depression Screening by clicking on this link.)

I want to see more links about Depression.

I am interested in help or therapy for my problems and/or depression.

Symptoms of Depression

If you have had five or more of any of the above symptoms, and they have lasted more than two weeks or so, then you probably are having a serious depression or mood disorder. If any of the above symptoms are causing you noticeable distress or inability to function in your life, no matter what the time frame involved, you should seek professional assistance.

If you are in an immediate, life-threatening crisis, call 911. 
If you live in the San Francisco Bay Area, and need to talk to someone
anytime during the day or night, call San Francisco Suicide Prevention
and Crisis Services at 415-781-0500.

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Why Depression?

Depression is usually associated with a life stressor or change in life circumstances. Four typical problems areas are:

    The causes of Depression are complex, and ultimately rooted in the experience and relationships of each human being, subject to any predisposing or underlying biological factors. On some level, it is a basic modality of existence, as one can see in such normal aspects of life, such as mourning, or feeling sad.
    Modern biopsychiatry (and popular magazines) will often tell you that depression is due to a so-called "biochemical imbalance" in the brain. There are two logical errors in this point of view. While it there are biological correlates between states of mind (or emotion) in the brain (that is, changes in relative concentrations of neurotransmitters in various nerve tracts), they remain just that, correlates. The causation of such states is either unknown, or complex. Recent scientific discoveries about the human genome have confirmed that purely genetic determinants for human behavior are insufficient to understand the diversity of psychological problems.

    If you forgive the technical digression, the two logical errors are: 1) a reductive fallacy, or the reduction of complex or diverse causes to simplistic formulas; and 2) the fallacy of mistaking correlation for cause (otherwise known as cum hoc, propter hoc). Correlation shows whether there is any relationship between two variables, positive or negative, but is agnostic about the cause for or meaning of that relationship. But correlation by itself can never explain a cause, though it can be cited as evidence against a particular cause. This is because there never is a consistent causal relationship without some correlation.

    Biological theories of Depression are the rationale for the prescription of psychotropic medications (like Prozac and Celexa, or older drugs such as imipramine). The fact that such drugs work sometimes, but not at all times, or for all people (leaving out, for the moment, the problem of side effects), I believe is ultimately rooted in the overly narrow view taken toward the view of mental illness by the psychiatric establishment.
    It is also important to point out here that various physical conditions or illness can mimic the symptoms of Depression. One of the most common is an underactive thyroid gland; this condition is called hypothyroidism. Diabetes, Chronic Fatigue Syndrome, Multiple Sclerosis, and any number of other diseases can also be responsible. You should always check your health first with a doctor (MD).
    Depression is also a condition that can piggy-back on other psychiatric or emotional syndromes. Some examples include eating disorders, post traumatic stress disorder, schizophrenia, and substance abuse, among others. Also, and importantly, depression affects and is affected by one's experiences in relationships. Our lives swim in a sea of relationships just as significantly as the brain is awash in a sea of neurotransmitters. Often, what we can do or adjust in our relationships, even our way of relating, can significantly affect or improve our mood. For more on relationships, see my page on relationship problems and couples therapy.

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Depression Questionnaire

Feel free to print out this questionnaire for your own use.
Please rate from 0 (Absence of Symptoms) to 4 (Extreme Presence of
Symptoms) the following statements, based on your feelings or experiences
over the past couple of weeks:

1) I feel gloomy and pessimistic about the future, just hopeless. _____

2) I feel guilty and blame myself for the things I have done. _____

3) I feel life is not worth living, and have thoughts of taking my own life. _____

4) I have difficulty going to sleep at night. _____

5) My sleep is restless and disturbed. _____

6) I wake earlier in the morning than I used to, and can't get back to sleep. _____

7) I feel extra anxious and restless when awake (play with hands, hair, nail-bite, wring my hands, etc.) ______

8) I feel nervous, tense, or frightened, or fearful of being out of doors. _____

9) I suffer from headaches, stomach aches, shakiness, or palpitations. _____

        10) My appetite is less than usual, or I have no appetite at all. _____

        11) I feel tired, or heavy in my limbs, back, or head. _____

        12) I have no interest in sexual activities. _____

        13) I am worried about disease or problems with my body. _____

        14) I have lost a lot of weight recently (or gained a lot of weight
        recently). ______

        15) I feel that everything is unreal, or that the world appears remote,
        strange or changed. _____

        16) I think that people are talking about me, or laughing behind
        my back. _____

        17) I have uncomfortable thoughts in my head that won't go away. _____

        18) I find I have to do things a special way or a certain number of
        times. _____


Scoring 2 or more on 5 or more items, is suggestive of a mild depression. Scoring 3 or more on 5 or more items, or having an overall score of more than 20 for all items, is suggestive of a serious depression. In any case, if you are feeling as if problems with mood (or any other symptom) are affecting your life, no matter what your score on this questionnaire, you should contact a mental health professional.

1 This depression questionnaire is based on statistically constructed depression assessment evaluations, but is not itself statistically evaluated. It is solely meant as a guide to self-assessment of depression, for educative purposes only. If you wish to be evaluated for depression with professional assessment tools, you must contact a psychologist and ask for psychological testing. Or speak to any health or mental health professional for further guidance.

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More Links on Depression

[When you select a link, you will be going to a site that has no connection or agreement with this site. While my site does not collect any personal information or download cookies to your site, I cannot vouch for the policies of other sites. So please use the Internet with caution, and especially be careful about giving ANY site your personal information.]

Depression Site at - This site has many links to other sites, as well as posted articles of interest.

Real Age® Depression Page -- Signs of Depression, Symptoms of Depression, Free Depression Test; Information on  types of treatment for depression, including both psychotherapy and medications

Articles on Postpartum Depression - The website has a webpage dedicated to the issue of postpartum depression. While this is a serious condition and a woman experiencing post-partum depression should consult her doctor or therapist, there is also an online bulletin board to talk to other women experiencing the same problem at The condition is described and discussed also at this site for the Mayo Clinic.

Adolescent Depression - Link to Yahoo's Health page on the subject, with links to other information about treatment, as well as other types of depression, antidepressants, etc.

Causes of Depression - This link at is an excellent introduction to the site, and a succinct summation of the issue of causation and risk factors in mood disorders.

Prozac Backlash, Book Review - Read's review of Dr. Joseph Glenmullen's important recent book about the dangers of the newer antidepressants. It is not a condemnation of all medications, but a sober and well-documented look at the risks associated with these medications. For another side to the issue, check out Glaxo SmithKline's site on Paxil and Eli Lilly's site on Prozac.

The Age of Depression - An interesting article I found on the web, which addresses the issue of what constitutes sadness, misery, normal reactions to loss, and what should be diagnosed medically as depression. It contains a brief history of the topic of depression, and a critique of the DSM diagnostic approach. Thought provoking, but not necessarily for the person suffering depression.

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Last modified: December 07, 2011
Copyright © 2003 Jeffrey Kaye, Ph.D.

All material provided on this website is for educational and informational purposes only. Direct consultation of a qualified, licensed health care provider or therapist should be sought as necessary for any specific questions or problems. This web site should not be construed as offering either medical advice or professional services; no therapeutic relationship is established by use of this site. Please do not send emails to this site or anyone associated with it that may include confidential information. A link to any other web site from this site does not necessarily imply any approval, recommendation, or endorsement of such site.