What’s Causing Your Depression? The Answer Can Be Complicated.

Cynthia McKay, JD, MA, LAC, MFT, LISAC / Depression / Mental Health

What’s Causing Your Depression? The Answer Can Be Complicated.

Although all depression results in mental health symptoms, sometimes the actual cause can be physical, emotional, or even spiritual. With Mental Health Awareness Month in full swing around Denver, I wanted to explore these 4 major types of root causes — as well as some ways they can be treated successfully.

Depression is complex. And medication isn’t always the answer.

At our center, I see a lot of patients who’ve tried all kinds of depression medications but can’t seem to find relief from their symptoms. Unfortunately, people can search for the right answers for years and never find them. As a clinical psychotherapist and licensed addiction counselor, I welcome this kind of challenge.

In some cases, these patients have treatment-resistant depression. In that case, they’ll have much greater odds of success with a treatment like IV ketamine infusions. In many other cases though, I see that the root cause beneath their symptoms might be very different — and much more complex — than that patient might think. Often the answer is an integrative approach that looks beyond just psychiatric medication for answers.

The 4 main root causes of depression

Depression is a complex and multi-faceted issue. Common symptoms like reduced motivation, loss of social connection, and trouble doing everyday tasks can have very different underlying causes from one patient to another. As Dr. Ballen says, no two depressions are exactly alike. Here are the 4 very different types of root causes that can be driving your symptoms.

1. Mental
2. Emotional
3. Physical
4. Spiritual

These different types of factors can not only co-exist, but they can even interact with each other and contribute to the development of your depression in various ways. I did mention depression can be complex, right?

I should mention that identifying which of these underlying causes is at play for a specific individual requires a thorough assessment by an experienced mental health professional as well as a personalized treatment plan.

Unfortunately, there’s no one-size-fits-all treatment for depression, and this is why relying on any one single approach like medication alone just might not work.  This is also why integrating psychiatry, talk therapy, and more holistic interventions like IV therapy can deliver far better results for many patients. Later in this article, I’ll explain why that is in a little more detail.

1. Physical causes of depression

I’m starting with physical causes because depression is so rarely thought of as a physical condition. This surprises a lot of people. Physical causes could be as simple as a hormone imbalance, but it can be quite complex. We’ve seen patients with undiagnosed Lyme disease or toxic mold exposure suffer for years before learning the real reasons behind their depression symptoms. Naturally psychiatric medication is never going to be enough if you have an underlying illness or other condition that’s not being addressed.
Some of the most common physical causes of depression include:
  • Genetic predisposition or family history of depression.

  • Imbalance of neurotransmitters in the brain, such as serotonin, dopamine, and norepinephrine.

  • Chronic medical conditions, such as diabetes, heart disease, or chronic pain.

  • Hormonal imbalances, such as those caused by thyroid disorders or menopause.

  • Substance abuse or addiction

  • Poor nutrition, sleep disturbances, or lack of physical activity.

Getting help: Treatments for this type of depression might incorporate psychiatric medication, hormone replacement therapy, addiction recovery, and/or lifestyle interventions like better nutrition, exercise, and sleep hygiene. Somatic work (body work) like massage and acupuncture can also be incredibly helpful things to add to the mix and attack your depression from multiple angles at once.

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2. Emotional causes of depression

In the hustle of everyday life it’s all too easy to neglect our emotional needs or even suppress them. Emotional health isn’t a luxury, however. Having unmet emotional needs, or having to deal with potent emotional situations, can easily lead to all kinds of other problems, not the least of which is acute or chronic depression.
Some of the more common emotional causes of depression are:
  • Relationship issues with friends, family, or loved ones.
  • Chronic stress from work, or financial difficulties.
  • Grief, loss, or trauma. This can include recent life events, or unresolved events from the past.
  • Poor coping strategies or a lack of emotional regulation skills.
  • Difficulty expressing or managing emotions, such as anger or sadness.

Getting help: As a psychotherapist, you probably knew I was going to recommend therapy and counseling here, right? Of course, other treatments like medication, meditation, and many other things can play a role in getting better, but talking it out and learning tools and techniques to help you deal with these causes in the future is often a core part of effective depression treatment. After all, it’s rare we get to avoid the causes of depression altogether. Learning to cope with these causes is often vital to finding relief.

3. Mental causes of depression

They say depression can come from dwelling on the past, and anxiety can come from dwelling on the future. We all know how hard finding the middle between these two poles and living in the present can be. The consequences of living too much in the past though can be devastating. You can literally think your way into depression if you have these habits below.

Some of the most common mental causes of depression include:

  • Negative thought patterns and cognitive distortions, such as all-or-nothing thinking, catastrophizing, or overgeneralization.
  • Low self-esteem and feelings of worthlessness or inadequacy.
  • Ruminative thinking, which involves dwelling on negative thoughts or experiences. This often means dwelling on the past.

Getting help: Core treatment for this type of depression might focus on psychotherapy (talk therapy) counseling, and CBT (cognitive behavioral therapy). Supporting modalities that ground us in the present and/or help us focus on the positive are also extremely helpful. These might include meditation, a gratitude practice, or even something like neurofeedback.

4. Spiritual causes of depression

Meaning, spirituality, and faith can be the greatest things in life when we’re aligned with them. When things go off track with them, however, they can also be tremendous areas of crisis.
Some of the most common spiritual causes of depression include:
  •  Feeling disconnected from a sense of purpose or meaning in life.
  • Struggling with existential questions. This can be a religious crisis of faith, but doesn’t have to be tied to religion.
  • A perceived lack of support from a higher power or spiritual beliefs.
  • Feeling disconnected from others or isolated in one’s spiritual journey.

Getting help: Not surprisingly, speaking to someone at your church, temple, mosque, or synagogue can be vital here. Professional talk therapy or counseling can also be tremendously helpful here, and there’s no reason why mental health treatment and spiritual development can’t co-exist well together.


Why an integrative approach to depression treatment often works better than conventional approaches

While conventional psychiatry works for many patients, it leaves out many other options that can be vital to relieving and even curing depression at a root level. I hate to say it, but conventional depression treatment often just masks the symptoms and doesn’t get to the underlying problem(s).

An integrative approach to treating depression gives patients the best of both worlds.

The great thing about an integrative approach is that it blends conventional methods like medication and psychotherapy with complementary treatments like IV infusion therapy, hormone replacement, nutritional supplements, and more.

This holistic strategy takes into account all dimensions of a patient’s well-being — mental, emotional, physical, and spiritual — to create a tailored treatment plan. 

It’s important to note that an integrative approach can still include conventional psychiatric medication and can sometimes look very similar to a more traditional plan of care. In my work, I’m part of a team that includes prescribers, so when a patient needs a prescription, we work together to make sure these needs are met.

That said, a lot of patients coming to an integrative center are more likely to want a treatment plan that goes beyond just medication — or a plan that reduces or even replaces medication altogether.

By addressing the root causes and not just the symptoms, many people can truly find success in their battle against depression.

There are always cases where treating and curing depression can remain elusive, but for most people, there simply is no need to live in a depressed state every day. The right treatment plan, tailored to your needs and preferences, can help you get rid of any black cloud that might be following you throughout your day.

Having difficulty finding relief? Our depression specialists would love to help you.

If you’ve been trying medication or other depression treatments but not seeing results, we’d love to see you at our integrative mental health clinic. We welcome complex and challenging cases and will work hard to make sure you don’t just “get through your day” but actually live life and thrive again.

If you’d like to learn more or schedule your first appointment, please fill out the contact form below or call our patient care team at (720)698-9710. Online appointments for most of our providers can be made here.

Cynthia McKay, JD, MA, LAC, MFT, LISAC

Cynthia McKay, JD, MA, LAC, MFT, LISAC

Cynthia is a clinical psychotherapist, licensed addiction counselor, and our lead therapist at Ballen Medical & Wellness. She specializes in a myriad of treatment modalities ranging from general psychological concerns to relationship/marriage & family therapy, depression, anxiety, addiction, grief, pre & post-divorce issues, sexual abuse, co-occurring disorders, and trauma-informed systemic psychotherapy.

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