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[Cassie]

Hi Ladies just looking for advice, a family member has been diagnosed with clinical depression.
I have tried googling but cannot really find an answer.
My question is, can  depression be brought on by a stressful situation or is it actually a physical issue in the brain as in an imbalance or perhaps the way the brain is put together that predisposes that person to depression?  Any idea?

[Tinkerbell]

You can get reactive depression, but i feel that in some people there is some inbalance in the brain. My husband has had bouts of severe depression as did his mother and his psychiatric consultant did say that there is a higher risk of depression if you have a first degree relative with it.

[racjen]

Depression is a really complicated thing - reactive depression (ie a rational if distressing reaction to a traumatic life event) is something anyone can get and will usually resolve itself over the course of time. Clinical depression I think is a lot more complicated and involves chemical changes in the brain, but the confusion is whether the imbalance causes the depression, or the depression causes the imbalance. Either way it's more likely to run in families but again, that can be confusing because traumatic events can be shared amongst family members as much as genetics can. For instance, in my own family we suffered the sudden death of my dad when we were teenagers, and all 4 of us have gone on to have significant periods of depression (my mum doesn't suffer from it at all). In this sort of case I suspect it's a mixture of factors - a genetic propensity to depression, a shared life trauma and a learnt but unhealthy behaviour to cope with it. That's why a combination of drug and talking treatments is recommended, because there may be multiple issues going on.

[CLKD]

OK - Clinical/reactive depression - usually caused by situations that the person is unable to alter.  Can be left over from childhood events or recent trauma.

Organic depression - caused when the chemicals in the brain don't work as intended.  I suffer with both. I don't use the word 'suffer' lightly.  I wrote a tome about my journey with depression, if I can find it I'll bump it.

I HATE with a vengeance the 'pre-disposition' theory.  When I was initially ill in the 1980s I asked for investigations to find out why I was depressed.  My paternal history is a grand-father who drank and gambled and a Dad with manic depression. Maternal granny had what would be described now as post natal depression and was hospitalised for 4 months after her youngest child was born. So no one was interested in finding out causation.  It is what it is in my case.  Treated with anti-depressant medication which I fought and then accepted. I have to take something for Life.  Even then events can over-take me, if so I up my dose of ADs for 5-6 days which usually helps.  Dad had various medications over the years as well as ECT and deep sleep treatment to rest the brain.

I found talking therapy really useful: discuss, decide, ditch.  As well as appropriate medication.  If it works it helps.  I would suggest to take meds for 6-8 months and review, not short term as many GPs will prescribe, i.e. 4-6 months.  It can take a while for my brain to realise that it is feeling well again 

Does it matter?  If someone is depressed it is better to treat the person rather than wondering why, whether it be causation, trauma, hormones ......

[pants46]

Cassie, the ladies all make very relevant comments. I won't add my own personal experience to the mix.
But, what I will say is that it is great that your family member has shared their diagnosis with you. It is really important that people suffering in this way can talk about their condition.
And, it's really thoughtful of you to try and understand their diagnosis a bit better. It is really quite difficult for those who have never suffered to understand and empathise.
The most important thing to do, is to support your famuly member as they work out what treatment is going to work for them. There are lots of antidepressants available to try, but it can be a bit difficult finding the right one. It's trial and error, and they all have some side effects in the first few weeks of taking them.  Unfortunately, some people really suffer with those side effects and give up. And then of course there are counselling type therapies available. Although there may be quite a long waiting list for help on the NHS.
Talk with your relative. Let them know you are supportive. Encourage them to pursue whatever treatment / treatment combinations they think will be right for them.
Best wishes. Pants.

[Tc]

Cassie.  agree. It is thoughtfull of you to seek information to support them.
As with some of the other ladies, I have been diagnosed with clinical depression although more recently they seem to refer to mine as mixed anxiety and depressive disorder.

I think the ladies have covered the technical terms regarding what constitutes clinical depression but I would like to add that

As a sufferer Imyself  i.would say to you maybe try not to dwell at the moment on what might have lead to this

. please remember that they are the same person. The diagnosis might have followed many weeks months or years of symptoms for them and their biggest worry about telling people will be that they will be seen differently.  So please try to treat them ad the person you have always known.

Sometimes people try to "fix" you. They want to help and do something practical and sometimes  practical help is wanted  but most of the time a listening  non judgemental ear is worth its weight in gold.

Let them go at their own pace and let them know you are there for them. Please dont give up on them if sometimes they ignore your calls or dont want to see you. It's not personal.
They may act or re act in a different way than they have in the past. This doesnt mean they have changed forever. They are still in there.
 
They may not ask for help but it can be given in a way that doesnt make them feel like they are failing, you might have to be a  bit creative with this one. But.. You dont have to walk on eggshells so dont be afraid to contact them and carry on as you always have  inviting and including them in things. Just dont be offended if you get a few knock backs.

Also. Supporting someone with depression can take its toll on you too. So it's important for you to be able to talk about it to someone you trust so you dont take things on board without having an outlet for yourself.

I'm saying these things from my own personal experience, which is all I can offer but I hope it might help.

Hopefully with the support of those around them and the correct treatment  they will come out the other side of this the other side Xx

[racjen]

CLKD, I just wanted to clarify - there are two different types of depression, reactive (which arises from a traumatic life event)and clinical (which originates in brain chemistry). The third type, which I think you must be referring, to is organic mood disorder, not generally referred to as depression and a lot less common. I hope you don't mind me splitting hairs over this,but clinical and reactive depression are not the same thing, which you seem to be implying they are.

[dangermouse]

Depression is the brain’s way of calming the Central Nervous System when anxiety has gotten too severe. It will numb the physical responses in order to protect the body and mind. It can come and go in an anxiety-depression-anxiety-depression pattern and may eventually settle in a depressed state when all hope appears to be gone.

Antidepressants will re-stimulate and re-motivate but can also bring back anxiety if current thought processes are still creating anxiety. Some SSRIs also have anti anxiety properties to try to combat this issue.

Biochemical depression is the same outcome but triggered by chemical or hormonal imbalances rather than thought processes. You can’t talk down this type of depression (or anxiety) as, although the brain is under or over stimulating the Central Nervous System in an attempt to rebalance what it perceives as a dangerous situation in the same way, it is a reaction to the chemical imbalance rather than the thoughts.

[CLKD]

   Tc - beautifully put.

Sorry, as a long term sufferer I have to argue - my experiences as well as my medical clinicians have explained it as I stated: as do the Psychiatrists and Psychologists with whom I worked more recently.  A big problem happens because many 'experts' still won't recognise organic depression which is where many mis-understandings happen.  A 'disorder' means absolutely nowt! it's a bit of a cop-out by the medics IMO and really does devalue how people with depression suffer and also means that it isn't taken seriously enough for patients to be given treatment 

Also  - for me anxiety began at age 3.  I had pre-menstrual weepiness for years but didn't have depression until the 1980s.  In 1991 I was diagnosed with cylical organic depression (over a 22 month cycle) by a Psychiatrist which is when I was advised to take medication for Life.  I have both clinical/reactive/situational and organic depression; clinically I get a sudden dip when something suddenly bothers me that I can't alter.  No one was interested in what was causing the organic depression but I can feel the difference.

I don't understand what the difference might be between chemical or hormonal imbalances  .  I've never had a return of anxiety with appropriate medication - R U speaking from experience?  Anxiety will take over when I'm stressed but over-all, I remain well with the medication regime.  It took nearly 3 years to get drugs that didn't give awful side effects though 

[racjen]

Sorry CLKD but I have to take issue with you here. As far as I understand it, depression is defined as being either reactive (ie an understandable reaction to a traumatic event), or clinical (there may be no obvious trigger and the cause is both chemical and emotional). Both can be treated with ADs, but the former is more appropriately treated with talking therapy, whereas the latter may need extra chemical input, but both would be seen as psychiatric illnesses.

I have a fair amount of experience of mental health situations and I've never heard of a third category of depression ie organic. Googling this does come up with something called organic mood disorder, and I quote

'an organic mental disorder (OMD), also known as organic brain syndrome or chronic organic brain syndrome, is a form of decreased mental function due to a medical or physical disease, rather than a psychiatric illness'.

 I think it's important to make the distinction because treatment will be different for all of these. If you have any detailed information/research you can put up on here I'd be really interested, because at the moment I'm a bit stumped as to what you're referring to.

[CLKD]

You will remain stumped then. 

Sometime stated as a 'disorder' means what exactly?  This isn't a competition by the way.  I know what I have been told regarding my mental health issues and by working with various mental health professionals for many years, on both sides of the bed as it was.   When I went into depression there was no such thing as talking therapy. It was drugs or admission.  The night I begged for admission because I felt unsafe, I was told to take more drugs  [1991].  Care in the Community then 

My detailed information is in my medical records. If you don't want to believe me then that's your choice, I am not responsible for your reaction to the truth of my history.

Many 'experts' will not recognise the organic depression.  They will deny it.  But I have clinical and organic, I can tell the difference as soon as I wake in the morning.  Could you put which part of 'google' states organic mood disorder as I don't trust google much. 

[CLKD]

One thing B4 I leave this thread: when very ill in the 1990s I needed somewhere to go.  A door to tap on and the person would invite me in without questions or expectations.  Somewhere that I could sit, with a cuppa and let the World wash over me whilst they 'got on'.

Several times I went to sit in the Surgery Waiting Room - when I felt that I might do damage to myself.  Because everyone was at work or would have freaked had I turned up on the doorstep 

A few years ago I had need of safety, I contacted my local MIND walk-in centre and although I didn't attend, they were very supportive for the 8-9 months I required it.  So there are options to suggest.  I never confessed to suicidal thoughts and no one asked but it was a necessity to have somewhere safe.

[Cassie]

Thanks girls, this has helped me tremendously, appreciate all the input.

[racjen]

CLKD, a disorder doesn't mean nothing, it means a different type of problem from actual depression. If you Google organic depression you'll come up with nothing, because it doesn't exist as a definition.  The following link is from  the MIND website, which hopefully is a reliable source of information: https://www.mind.org.uk/information-support/types-of-mental-health-problems/depression/#.XQ9f4utKjIU

No mention of anything called organic depression. The following link describes organic mood disorder, which I think is what you're talking about - it's a physical disorder more akin to bipolar or schizophrenia. https://www.gomentor.com/articles/organic-mood-disorder. I'm really sorry to be harping on about this, but i feel it's really important to give accurate information on forums like this. I'm not in any way trying to deny your experience or your diagnosis, but it's not helpful if you cloud the issue by giving out inaccurate information.

[Tc]

Many years ago a phychiatrist raised the fact he thought I may have "cyclical bi polar". More recently different phych diagnosed EUPD, not .  bi polar but does have some similar features. The EUPD is on my care plan as separate from "mixed anxiety and depressive disorder".  EUPD affects the way my thought processes work and there are certain features which lead to them making the diagnosis. . A disorder doesnt mean nothing if you are diagnosed with one  !!  If it was a cop out then why are they also acknowledging my anxiety depression as a separate issue. The "disorder"  label has not prevented me receiving treatment. It's my personal experience.