What causes depression? Why do some people find it easy to leap over life’s difficulties like an Olympic hurdler while others seem to trip over them? Some can celebrate life’s losses as a new beginning while others grieve them for years.

While we don’t know the exact answers to these questions, we do know there are a number of factors that all contribute to one’s state of being. We will discuss two of the major players: thought patterns and brain chemistry.

The Cognitive Factors

How you think truly does determine how you feel. Depressed people have a more pessimistic inferential style, which means that when it comes to deciding why something happened, those that are depressed tend to believe the worst. These people also tend to ruminate a lot, which is compulsive focused attention on the symptoms of their pain and its causes, rather than its solutions. This interferes with problem solving, which could potentially improve the situation, worsens mood and actually increases activity in the brain’s fear system.

Biology and The Blues

That brings us to the next contributing factor, biology. There are known genes and variations of genes, including the 5HTT gene famously associated with serotonin, that are found in depressed individuals and not the general population. This is where things get sticky. Many people believe that their mood is all a product of a genetic defect or lack of serotonin, which can only be cured by medication.

This is simply not true.

Ronald Pies, editor of the Psychiatric Times, wrote “In truth, the ‘chemical imbalance’ notion was always kind of an urban legend-never a theory seriously propounded by well-informed psychiatrists.” To further drive home the point, it is notable that there are some antidepressants that raise serotonin levels while others lower it. Both have been successful in treating different patients.


So What’s A Person To Do When The Blues Won’t Go Away?

Research tells us that talk therapy is actually more effective than medications at treating depression. Over 20 studies show that talk therapy permanently changes multiple areas of the brain, including that good ole’ 5HT gene, while medication’s effects last only while taking it. That means that while changing your thinking patterns, you are also changing your biological factors. A double whammy against two major causes of depression.

Cranial electrotherapy stimulation (CES), a device available for home purchase, is also successful in treating 86 percent of patients. Exercise has been repeatedly shown to be as useful as medication at treating depression and preventing relapse. There’s even a growing body of evidence that meditation, yoga and acupuncture can also improve symptoms. While we may not be able to answer “why,” we can answer “how” to make it better.

So the next time you feel down, remember that no matter the cause, there is hope! You can literally rewire your brain and learn to enjoy life more.


For more information visit www.alpha-stim.com or www.kasihoward.com. Kasi Howard, Psy.D., is a licensed psychologist at the Alamo Wellness Group located at 6243 W Interstate 10 in San Antonio, TX 78201, and she can also be reached at 210.838.0090. 

About The Author

Dr. Howard is the Executive Director of Innova Recovery, a telehealth trauma treatment program. She is a Texas native and Baylor graduate who moved to San Antonio in 2009 for her pre-doctoral internship. After many years of working with at-risk and adjudicated youth, she began her transition to specialize in eating disorders and trauma. Dr. Howard has been intensively trained in Eye Movement Desensitization and Reprocessing (EMDR), Dialectical Behavior Therapy (DBT), and Interpersonal Therapy. She has developed several group curriculums, including an educational support group for spouses and significant others of those who suffer from mental illness. She believes in the importance of engaging family in treatment. Dr. Howard served as President of the Bexar County Psychological Association. She has also taught at Trinity University and is passionate about promoting the field of psychology.

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