an event in order to provide optimal care. Depressive disorders due to another medical condition should be differentiated from medication-induced depressive disorders Biological Factors Genetic, neurological, immunological, hormonal, and neuroendocrinological factors play a role in the development of major depression (Remes et al., 2021). Many of these factors center around reactions to stressors and the processing of emotional information in a way that emphasizes the complexity of biopsychosocial factors (Penner-Goeke & Binder, 2019; Remes et al., 2021). A study of genetic records from 1.2 million people found 178 gene variants linked to depression (Levey et al., 2021). When an Psychological Factors Although everyone experiences stress or adverse life events, certain psychological factors may make some individuals more vulnerable to the development of major depression. When an individual’s coping abilities are ineffective or maladaptive, depressive symptoms can arise, particularly if one has a genetic predisposition for the disorder. Remes et al. (2021) found many affective risk factors for depression, distilled to four main key determinants of depression: negative self-concept, sensitivity to rejection, neuroticism, and negative emotionality. Personality traits have been linked to the risk for the development of a depressive disorder (Yang et al., 2023). Personality traits are enduring patterns of inner experience and behavior, usually established in childhood. These traits may have a genetic component as well as a psychological component. Kendler and Myers (2010) found that individuals whose personality tends to be emotionally unstable and more affected by negative emotional states such as anxiety, anger, and sadness can have a greater genetic risk of developing major depression. A modest but significant relationship to major depression was found among those whose personality tends to be less extroverted, meaning less socially engaged and less energetic. Yang et al. (2023) reported that neuroticism was the personality trait that was the highest risk factor for the development of depressive and anxiety symptoms, and agreeableness was the most protective factor for college students in China. A systematic study found that individuals with impaired executive function were more likely to develop major depression and have more severe depressive episodes (Snyder, 2013). This may be especially true for individuals genetically predisposed to the disorder (Snyder, 2013). For example, in the case of being faced with an acute crisis, such as the loss of a job, marital separation, or the onset of a sudden illness, a person with greater executive functioning may determine short-term methods of solving the crisis; locate available social support systems, such as counseling or family support; or may try to think of better solutions to the problem (Snyder, 2013). Individuals with impaired executive function may not have the ability to use those problem-solving or resource-gathering methods wto cope with problems. They may increase depressive symptoms by ruminating or using maladaptive coping strategies to try to lessen suffering rather than engaging in Social Factors Social stressors on individuals, acute as well as chronic, can influence whether a person develops a depressive disorder. Chronic stressors, such as financial hardship due to economic decline, poverty, crowded living conditions, marital problems, unemployment, and discrimination, can also affect the development of symptoms (Remes et al., 2021). Economic recessions, characterized by job insecurity and high unemployment, can affect individuals
and adjustment disorders, in which the onset of the medical condition is itself the stressor that could precipitate the adjustment or depressive disorder (APA, 2022).
individual’s biological relatives have either major depressive disorder or dysthymic disorder (also referred to as persistent depressive disorder ), he or she is more likely to have either disorder (Levey et al., 2021). However, not all individuals who have a genetic predisposition for depression manifest the disorder, and there is no one biological marker or condition that identifies a depressive disorder (Levey et al., 2021). adaptive reappraisal or problem-solving (Snyder, 2013). This, combined with having a pessimistic worldview rather than an optimistic one, may further place an individual at risk for depressive symptoms and affect overall treatment outcomes (Armbruster et al., 2015). Cognitive theorists note the presence of a “cognitive triad of depression” among people with major depression (Braet et al., 2015). This triad consists of maladapted self-schemas, or mental organizations, which cause negative thoughts about three areas of a client’s life: (1) thoughts about oneself, (2) thoughts about one’s environment, and (3) thoughts about one’s future (Braet et al., 2015). Clients with depression may view themselves as worthless, inadequate, and unlovable. They may see their environment as overwhelming and prohibitive and may see their future as hopeless and meaningless (Braet et al., 2015). These maladapted self- schemas are deeply held and thought to develop as a result of negative interactions during childhood, particularly with primary caregivers (Braet et al., 2015). According to cognitive theorists, clients with depression distort their interpretations of events to perpetuate negative thinking, which continues the cycle of depression. Young and colleagues assert that clients who are depressed create negative schemas that lead to maladaptive coping. In other words, depressed clients develop a worldview based on earlier life experiences that reinforces negative beliefs about themselves and their environment. Those internalized belief systems, in turn, are the underlying foundation upon which coping strategies are formed. When clients see the world through a negative schema, responses to stressors can be distorted and maladaptive. Furthermore, clients who were emotionally neglected or severely overprotected as children may develop symptoms of anxiety and depression, as well as maladaptive coping strategies (Williams et al., 2015). Similarly, childhood traumatic events increase the individual’s vulnerability to developing anxiety and depressive disorders (Huang et al., 2022). Given that women are twice as likely to develop major depression as men, attention must be paid to the psychological and social factors that affect women. Researchers point to gender differences, including hormonal differences, socialization differences, social roles, coping styles, and stressful life events (Schimelpfening, 2020). and communities (Remes et al., 2021). Individuals who are middle-aged, in debt, or perceive their job security to be unstable are more likely to develop depression and may be at higher risk of suicide (Law et al., 2014; Phillips & Nugent, 2014). Neighborhood characteristics can also influence whether individuals are more likely to be depressed (Remes et al., 2021). Communities with higher levels of environmental
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