Did you know that the whole chemical imbalance slash serotonin deficiency theory of what causes depression has been debunked?
I didn’t know until relatively recently. Although I have known for a long time that the chemical imbalance theory didn’t fit my experience with depression, I thought that maybe I was a pretty isolated case. I thought that anti-depressants just didn’t work for me, but that they were the right fix for many other people.
But then I read two books that totally blew my mind on this topic. Both of these books start with a lengthy and thorough review of the research related to serotonin and the efficacy of anti-depressants and then go on to discuss potential alternative causes of depression.
Although the alternative causes discussed are quite different, both of these books come to the same conclusion about anti-depressants: Anti-depressants rarely cure depression in the long term and we have been sold this chemical imbalance story for one reason only. We have been sold this story so that the pharmaceutical companies manufacturing anti-depressants can make more money.
Now, I’ll be the first to admit that I don’t have the expertise to declare the conclusions in either of these books 100% accurate. They probably don’t tell the full story and there are probably people out there who have had a completely different experience with depression and anti-depressants. But my strong hunch is that there is a lot of truth to these books. Why? Because they match my own experience with depression so closely.
I don’t dispute the fact that a depressed brain is going to look and work differently than a healthy brain. I have felt this difference. But many years ago, I came to understand that this difference didn’t just show up one day. My depression was not a brain disease that had struck me out of nowhere like a flu virus. It wasn’t just that one chemical was suddenly out of whack and all I needed was to find the right combo of medications to fix the problem.
Instead, my depression was a symptom of several other factors that were wreaking havoc in my body and my life. There were things that happened before I became depressed that made me vulnerable to depression. And until these factors were all addressed – one by one – my depression wouldn’t lift.
The reason I’m confident that my depression was not a matter of a simple serotonin deficiency (or whatever else anti-depressants are supposed to correct) is that my depression lifted, not when I was on anti-depressants, but much later when I learned to address the true causes of my depression.
What true causes? If depression is not caused by a chemical imbalance, what is it caused by then? This is a key question to ask because identifying the cause determines the correct treatment.
Well, I don’t claim to know what causes your depression. Depression is very complicated and there are many possible causes. While the destination – depression – may look the same for many of us, we didn’t all reach that destination via the same path.
But I do know what caused my depression, and based on my reading, I’m not nearly as unique as I once thought. So in this article, I want to talk about three possible causes of depression, all of which I know very well, because they have played a large role in my own depression.
The three causes of depression I’m about to discuss seem kind of obvious at first glance:
- Hormonal imbalances
- Generalized Life Suckery (a term coined by yours truly! 😉 ).
But it took me a very long time to identify these three as the causes of my depression, which is why I wanted to write this article. They are, in fact, not always that obvious, so I want to share my experience in case any of it will get the bells ringing for you.
(Pssst, I like to share my personal experience overcoming depression with the hope that some of my discoveries might resonate with others. Making lifestyle changes has greatly contributed to my own well-being, and as a life coach, I help people make impactful changes in their own lives. But I’m not a mental health professional and I’m not qualified to diagnose or treat mental health conditions. Depression has many potential causes, and if you have questions about the appropriate intervention for you, please consult a qualified professional.)
Three Possible Causes Of Depression
The most significant root cause of my depression has been stress. And in a way, I could have said it has been the only cause, because it’s so intimately related to the other two potential causes of depression on this list. All three of these factors play a nice little back and forth game with each other. It’s like they bounce a ball from one to another, and every time they do so, the ball – depression – gets a little bigger.
Generalized Life Suckery leads to stress.
Stress leads to hormonal changes.
Hormonal imbalances and their associated symptoms are a source of stress.
Stress leads to Generalized Life Suckery.
And the overarching shadow hanging over all of this is that chronic stress makes you tired. Eventually it can make you so tired that it becomes nearly impossible to think clearly. Your problem solving skills disappear. You are wondering in a fog and can’t find your way out. You are depressed.
There are some obvious reasons why people become stressed: living in a war-torn country, living in poverty, being the target of abuse, losing your job, losing a loved-one… But stress isn’t always this obvious.
Why Stress May Be Hard To Identify As A Cause Of Depression
What Constitutes A Stressful Situation Can Vary From Person To Person
- I’m an introvert and I get stressed if I don’t get enough alone time. My husband is an extravert and he gets stressed if he has too much alone time.
- I love reading and abstract learning and never found studying for tests stressful. However, any time I need to do anything the least bit complicated with my hands, I break into a cold sweat. My sister, on the other hand, is an artistic person who loves creating with her hands, but she used to get super stressed over lengthy homework assignments and testing at school.
There Is No Universal Level Of Stress Tolerance
- We each have our own unique level of stress tolerance determined by genes, temperament, life experience, and learned coping skills. The only way to know your personal threshold for what constitutes too much stress is trial and error.
- I’m a Highly Sensitive Person (HSP), and if I try to copy the lifestyle of the typical American non-HSP extravert, I will eventually get physically and mentally ill. How do I know? Because I did get physically and mentally ill leading such a lifestyle, and when I changed my lifestyle, I recovered. The lifestyle that is just fine for many other people is way too stressful for me.
Signs Of Stress May Not Be Visible To Outsiders
- I had what you would call high-functioning depression and anxiety. According to any external measurement sticks, I was successful. I was the student who aced all the tests. I was the employee who worked hard and got the raises and promotions. I was the mother who somehow managed to breastfeed twins while working full-time. I may have gone to sleep at night secretly hoping that I wouldn’t wake up the next morning, but I always did. I always got out of bed and did what was expected. I was anxious but I did it anyway. I faced my fears. I achieved. Nobody saw how stressed out I was. Nobody saw that I was about to break apart.
Stressed Out People May Not Realize How Stressed They Are
- I didn’t even realize the depth of my stress myself. I grew up in a dysfunctional household and my childhood was stressful. As an adult, other kinds of stressors gradually made their way into my life. Little by little. I didn’t realize how stressed out I had been until the stress was gone.
- Until the stress was gone, I hadn’t known what it was like to not be tired every second of every day. I hadn’t known what it was like to wake up in the morning and look forward to the day ahead. I hadn’t known what it was like to feel relaxed and without worry. I hadn’t known what it was like to enjoy simple moments in life. I hadn’t known all this was missing, because I had either never felt it before or it had been so long that I had forgotten what it felt like.
What You Can Do About Stress
What exactly you do about stress obviously depends on what your personal stressors and your personal stress tolerance level are. But in a nutshell:
- You make a list of everything that is causing stress in your life.
- You get rid of as many stressors as you can.
- You make plans to get rid of the stressors you can’t ditch immediately (e.g. the job you hate).
- You devise coping mechanisms to deal better with the stressors that you either want to keep in your life (e.g. your kids can be a stressor) or that you can’t control (the unexpected shit that inevitably happens to everyone).
- You seek help when you get stuck – not knowing how to get rid of a stressor or not knowing how to cope better.
You might also be interested in some of my more in-depth articles about stress, anxiety, and self care.
2. Hormonal Imbalances
Hormonal imbalances can cause a variety of symptoms that…
a) mimic depression in that you might meet many of the diagnostic criteria for depression when you are actually experiencing symptoms of a hormonal imbalance and
b) exacerbate depression in that they are not fun to live with.
Here’s a sampler:
- Sleep problems
- Mood swings
- Decreased stress tolerance
- Carb cravings
- Weight management problems
- Skin problems
- Menstrual and fertility problems
- Low libido
- Temperature problems (frequently too cold or too hot)
- Nausea, vomiting
Sometimes hormonal imbalances are so obvious that all you need is a basic physical exam with basic screening tests to detect the issue. But sometimes hormonal imbalances are not that easily identified. Sometimes you are told that “it’s all in your head” and you are offered an anti-depressant when in fact you would be feeling a lot better if your hormones were at healthy levels.
Why Hormonal Imbalances May Be Hard To Identify As A Cause Of Depression
Many Doctors Are Not Knowledgeable About Hormonal Imbalances
- I’m making this claim based on countless accounts I have read or heard about from other people and based on my own experience. The vast majority of doctors and nurses I have encountered over the past 20+ years of dealing with my own health problems know less about my specific hormone-related illness than I do. It’s not that knowledgeable doctors don’t exist, but I needed to do some work to find them.
Many Doctors Will Only Order Basic Screening Tests That Are Not As Revealing As More Detailed Testing
- Again, I’m making this claim based on countless accounts I have read or heard about from other people and based on my own experience. I was declared “perfectly healthy” by several doctors until I diagnosed myself and requested the specific tests that revealed that my hormones and blood sugar levels were out of whack.
Many Doctors Trust Blood Test Reference Ranges Without Further Investigation
- The blood test reference ranges that doctors use to determine what is “normal” don’t necessarily indicate whether your levels are optimal. Someone with borderline “normal” results might still be “off” enough to exhibit symptoms.
The Medications You Are Taking Could Mask The Problem Without Addressing The Root Cause
- Two very common causes of hormonal imbalances are stress and diet. When a hormonal imbalance is identified, many doctors will prescribe medications rather than helping you address the root causes of the imbalance. These medications can mask the imbalance and fool you and your doctors into thinking that your imbalance is under control, although the real cause of your problems is yet to be addressed. For example, taking the birth control pill might normalize some of your hormones and might reduce some of your symptoms, but stress and a poor diet might still be causing problems in terms of your overall well-being. (Again, been there. 🙂 )
What You Can Do About Hormonal Imbalances
- Here are three books that have taught me a lot about this topic. For all of them, I recommend getting a hard copy rather than the Kindle or audio version, because they contain a ton of information to internalize and you’ll want to be able to easily go back to refer to specific sections that are the most applicable in your unique case.
#1 This is the best overall guide. It helps you identify which hormonal imbalances you might be experiencing based on your symptoms and what treatment options are available for each problem.
#2 This is one of the ones already mentioned above and discusses the mind-body connection in depression specifically.
#3 This is the most helpful book I have found about polycystic ovary syndrome (PCOS), which is one of the most common hormonal disorders in existence. PCOS is also way underdiagnosed.
- Stress is one of the most common causes of hormonal imbalance. For me personally, addressing my stress levels was the key to normalizing by blood sugar levels (and hormones) after years of medication and conventional low-carb diets failed to do so.
Improve Your Diet
- Another common cause of hormonal imbalance is the typical Western diet. All of my reading on this topic has suggested the same type of diet with only slight variations:
Do eat meat, eggs, veggies, healthy fats, nuts, and some fruit.
Don’t eat any processed foods, sweeteners, grains, or dairy.
- The recommendations above go counter to what most of us have been taught is healthy food: whole grains and low-fat products. There are so many conflicting views out there about nutrition that it’s really hard to know who to trust. Here’s my advice on this topic: Try it for yourself. I did the Whole30 a year ago and I believe the meat+veggies diet is the best for me, simply because I feel better than I ever have on any other diet. If you’d like to read more about my experience, you can check out the two articles below:
- Ideally, everyone would be able to work with a doctor to diagnose and address hormonal imbalances. If your regular doctor is not open to thoroughly investigating this, it might be helpful to seek out a functional medicine practitioner and/or a nutritionist.
3. Generalized Life Suckery
Here’s the deal, guys. Sometimes life sucks. Sometimes life is hard. Sometimes it has sucked and been hard since you were a kid and you’ve never known any other kind of life. To suggest that this is all “in your head” and “your depression talking” is a) insulting and b) takes you further away from the solution.
In Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions, Johann Hari identifies a bunch of different ways in which life can suck to the point of causing depression:
- Doing work that is not meaningful to you
- Not having close connections with other people
- Being taught to measure success by “junk values” rather than meaningful values (e.g. by the amount of stuff one owns)
- Experiencing childhood trauma
- Experiencing low status and lack of respect
- Being disconnected from the natural world
- Feeling insecure and uncertain about the future
When life sucks and it has sucked for a long time and you have no idea how to make it suck less, it’s really not that surprising that you start feeling hopeless and losing your will to live.
Sometimes the hardships that lead to Life Suckery are obvious. But sometimes they are not.
Why Generalized Life Suckery May Be Hard To Identify As A Cause Of Depression
There Is No Universal Level Of Life Suckery Tolerance
- Life Suckery leads to stress. And as we already established, we each have our own unique level of stress tolerance determined by genes, temperament, life experience, and learned coping skills.
One Person’s Ideal Life Is Another Person’s Nightmare
- “Why am I so unhappy when I have everything?” “I shouldn’t complain when there are so many people who are worse off than I am.” You know who says things like this? People who are living someone else’s ideal life. People who have let someone else dictate their values and goals in life. People who are not living in alignment with their true selves.
- I used to “have everything”. I had academic degrees and a good job and money and a loving husband and awesome kids and a bunch of friends. All the elements of a “good life” that we have been taught to seek. And yet I wanted to go to sleep and never wake up. Why? Because my job wasn’t fulfilling and my friendships weren’t meaningful and I was too damn stressed and tired to enjoy my husband and kids. My “perfect” life was a big fat sham.
What You Can Do About Generalized Life Suckery
The solution to Generalized Life Suckery is simple but complicated. You gotta change your life.
But how? How do you change your life? Isn’t it way too hard?
Yes, it’s hard. It’s so hard that I get overwhelmed and discouraged and want to quit all the time.
But you do it little by little. One day at a time. One step at a time.
The hardest thing about changing your life is that it requires hope and energy and I realize that you might be very low on both. I know because I’ve been there.
But please know that you don’t have to change your whole life at once.
And every time you manage to take one little baby step in the right direction…
Every time you manage to remove one source of Suckery and replace it with something worthwhile…
There will be one less energy drain in your life. And that one positive action will give you the hope and energy to take the next step.
And then the next.
And the next.
Slow hesitant baby steps at first.
Maybe some stumbling.
But before you know it, you’ll be speed walking.
Like those funny guys in the Olympics.
And then running.
In leaps and bounds.
Not looking back.
P.S. Wanna Learn More About Creating A Life of Less Suckery?
If you want to learn more about creating a life you ACTUALLY like, you might be interested in my free video class. You’ll learn:
- The SECRET to creating a lifestyle that maximizes happiness and minimizes stress.
- The simple 5-step framework for turning your life around even if it seems way out of reach and you have no clue how to get started.
- The 3 critical mistakes that keep people stuck in life and how YOU can avoid them.
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