What Causes Depression

What Causes Depression

The Albany Clinic • October 9, 2022

Depending on your moods and how you deal with them, nearly all facets of your life can be turned upside down if you’re experiencing long-term depression. Identifying symptoms is critical in finding effective treatment, but also knowing what can worsen your condition is important, too.

According to the National Alliance on Mental Illness , depressive disorder, more commonly referred to as depression, is greater than just being sad or navigating through a tough stretch of life. It’s a severe mental health illness that demands understanding and medical attention. If ignored, depression can be devastating for anyone who has it and their families. Early detection, combined with diagnosis and treatment, including medicine, psychotherapy, and healthy living, can help many people to get better.

What is Depression?

Depression is a type of mood disorder that is characterized by a perpetual feeling of desolation and sorrow. It is different from grief or temporary sadness over a loss or unpleasant event. It is a prolonged feeling of sadness, cheerlessness, or total displeasure with life. 

We all experience occasional down moments. It is very normal to feel blue or experience sadness over an unpleasant experience. However, this feeling is very much different from depression. Depression entails a constant feeling of sadness, tiredness, and self-loathing. 

While there are always identifiable reasons for grief or normal sadness, there might be no obvious reasons for depression. Oftentimes, depressed people are not able to explain why they feel the way they do.

Causes of Depression

Clinical depression is a very complex condition. There are no clear causes of depression. People get depressed for several reasons and sometimes for no obvious reasons.

Some of the observed spurs of depression include:

Genetics

Genes are sometimes responsible for depression in people. People from families with a history of depression have higher risks of being depressed than others. It is also common to see multiple siblings or cousins diagnosed with clinical depression.

According to Healthline.com, people who have a family history of depression are five times more likely to have it than people who don’t. 

However, depression is not a purely genetic disease. There are many other factors responsible for depression.

Chemical Imbalance

Depression has also been said to result from chemical imbalances in the brain. These imbalances happen when the brain has either insufficient or insufficient neurotransmitters. These are also called chemical messengers.

There are parts of the brain responsible for regulating moods and emotions. These include the hippocampus and frontal lobe. Changes in these structures have been linked to mental health diseases like depression.

However, many scientists have disputed this theory. Some believe chemical imbalances have no impact on mood.

Hormonal Changes

Another trigger for depression is alterations in hormone functioning and production. Hormones help control most of the body’s processes, reproduction, and metabolism. Changes in hormone or hormonal imbalances can result in mental health issues.

Major hormone changes can be traced to several factors. These include:

  • Medical issues related to ovulation or menstrual cycle
  • Puberty
  • Pregnancy and Childbirth
  • Onset of menopause
  • Medical conditions like Osteoporosis, thyroid problems, and many more

A major type of depression caused by hormonal changes is postpartum depression. This is a form of depression developed by new mothers. It occurs just after giving birth and can last a while.

Medication and Substance Abuse

Depression can also be induced by certain medications. Feelings of sadness and discouragement are side effects of some medicines. For example, isotretinoin, a treatment for acne, has been observed to trigger depression in some people. Other types of these medications include contraceptives, stations, and high blood pressure drugs. 

It is estimated that one-third of depressed people abuse drugs. Drug use only intensifies feelings of sadness and may trigger self-hurt and other destructive behaviors.

Situational Causes

Several unfavorable situations, such as abuse and major life changes, can also cause depression. Many cases of depression have been linked to childhood trauma, such as accidents or parents’ divorce. 

Also, major events such as relocation, marriage, divorce, losing a job, graduation, and retirement can trigger depression.

Other causes of depression include:

  • Gender identity
  • Personal problems
  • Medical conditions
  • Vitamin D deficiency
  • Socioeconomic Status

Conclusion

While some people diagnosed with clinical depression might be able to identify the cause of their predicament, many others can not. Sometimes, seemingly perfect people with no clear reason suffer chronic depression.

Although medical diagnosis might be able to detect depression and its level of severity, it might be more difficult to identify the causes.  Nonetheless, depression is treatable and can be managed with treatments like ketamine infusion therapy. Contact us today to get started.

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Stellate Ganglion Block (SGB) for Depression

By Kimberly Mercille • May 27, 2025
Stellate Ganglion Block (SGB) is an emerging mental health treatment that targets key mechanisms linked to depression. In this article, we’ll discuss the science behind SGB and its potential benefits. If you or someone you know is struggling with depression, this information can help you make an informed decision about whether SGB might be the right option. What is a Stellate Ganglion Block (SGB)? What is the Stellate Ganglion? The stellate ganglion is a cluster of sympathetic nerves located on each side of the neck near the first rib. These nerves are part of the autonomic nervous system, which controls automatic body functions like heart rate, blood pressure, and digestion. The term "stellate" means "star-shaped" because the ganglion often looks like a star under a microscope. It helps regulate the body's stress response by controlling norepinephrine, a chemical that triggers the fight-or-flight reaction. When this system becomes overactive, it can cause various physical and psychological problems, including depression. Stellate ganglion block (SGB) therapy may help by reducing the activity of the stellate ganglion, calming the fight-or-flight response, and lessening the damaging effects of prolonged nervous system stress. How Does Stellate Ganglion Block Work? Stellate Ganglion block (SGB) is when a local anesthetic is injected near the stellate ganglion. These drugs inhibit transmission between nerve cells, dampening activity in the ganglion. They typically include lidocaine, bupivacaine, or mepivacaine, which are sometimes combined with a steroid medication. Patients may also receive another medication to relax them before treatment. SGB is typically performed using ultrasound guidance . The injection process lasts no more than 10 minutes, but patients will motinoted for another 30-45 minutes after treatment to ensure their safety. How Does Stellate Ganglion Block Work for Depression? Chronic stress is a major contributor to depression and is often linked to an overactive sympathetic nervous system. People with depression commonly show high levels of cortisol, a hormone that plays a key role in the body's stress response, in their blood stream. Cortisol is helpful in small doses, but when chronically elevated, it can disrupt neural circuits in the brain. Excessive cortisol can lead to: Neurotoxicity - Cortisol can be toxic to nerve cells, especially in the hippocampus, which is crucial for memory and emotional regulation. Overinflammation - Cortisol increases the activity of the body’s natural defense system, resulting in the system causing damage to nerve cells. Impaired synaptic plasticity - Cortisol inhibits the capacity for the brain to “re-wire” itself. This makes it harder for people to adapt to stressful situations and learn new patterns of behaviour. Disrupted sleep - High cortisol can prevent people from sleeping well. During sleep, restorative biological processes occur in the brain, and excess cortisol can prevent these from happening. SGB decreases sympathetic nervous system activity, which can reduce cortisol levels. This can help restore function in brain areas and pathways associated with positive mood, emotional regulation, and stress resilience. Evidence Supporting SGB for Depression To date, there’s very limited evidence supporting the use of SGB for depression. One pilot study found that SGP significantly reduced depression symptoms in people with treatment-resistant depression (TRD) and was well-tolerated. However, there was no significant difference to the placebo group and the sample size was very small. Nonetheless, multiple lines of research show that SGB can alleviate symptoms of post-traumatic stress disorder (PTSD), which shares similarities with depression. In a trial of SGB for PTSD , participants reported significantly lower scores of depression following treatment. Who May Benefit from SGB for Depression? SGB is primarily utilized for treating PTSD, so individuals with PTSD who also experience depression may find SGB beneficial. Additionally, SGB has shown potential in alleviating anxiety symptoms, suggesting it may be advantageous for those dealing with both depression and anxiety. Because SGB isn’t approved by the FDA, it is typically only used when standard treatments like antidepressants and psychotherapy haven’t worked. SGB is an “off-label” treatment, much like ketamine therapy or brain stimulation therapies. Importantly, SGB may not be suitable for everyone because of medical reasons. Contraindications include: Recent myocardial infarction Coagulopathy or anticoagulant therapy Glaucoma Pre-existing contralateral phrenic nerve palsy Severe emphysema Cardiac conduction block Potential Risks and Side Effects of SGB Common Side Effects Most side effects of SGB are temporary and resolve as the anesthetic wears off. These may include: Hoarseness or Voice Changes: The proximity of the stellate ganglion to nerves controlling the voice box can lead to temporary hoarseness. Drooping Eyelid (Ptosis): Temporary drooping of the eyelid on the side of the injection may occur. Red or Bloodshot Eyes: Some individuals may notice redness in the eyes following the procedure. Watery Eyes and Nasal Congestion: Increased tearing and nasal stuffiness are possible but typically short-lived. Sensation of a Lump in the Throat and Difficulty Swallowing: Some individuals may experience a sensation of a lump in the throat and have difficulty swallowing after the procedure. Warmth or Tingling in the Arm or Hand: A warm or tingling sensation in the affected limb may be experienced temporarily. Although uncommon, some individuals may experience more serious complications, such as nerve damage, seizures, and allergic reactions. Given the potential risks, patients interested in SGB at the Albany Clinic will have an in-depth consultation with one of our qualified healthcare professionals before undergoing treatment. They can assess your medical history, current health status, and the potential benefits and risks of the procedure in your specific case. SGB for Depression in Illinois If you're in the Carbondale area and interested in the potential benefits of SGB for depression, the Albany Clinic is here to help. We specialize in innovative mental health treatments, including SGB, which has been shown to provide rapid relief from mental health symptoms, with effects lasting several weeks. Our experienced team offers personalized support, guiding you through every step—from determining if SGB is the right option for you to exploring alternative treatments and financial considerations. Contact us today to learn more about how we can support your mental health journey.

SGB for Long COVID: Can a Nerve Block Help Ease Symptoms?

By Matt Rodriguez • May 7, 2025
Long COVID is a condition in which symptoms–such as brain fog, fatigue, and shortness of breath—persist for months after a COVID-19 infection. Researchers are still working to understand why this happens and how to treat it. One potential therapy being explored is the stellate ganglion block (SGB) , a procedure that numbs a cluster of nerves in the neck. In the article, we’ll explore the science behind SGB and long COVID and the evidence supporting its use.

Insurance-Backed Options for Depression Treatment in Illinois

By Matt Rodriguez • April 1, 2025
Finding effective depression treatment can be challenging, especially when cost and insurance coverage add to the stress. Fortunately, for individuals in Illinois, several advanced, insurance-backed options are available beyond traditional antidepressants and therapy. This article explores innovative treatments for depression that are available at our Albany Clinic in Carbondale. Addressing the Need for Affordable Depression Relief in Illinois Depression remains a significant public health concern in Illinois. In 2023, data showed that 18.1% of all adults in the state had a doctor's diagnosis of a depressive disorder . Traditional first-line treatments for depression include medications such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). However, these are not universally effective; approximately one-third of patients are treatment-resistant. Even when these medications do work, they often take a long time to produce noticeable improvements, and unpleasant side effects can deter their use. Talk therapies , such as cognitive behavioral therapy (CBT) and psychodynamic therapy, are also strongly recommended. These treatments can have hugely beneficial effects, but it can require a lot of time commitment for results to show. Moreover, not all therapists accept insurance–especially for those practicing more specialized forms–making the treatment inaccessible for many. Spravato (Esketamine) for Depression What is Spravato, and how does it work? Spravato is an FDA-approved nasal spray that contains esketamine, a derivative of ketamine. Like ketamine, esketamine treats depression by interacting with NMDA receptors , proteins that play a key role in learning and memory. This interaction triggers several neurological processes, including neuroplasticity —the strengthening and forming of connections between nerve cells. Enhanced plasticity may improve the function of nerve circuits responsible for mood regulation, increasing overall well-being. A typical Spravato treatment involves sessions administered under medical supervision, starting with twice-weekly doses and then tapering as appropriate. Whereas antidepressants typically take around four weeks to show an effect, Spravato can have rapid action at alleviating symptoms. A study found that Spravato significantly reduced depression symptoms compared to a placebo drug within just 24 hours of administration. Does Insurance cover Spravato? Due to its FDA approval, Spravato is covered by most major insurance plans in Illinois, including Medicare and Medicaid. However, only patients with a formal diagnosis of treatment-resistant depression (TRD) or major depressive disorder with suicidal ideation (MDSI) are eligible for the treatment. While the medication is usually covered by insurance, patients may still have out-of-pocket costs , including copays , deductibles , and pre-treatment medical evaluations . Your exact expenses will depend on your specific insurance plan. At the Albany Clinic, we’re here to help you understand your costs and maximize your coverage. Transcranial Magnetic Stimulation (TMS) Therapy What is TMS, and how does it work? TMS therapy is a noninvasive procedure that uses magnetic fields to stimulate underactive regions of the brain associated with mood regulation. In depression, TMS targets the dorsolateral prefrontal cortex (DLPFC) , which is often less active in individuals with the condition. TMS therapy works by: Inducing electrical activity in neurons , prompting the release of neurotransmitters involved in mood and motivation. Increasing the activity of neural circuits responsible for mood regulation. Enhancing neuroplasticity , potentially “re-wiring” nerve circuits associated with unhealthy thinking and behavior. The treatment protocol typically consists of daily sessions over several weeks. Each session lasts about 20-40 minutes, during which patients remain awake and alert. Does insurance cover TMS? Since TMS therapy is FDA-approved, some major insurance providers in Illinois cover costs, but unfortunately, the state’s Medicaid does not. If you're considering TMS, check with your insurance provider to see if your plan includes coverage, as eligibility and benefits vary. At the Albany Clinic, we're here to help clarify details and explore options to make treatment more affordable. IV Ketamine Infusion Therapy What is an IV ketamine infusion and how does it work? IV ketamine infusion therapy involves administering ketamine intravenously at sub-anesthetic doses . This approach has shown rapid and robust antidepressant effects, especially in individuals with treatment-resistant depression. IV ketamine shares the same mechanism as Spravato but tends to have more rapid-acting effects. A standard course includes multiple infusions over a set period, with each session lasting approximately one hour. Does insurance cover IV ketamine? Unlike Spravato and TMS, IV ketamine infusion therapy is not FDA-approved for depression treatment and instead is used “ off-label .” This means most insurance plans don’t accept ketamine, and coverage is limited. However, some insurance companies may reimburse some of the treatment costs, such as the evaluation and management part. At the Albany Clinic, we’ll provide you with all the documentation to submit a claim to your insurance provider, but full payment is required before each procedure. Navigating Insurance for Depression Treatment Understanding insurance coverage for depression treatments can be complex. Here are steps to help streamline the process: Verify Coverage : Contact your insurance provider to inquire about treatment coverage specifics. Some insurers require a history of treatment failures with traditional antidepressants before approving coverage for these advanced therapies. Obtain Pre-Authorization : Many insurers require pre-authorization for certain treatments. Ensure all necessary approvals are secured before initiating therapy. The Albany Clinic's administrative team can assist in submitting pre-authorization requests. Understand Financial Responsibilities : Clarify any co-pays, deductibles, or out-of-pocket expenses associated with your treatment plan. Consult Our Team : The Albany Clinic's administrative staff is experienced in navigating insurance processes and can assist you in understanding and managing the financial aspects of your treatment. We also provide financial counseling to help patients explore payment plans and reimbursement options. Going Forward Navigating insurance for depression treatment can be complex, but you don’t have to do it alone. At The Albany Clinic , we’re dedicated to helping patients access effective, insurance-backed treatments while minimizing out-of-pocket costs. Contact us today to learn more about your options and take the next step toward relief.