Q. Would you list factors that can contribute to depression?

A. Many factors have been found to contribute to depression. Here are examples:

• Events. Some types of depression can be contextual. That is, a specific event served as a trigger or contributed to the depression. Often the event involved some type of loss. Loss can involve the death of a person or pet, but it can also involve something you wanted that didn’t materialize (e.g., weren’t accepted into your choice of school, failed a class, were laid off from work, didn’t get a job you applied for). In event-related depression, once you have identified the loss, grieved it and moved through the recovery process, the contextual depression can lift. You may want to refer to the Grief Recovery Pyramid for additional information.
• Dieting. Dieting can reduce the level of serotonin in the brain. This can trigger a cycle of dieting and bingeing, as there isn’t enough serotonin present to signal satisfaction. Depression has been connected with lowered levels of serotonin.
• Deficiency in micronutrition. German researchers found that individuals (ages 65-91) who had a vitamin deficiency (especially thiamin, riboflavin, vitamin B12, and vitamin C) were much more likely to be emotionally unstable, depressed, excitable, nervous, anxious, angry, irritable, easily discouraged, and fatigued.
• Stress. Stress can interfere with the relative balance of two brain chemicals: serotonin and dopamine. If the stress if severe enough, mismanaged, or chronic, it can seriously impact rebalancing efficiency. When the chemical balance become severe enough, symptoms of depression can occur.
• Gender. According to Jean Carper in her book Your Miracle Brain, women synthesize brain serotonin at half the rate of men. This may help explain why women are more prone to depression. Serotonin circuits also grow weaker with age as neurons lose receptors needed to bind with serotonin. Studies using PET scans have shown that males produce serotonin at a rate that is 52% higher than that produced by females. Lowered levels of serotonin have been connected with depression.
• Fatigue. A failure to obtain sufficient sleep, rest, and relaxation can contribute to depression. One researcher put it this way: for every period of exhaustion there is a corresponding period of depression.
• Self-esteem issues. A low sense of personal worth, including guilt and self-reproach, can alter your neurochemistry. In fact, each thought you think, each action you take, each behavior you exhibit, affects every cell in your brain and body—and can move you toward health or toward illness.