At a family gathering at the weekend someone asked the inevitable question – ‘so what actually causes depression?’
It’s a frequently asked question, and one that everyone from scientists to the Buddha have offered an answer to. For me, it has to come down to a combination of things.
I know that might sound like a cop out! A classic counsellor’s answer. The thing is, our culture creates an expectation for the simplest and truest explanation of something to be readily available in the time it takes to Google search. But, as with any matter of the mind or the heart, the most helpful explanation (and solution) will always involve a combination of things. So I’m not going to put it solely down to genetics, or eating the wrong foods, or not enough sunlight, or insufficient serotonin levels. Those things may be involved, but depression is a bigger and more complex picture, which usually involves how we manage our emotions long-term. But that’s no reason to avoid tackling it.
There is a fairly simple but beautifully holistic explanation that helped me to better understand depression (and the many questions that come with it – why me? Why now? Why can’t I shift it? What can I do? What should I have done? What can I do for depressed loved ones….?) There are so many questions. This is the Diathesis Stress Model, or the Stress Bucket Explanation in normal language:
(the word stress can be swapped for depression, anxiety, or any other overwhelming emotional response)
We are each born with a bucket. Our genetics will pour a certain amount of stress into the bucket before we’re even born, so some people will be more prone to developing mental health difficulties than others. Our genetics will also determine how much stress our bucket can take before we overflow into depression, anxiety etc. This is our maximum capacity. I might be born with a baseline at 25% prefilled, and a maximum capacity at 75%. Whereas you might be born with a baseline of 10%, and a maximum capacity of 80%. That stuff is set, and will vary significantly from person to person. (This is important to acknowledge because it takes the shame out of mental illness – everyone has the potential to overflow. No-one is ‘stronger’ or ‘weaker’, just different.)
So we’re born with a predisposition, which might be lower or higher than others. Then life happens. Sometimes life will throw in stressors – painful experiences such as bereavement, abuse, being bullied, or feeling lonely or unloved. Unfortunately some people will experience more pain than others. Life might also throw in happiness and enjoyable experiences, which can help to empty out the bucket a little too.
As we grow up we are taught how to empty the bucket, often indirectly by watching how our parents or caregivers deal with stress. The most common way in our culture is to avoid it. Stiff upper lip – just get on with it. Don’t stop, don’t get emotional, just carry on with life. Maybe have a drink and a smoke to temporarily feel less stressed. This isn’t necessarily wrong – it might be very helpful for a while to do this. However, the stress that has poured into the bucket will stay there. This might be okay for a while. But over time we might experience more pain – divorce, stress at school, uni or at work, the pressures of being a parent, more losses. And our stress bucket levels will increase again. Without being taught a way to empty some stress out, it will keep increasing. Then one day, your body will have had enough of carrying around that pain. So it might develop the deep numbing sensation of depression. It might develop a heightened sense of fear that something else bad will happen, because it knows your bucket can’t hold any more stress comfortably – and we develop anxiety. Every single one of us could get to that point, but each of us starts at a different point, can take a different amount, experiences different stressors and learns different ways to cope. Reaching your maximum capacity does not make you weak. It makes you human. We can only take so much. And it is irrelevant to your recovery if it seems someone else can take more stress. You can only work with your bucket.
Once we can understand this, there is hope. We can’t do much about our genetics or what happens to us throughout life, but we still have the ability to reduce our stress levels. This might be necessary to reduce what is already in the bucket and reduce a current depression. Or it might be necessary to prevent it from building up again. Either way, we can actively take stuff out of the bucket. You probably already do many things that reduce your stress or depression levels – seeing friends, exercising, eating enjoyable food, getting enough sleep, seeing children or grandchildren… But sometimes this is not enough. Sometimes we need something that will reduce our stress levels more significantly and for much longer, in order to feel comfortable again.
This is one of the best things that counselling can offer. It is a chance to siphon out painful memories, traumatic experiences, unhelpful coping mechanisms and many other things that contribute to your stress levels. Saying them aloud to someone who will listen with care and without judgement can greatly reduce depression, and the risk of depression over time. People often say well what can talking about it do? Quite a lot, actually. It helps you to feel that you’re not alone with the pain you’re carrying. It helps you to realise that the pain is not your fault but a part of being human. It helps you to feel more in control of your emotions, because they no longer feel like they’re about to overflow if you slightly lift the lid of the bucket.
I feel so privileged as a counsellor to offer people a chance to empty their stress buckets, and feel more comfortable. Even in just a couple of sessions people can feel significantly lighter and able to cope. The stress might still be there and there may be more stress to come, but if you can empty your bucket you can feel okay in spite of the stress. You’re in control then. Learning how to empty your bucket can help you to avoid a lifetime of carrying around stress.
If you would like a free consultation with me or one of my colleagues, please contact us – we can be very flexible and find a time to suit you, and we’d love to help. Written by Suzie Clancy.