Chapter 4 Chapter 2 How does depression arise?

Fengzhang will discuss several theories about the causes of depression.When we are depressed, we often wonder what caused our current state.Sometimes the cause of the depression is easy to find, such as a breakdown in a relationship, but other times the cause of the depression is not. Theories about the causes of depression fall into three categories: biological, psychological, and sociological.Some theories may be esoteric and difficult to understand, but not understanding these theories will not affect your reading this book.The reason I present these theories here is that some people are genuinely interested in them.In fact, you can skip and go straight to part two if you want.If you're looking to do some research on the theories of depression, you'll probably find that there's something for each of them.Of course, no theory can claim to answer all questions.

What causes depression? It's been a topic of interest for millennia.Around 2000 noon, the Greeks believed that depression was caused by an excess of "black bile" (blackbile) in the body, and the word "melancholy" itself means "black bile". With the deepening of people's research on this issue , but another question arises, that is, what is the reason for the increase of black bile? The Greeks have a very complicated view on this issue. They think that some people are born with black bile-melancholic individuals. However, they also believe that , Stress, diet, and seasonal changes can affect the content of black bile in the body. It can be seen that the Greeks have realized that events that happen to us cause us to feel depressed, which in turn affects our physiological process, namely black bile. The secretion of bile.

Today, we discard the old "black bile" theory and look for the causes of depression by studying changes in brain chemistry, or more precisely, "neurochemical changes."Unfortunately, we are not as speculative as the Greeks: some people think that changes in brain chemistry cause depression, however, although those who suffer from depression do have changes in brain chemistry, this does not mean that changes in brain chemistry cause depression. depression.For example, we know that the secretion of adrenaline has a certain relationship with anxiety, but this does not mean that adrenaline is the direct cause of depression, or that reducing adrenaline can treat anxiety.Just like a robber forces us to give money, our adrenaline level may increase, causing us to have a certain anxiety experience. If we want to eliminate this anxiety, the effective way is to get the robber away instead of taking some kind of drug.

Too often our theories lack an interactive perspective, that is, we fail to consider the interaction between our living environment (the way we think about things) and our bodies.If you go to your doctor, she or he accurately diagnoses you as depressed and prescribes you medications that effectively ease your mood, improve your sleep, and lower your anxiety.But medication can't help you get to what caused your depression in the first place, nor can it teach you to learn to better manage it. On the other hand, some psychologists blame depression entirely on our relationships and the way we see the world.They ignore the fact that our brains do work differently in a depressed state than in a non-depressed state.Mind and body are one, and our brains do change when we're anxious, angry, ecstatic, or orgasmic.In other words, our brains work differently in different mental states.This fact shows that once we are depressed, it is very difficult to get out of it.Sometimes antidepressants help (assuming the side effects are not that severe), and in some cases antidepressants can make a big difference.So if we want to figure it out, we have to consider the interaction of various factors—the interaction between the brain, our perceptions, and the social environment.biological level

We have already mentioned that in the depressed state, there is a certain change in the activity of the cerebral cortex.For example, the sleep mechanism is affected, the cerebral cortex that controls positive emotions is inhibited, and the excitability of the cerebral cortex that controls negative emotions is increased.Most importantly, the brain's information-retention processes were also altered.The current research has not been able to clearly reveal these changes, but it is generally believed that the most important of these changes are changes in the monoamine circuit in the brain.The real changes in brain neurochemicals are complex, and all we know is that antidepressants increase the activity of the monoamine system that controls positive emotions and suppress the activity of the monoamine system that controls negative emotions.Different antidepressants have slightly different mechanisms of action (see section on antidepressants).The crux of the question is: Why do these changes occur in the brain?

Our brains are affected by at least three factors that make us susceptible to depression. Gene The first possibility is that some people are born with a predisposition to depression.We fall into depression because of abnormalities in the production of neurochemicals in our brains. This abnormality has its roots in our genes, which are the DNA segments that control a large number of biochemical substances.If this insight holds, then we could see the continuation of depression in families, that is, depression is heritable. Likewise, if the above assumptions were true, we would find the same susceptibility to depression among twins who were fostered in different families.And indeed it is.If one twin has depression, the other twin is much more likely to be depressed than the general population.Also, the more severe the depression (such as psychotic or bipolar depression), the greater the probability of co-morbidity.For fraternal twins, although the probability of co-morbidity is higher than that of the general population, it is lower than that of identical twins.The above facts suggest that some depressive disorders have a genetic basis, and genes lower the threshold of the brain's depressive state caused by life events.

Of course, we should avoid the simplistic error of concluding that "all depressive disorders are hereditary."Because, first of all, whether it is genetic depends largely on the definition of depression, although more and more evidence shows that some types of depression have a genetic basis, but not all types of depression have a genetic basis.Second, if someone's close relatives have a certain mental illness, such as anxiety, alcoholism, etc., the probability of suffering from this illness will be greatly increased.However, common sense tells us that anyone other than identical twins is so different in genetic makeup from each other that we cannot be a carbon copy of the other.Studies of babies show that from birth, babies display different temperaments, some babies are timid, while others are more interested in exploring new things.

growing up Genes are the foundation of life, they determine the color of our eyes, our hair, and are what make us grow.For example, genes ensure the development of our sex organs as we grow.However, the brain is not a closed system that is independent of the external world according to the established pattern. Instead, early human relationships affect the types of connections in the nerve cells of our brains.As far as we know, the brain is very plastic in this regard.Early childhood brain growth and development is dependent on social influence.A child raised in a loving environment develops differently than a child who is often abused and threatened.

The above perspective connects external events to internal changes in our bodies and brains, making us realize that experiences shape our brains.As an example, if we're stressed, stress chemicals like cortisone kick in and over time, the brain's messaging changes.These chemicals affect not only the activity of "neuroreceptors," but also the way nerve cells, or neurons, connect to each other.Therefore, from birth, the brain establishes a connection with the outside world.A susceptibility to depression is sown early in life.At present, more and more evidence shows that those patients who suffer from chronic depression have a history of abuse, and some of them have a significant increase in the sensitivity of the stress system.

Biological susceptibility to depression may stem from childhood life experiences that affect brain growth and development.However, we cannot have pessimistic thoughts based on this assertion, because psychological intervention is of great help in the change of this symptom.If a person realizes that he has this sensitivity, learns relevant psychological knowledge, and actively participates in psychological training, he can not only cope better, but also change this sensitivity. Uncontrollable stressful events Another factor that keeps our brains stuck in a depressed state is stress.Many years ago, Martin Seligman discovered in his research that if animals are given uncontrollable stress stimuli, they will show all the passivity and passivity of depressed patients.Later, other researchers conducted further research on this, and they tried to figure out what changes occurred in the brains of animals under uncontrollable stress stimuli.The findings suggest that some of the brain changes are very similar to those seen in humans when they are depressed.For example, the cerebral cortex that controls positive emotions and behavior is suppressed.If the animals are given controlled stress stimuli, the animals will have completely different brain changes, that is, the activity of the cerebral cortex that controls positive emotions and behaviors will be greatly increased.The same stress stimulus, but different controllable levels, can lead to completely different biological changes in the animal brain.If you are stressed, but you are able to take positive action, your brain is in one mode of change; if you are stressed, but there is nothing you can do about the situation, your brain is in a completely different mode, where, Coping style is the key factor.

These findings are crucial because they suggest that in real life, the better we are at coping with stressful stimuli, the less biochemical changes occur in our brains. evolution level Evolutionary theory tells us that the reason why we often fall into various painful psychological states is because we have "a certain potential".For example, when someone we love dies suddenly, we will be in great pain. We may share the pain with others, or we may bear it alone, but no matter what, there is a potential for grief within us.Similarly, each of us has the potential for aggression, and if someone hurts your child, you develop a strong desire to retaliate.Likewise, we all have sexual or anxious potentialities. Let's explore anxiety.We know that any animal has an internal (or innate) fight-to-escape system. When faced with a threat, this system is activated. Different actions are taken for different hazards.For example, when threatened by a robber, our heart rate increases and we either fight back or run away.But, just as a bloodsick person faints at the sight of blood, sometimes the object of our fear does not harm us.For example, guns, batteries, and cars are far more lethal than spiders, but terror of spiders is more common.Intellectually, we know that spiders can't harm humans, but people's fear of spiders will not decrease in the slightest, as if there is some kind of "spider horror" program in the human brain. The basic point of evolution theory is that the brain can switch to a certain state because the brain is pre-programmed to switch to that state.That is, the biological changes in the brain in the depressed state are caused by the "activation" of the underlying depressed state in the brain.Similarly, we also have underlying states of anxiety, anger, excitement, sadness, etc. in our brains.However, that's not to say that all depressive states are the same. There are different types of depression, and genes, sensitivities, life events, and other factors can combine to influence a person's susceptibility and type of disorder. You may have a question, what good does depression do to people? Anxiety and anger can help humans better adapt to the environment (they can help us better protect ourselves), but depression seems to have little value.The first thing we want to say here is that humans have the ability to magnify various psychological states. We can foresee dangers that animals cannot foresee. We will worry about future events-such as how the party will be, whether the interview will go well.Our internal biological mechanism (the fight-flight system) makes us feel anxious.This mechanism has a history of millions of years from the perspective of evolution.But in humans, it can be activated by a variety of stimuli.You go a step further and ask, even if humans can amplify underlying anxiety states, where is the value of depression? In fact, there are many possibilities for this question. prevent us from fishing for moons in water One idea is that moderate depression has an adaptive function in that it helps us abandon unlikely pursuits, making us more likely to give up because the depressed mood reduces the pleasure we derive from certain types of events.If there is nothing (such as low mood) to prevent us from pursuing those impossible goals, we are likely to waste a lot of time and energy in vain. give up on unlikely pursuits Evolutionary theory suggests that many depressive symptoms share similarities with grief.When we lose a loved one, we grieve, and once we're in a state of grief, we become anxious, miserable, feel life is meaningless (at least for a while), and end up in a state of depression.The evolutionary value of grief and pain is to help us rebuild our relationships.Obviously, if we were not capable of mourning, we would not care whether we had intimate relationships with others.From an evolutionary point of view, intimate relationships are crucial to our survival.We have always been proactive in our search for good relationships.Without this relationship, we become very depressed, so the "loss of attachment" is very distressing because it is biologically predetermined.Our need for intimacy and joy in the company of others is a biological response, an evolutionary need, especially for children. Sometimes people go into a depressed state even though they haven't experienced any major loss because they never experienced being loved and needed by their parents.They also once wanted to establish an intimate relationship with their parents, but in their early family life, they found that intimacy was often associated with punishment and threats. Therefore, on the one hand, they longed for intimacy, and on the other hand, they thought that either they were unlovable , or others are unreliable and will disappoint them.So this depression is not just a disease, but a state of longing for unattainable intimacy. In everyday life, people form relationships with other people in different styles.Some people often experience "attachment anxiety," their fear of being rejected and abandoned, their anxiety about being left alone, and their anger at being separated from others.Conversely, others believe that intimacy with other people is very difficult and distressing, so they avoid it.And then there are those in between, sometimes they seem desperate for intimacy and need to prove cute, but at other times they're distant, lonely and aloof.Each of us has the interpersonal patterns described above to varying degrees, and stress can polarize them.For example, in times of stress, we often need affirmation from our loved ones more, and if we don't get that affirmation and feel alone, we can slip into depression. save us from hopeless struggles Evolutionary theory believes that the state of depression is related to the sense of failure and oppression to a certain extent. Depression makes us give up challenges, reduces ambitions, makes us give up optimistic and seeking attitudes, and makes us feel ashamed and inferior. This theory also holds that there are biological differences between lower animals and higher animals in this respect.Animals that are forced to obey, or are frequently attacked, show the same physical and behavioral changes as depressed individuals.Thus, this theory suggests that some depression is related to an underlying mental state.This state can be triggered by situations of failure or forced conformity (having to do something you don't like because of fear), which is why depressed individuals often feel inferior, worthless, repressed (lower social class), and lack self-confidence reason.They see no point in trying anything because everything requires too much effort.This kind of thinking can easily make people abandon their ideals and lower their expectations. Thus, not only are depressed people judged by themselves or others as negative and inferior, but, in extreme cases, they are literally ostracized by others and branded as "unlovable," "worthless," "waste" , "bad guy", "useless" and other words used to describe low-level characters.Emotions can serve as an energy-regulating system for conveying self-information, thereby demonstrating to others the ability to challenge others' confidence and to obtain important resources (such as friends, sexual partners, or satisfying jobs). Many situations induce a sense of failure in us, and sometimes we feel defeated when we think about the attitudes of others toward us.We try our best to get rid of this feeling, but to no avail: Sometimes, when others judge us harshly, we gradually believe in their harsh judgments, and finally we are defeated by our own harshness and criticism.We often make social comparisons that demean us, and we think others are better or smarter than us.Common in depressive states are feelings of worthlessness, inferiority, incompetence, and inadequacy.Often the messages from others or ourselves are not about how lovable, accepted, or valuable we are, but are critical and demeaning. Forced submission and trapped situations often activate depressive states.If we have a bad marriage, a bad job, or a situation we don't like but can't get out of, we can feel like we're stuck in the cracks and we can't get out.Two examples: David was heavily in debt and accustomed to a certain lifestyle, he found himself unable to find another job and felt trapped in a stressful and demanding environment.Katie lives in a slum with a high unemployment rate. Her husband often beats her. She has no money of her own and has to support two children. She feels isolated and trapped in such an environment. The second cause of our sense of failure is that we aim too high: the pursuit of perfection.We also often experience a sense of defeat because we set goals that are too high to achieve.When we fall short of our set goals, we experience a sense of failure.However, it is the depressive mood that prevents us from continuing down the path of low probability of success. A third source of our sense of failure is that we perpetually play the role of the loser in our conflicts with others.For this reason, we often experience anger (often without showing it), because we are always the loser on both sides of the conflict.In the case of Fran, her conflict was between her and her mother, who always found her fault and taught her what to do no matter what she did.Fran felt unable to tell her mother how she really felt, that she felt inferior and that no matter what she did, she felt that she was not doing well enough.Whenever she had a conflict with her mother, she always felt that her mother was stronger than her and firmly controlled the ground. Clearly, certain situations trigger certain states of mind in us.We explore this for two other reasons, one, it will help you understand the depression you are experiencing, and two, if you can get to the heart of the matter, you will understand the depressive symptoms and the activation of underlying states closely related.Seeing depression as an activated part of the body makes us feel ashamed and inferior. This theory also holds that there are biological differences between lower animals and higher animals in this respect.Animals that are forced to obey, or are frequently attacked, show the same physical and behavioral changes as depressed individuals.Thus, this theory suggests that some depression is related to an underlying mental state.This state can be triggered by situations of failure or forced conformity (having to do something you don't like because of fear), which is why depressed individuals often feel inferior, worthless, repressed (lower social class), and lack self-confidence reason.They see no point in trying anything because everything requires too much effort.This kind of thinking can easily make people abandon their ideals and lower their expectations. Thus, not only are depressed people judged negatively and inferior by themselves or others, but, in extreme cases, they are literally ostracized by others and branded as "unlovable."Worthless", "waste", "bad guy", "useless" and other words used to describe low-level people. Emotions can be used as an energy regulation system to convey self-information, so as to express to others the confidence to challenge others, to show The ability to obtain important resources (such as friends, sexual partners, or a satisfying job, etc.). Many situations induce a sense of failure in us, and sometimes we feel defeated when we think about the attitudes of others toward us.We try our best to get rid of this feeling, but to no avail; sometimes, when others judge us harshly, we gradually believe that other people judge us harshly, and finally we are defeated by our own harshness and criticism.We often make social comparisons that demean us, and we think others are better or smarter than us.Common in depressive states are feelings of worthlessness, inferiority, incompetence, and inadequacy.Often the messages from others or ourselves are not about how lovable, accepted, or valuable we are, but are critical and demeaning. Forced submission and trapped situations often activate depressive states.If we have a bad marriage, a bad job, or a situation we don't like but can't get out of, we can feel like we're stuck in the cracks and we can't get out.Two examples: David was heavily in debt and accustomed to a certain lifestyle, he found himself unable to find another job and felt trapped in a stressful and demanding environment.Katie lives in a slum with a high unemployment rate. Her husband often beats her. She has no money of her own and has to support two children. She feels isolated and trapped in such an environment. The second reason we feel like failures is that we aim too high and strive for perfection.We also often experience a sense of failure by setting goals that are too high to achieve.When we fall short of our set goals, we experience a sense of failure.However, it is the depressive mood that prevents us from continuing down the path of low probability of success. A third source of our sense of failure is that we perpetually play the role of the loser in our conflicts with others.For this reason, we often experience anger (often without showing it), because we are always the loser on both sides of the conflict.In the case of Fran, her conflict was between her and her mother, who always found her fault and taught her what to do no matter what she did.Fran felt unable to tell her mother how she really felt, that she felt inferior and that no matter what she did, she felt that she was not doing well enough.Whenever she had a conflict with her mother, she always felt that her mother was stronger than her and firmly controlled her. Clearly, certain situations trigger certain states of mind in us.We discuss this for two other reasons. First, it will help you understand the depression you are experiencing. Second, if you can get to the heart of the problem, you will understand the relationship between depressive symptoms and the underlying internal state. Activation is closely related.If you see depression as an activated part of your body, you will be able to exert better control over it.Your depressed state is one of many underlying mental states, and it is no more representative of the real you than any other. Life is like strings, you can make beautiful music or annoying noise.One of life's tasks is to figure out which tunes we are good at and learn to play them when we need them.If we think we are unlovable, unworthy, and feel inferior, we activate an underlying depressive state.Therefore, if you want to get rid of this situation, you must first change your view of yourself.psychological level In recent years, we have gained a better understanding of the psychological mechanisms of depression.There are many theories and theories about how thinking styles, attitudes, and behaviors increase our likelihood of developing depression.As early as 1917, Freud proposed that when a person faces loss and turns his anger on himself, depression will appear.This is what came to be known as the "anger internalization theory".We did find out later that when we're depressed, we often feel angry, sometimes at others but more often at ourselves. Recently, some psychologists have conducted research on the behavior patterns of depression.They found that depressed people behave in ways that don't lead to positive outcomes or greater happiness for themselves.Many people struggle with depression because they find that nothing in their life seems to bring them joy, fulfillment, or confidence.If they have no job, no friends, and social anxiety at the same time, they cut off all social interactions that have brought them pleasure. The most studied psychological theory of depression is the so-called "cognitive theory."This doctrine focuses on the way we understand and know the world.It was originally proposed by psychiatrist Baker and psychologist Erikson.Many pamphlets to help people with depression use cognitive theories and methods.In the second and third parts of the book, the author puts forward many suggestions on how to get rid of depression, among which cognitive theory plays an important role. Cognitive theory points to the specific way in which depressed patients perceive problems: question view panic attack I am dying from these anxiety symptoms. social anxiety I used to do things that seemed really stupid, and I was ostracized and humiliated. depression I'm a cowardly, incompetent bad guy with no future ahead of me. delusion People go out of their way to find out about me. anger Others are bad or unkind, treat me unfairly, take advantage of me, and they deserve to be punished. By reflecting on the way they see things, people can learn to test their own perceptions and learn to see things in new ways.The main purpose of cognitive therapy is to teach patients to reflect on their attitudes and beliefs, and to help patients realize how their thinking styles lead them into depression (especially the sense of failure).By changing the way they think about the problems they face, their symptoms can be alleviated.If they further change their fundamental view of themselves, they will increase their ability to grasp their emotions, thereby reducing the possibility of falling into depression and anxiety. When we are depressed, we are often troubled internally and externally (internally, manifested as a pessimistic view of ourselves, the world, and the future; externally, manifested as poverty or poor relationships).Learning to see internal problems from a new perspective and avoiding negative self-concepts (eg, I'm a piece of shit) enables us to better deal with external problems. Depressed people often think in certain ways, which raises the question of what causes us to think in a negative way? Cognitive theory suggests that during childhood we form ideas about ourselves, about others, and about the world. Later, these basic ideas come to control our emotions and attitudes towards various things.For example, if we are constantly being told that we are unlovable and a failure, we will develop such beliefs.Again, if in childhood people often say that he is not good at sports, later on, this becomes his opinion of himself, he will further reduce sports, and because of this avoidant attitude, he may never be good at sports.This, in turn, reinforced his unsportsmanlike self-concept.As he grows up, he continues to avoid sports because once they try, the idea of ​​not being good at it, or looking ridiculous (although as an adult he looks graceful in his movements).Thus, early beliefs and experiences can have a huge impact on later emotions and behaviors. Negative self-views are often suppressed or hidden (latent) as we age.But when certain important life events occur (such as the disintegration of an important relationship), the concepts and ideas formed in childhood will revive.So when we are distressed by the breakdown of a relationship, we often interpret what we are facing in terms of thoughts and ideas we formed as children.For example, "I'm not likable as the cause of the relationship breakdown."Negativity affects the way we interpret events, so when misfortune happens to us, especially when it triggers a strong emotional response in us, we often see it as evidence that we are unlovable or a failure. Instead of blaming it on luck or life itself. As an example, Sally lived in a family that lacked love. When she was a child, her mother told her that when she was conceived, her mother was married. Unfortunately, the marriage was not satisfactory. Her mother Often think, if not pregnant, life will be another situation.She often said, if it wasn't for you, what would I have done.Sally felt that her mother believed that she had dragged her back, and this did not arouse Sally's anger, but it did trigger a strong sense of guilt in her.When her mother hinted at the idea of ​​running away, Sally took it as a warning that her mother was abandoning her.She gradually developed the concept: "I'm a nasty piece of shit that influences other people to do what they like. People don't like me being around them. I must never do things that irritate them, because they can do it at any time." might leave me." These basic concepts have influenced her throughout her life. Whenever a conflict occurs, she will feel anxious, thinking "maybe I am an annoying guy", "I must let them do what they want to do".As soon as she feels that she has rejected someone or made them unhappy, she will feel guilty.As a result, she found it difficult to be assertive, often looking for evidence that she was a burden to others.When she broke up with her boyfriend of many years, she thought, "No one really needs me, I'm a piece of shit, I'm a dislike".It is worth noting that these concepts are not cold-toned, but full of emotional color. As you may have guessed, behind these ideas lie other ideas, lurking a great deal of anger.Constantly being subservient to others (subordinating yourself to the needs of others) can lead to feelings of injustice.After all, Sally didn't ask to be born herself, so why does she have to do things that other people need? Why is she so unlikable?Of course, she believed that once she became confident, she would face the danger of being abandoned.Therefore, these angry concepts and thoughts have to be "repressed" and "avoided".She felt that since her mother had done her best for her, she had no right to be angry with her.Otherwise, he is a bad person, a betrayer. Therefore, it can be said that the way we know and understand things causes (or at least maintains) our depressed state.We'll see later that our beliefs can send us down a spiral into depression: when we're depressed, we have more negative thoughts, and once we have negative thoughts, we become more depressed.Below is an overview of Sally's basic beliefs and emotions, and how they work together to affect her life. early childhood experiences Mom used to say that if it wasn't for me, she would be doing more and her life would be different.Therefore, I always worry that my mother will leave me one day. basic concept I am a waste to others; I am preventing others from doing what they like; people don't like me being around them; I can't do things that say no to them; I have to play a role that people need; express anger or emphasize my own needs would lead to ostracism; I must be grateful for the love of others; if I express my inner discontent, I become an ungrateful bad person. basic behavior lack of confidence. avoid confict. Can't do what I want to do. event that triggers depression Relationships break down, important people leave me. typical concept To others, I am a piece of shit. I can never handle it. I'd be fine if I wasn't around him. I have trouble handling relationships. I can't stand being alone. symptom Poor sleep, exhausted. Constantly thinking about loss, blaming yourself. A sense of worthlessness. Loss of ability to enjoy pleasure or good things. hopelessness. weight loss. Feeling of emptiness. Fear, aimlessness. You may notice two things: First, there is a problem with her attachment relationship.She was anxious about forming an intimate relationship, feeling that she might be abandoned.However, the way she behaves (i.e. her interpersonal tactics) makes her seem like a vassal, even a slave.她的人际关系没有提高她的引言心，相反，她不仅没有感到自己与他人相处融洽，反而觉得自己没有能力与他人建立良好的关系。因此，当她考虑自己的观点和需要时，她感到自己既没有权利，也没有理由。结果，她的自信常依赖于某种人际关系，如果没有外在的肯定，她会感到自己空虚、脆弱、自卑和依附于他人。 早期创伤经历的影响 早期创伤经历对个体的价值观、自我评价的形成，会产生重要的影响。例如某些受过性虐待的人，会认为性是丑陋、肮脏、危险的(甚至他们目己也是丑陋、肮脏的)。创伤经历将影响他们的性生活和性快感。 有的父母不善于应付挫折，他们骂孩子，或者拿孩子出气，这对于儿童而言是极为痛苦的。他们很难认识到自己挨批评是因为父母的挫折耐受性低。作为被攻击对象，他们常常责备自己，认为自己真的很坏。有的父母无法给孩子身体上的爱抚，因为他们不知道该怎样做，或者为此感到尴尬。更令人遗憾的是，至今仍有些父母认为，给孩子身体爱抚，尤其对于男孩，会使他们变得女里女气。 许多抑郁症患者回忆，他们早年的生活缺乏一种爱，有时父母甚至很粗暴。现在，你应当思考：你早年形成而至今仍然保留的价值观有哪些?你要重新审视它们，抛弃那些对你不利的价值观。如果别人曾经对你非常粗暴，现在不正是你该善待自己的时候吗? 当我们还是孩子的时候，我们不可能将我们的父母看作是有自己问题的、不完善的个体；相反，我们认为，他们这样对我们肯定是我们自己的过错，肯定是我们某些地方做得不对，以至于父母如此对待我们。父母对我们的苛责使我们学会了苛责自己。然而，我们应当通过了解、领悟以及个人的努力，改变这些习惯，学会爱自己。社会学层面 抑郁病人不仅存在内部问题，如思维方式、消极情感等，同时也常常面临一'些外部问题。社会学理论关注的正是这些外部问题。许多社会学研究者(例如乔治·布朗与哈里斯)发现：外部(社会)因素在抑郁的形成和康复过程中扮演着重要的角色，有些事件使我们易于罹患抑郁症(被称为易感因素)，而另一些事件会使我们陷入抑郁(被称为诱发事件)。 正如进化学理论所预测的那样：抑郁的易感性与无法和亲近、可信赖的人建立亲密关系之间有着密切的联系。自尊水平(即无能感、自卑感、无价值感或劣等感)属于易感因素。值得注意的是，我们的自尊很大程度上来源于能给我们带来价值感和成就感的社会角色，以及那些重视我们的朋友。 一些人认为，作为父母，照看孩子是其社会角色的全部内容。事实证明，这种观点并不正确。尽管我们爱自己的孩子，孩子也能给我们带来很多快乐，但是，我们无法将自己封闭在家里，仅与那些耗人精力，无片刻安静的孩子呆在一起(坦白地说，他们会使我们精疲力竭! )。孩子对我们的要求很多，但我们却无法向他们寻求支持，与他们分享个人情感。而且，孩子也不能提高我们的自尊水平，至少在这一点上不如成人。 并且，许多事情会突然向我们袭来：我们发现对方有外遇；失业造成了经济紧张； 孩子患了严重的疾病；我们遭受了严重的失败……那些看上去对未来会产生深远影响的事件，能使我们从悬崖边缘一步跌进抑郁的深渊。 社会角色 一些社会心理学家发现：我们的自尊很大程度上取决于我们所扮演的社会角色，即我们做什么。这些社会角色赋予我们一定的社会阶层或地位。如今，照料孩子尽管仍是人生中最重要、对情感要求最多的工作之一，但“家庭主妇”已不再被视为有地位的社会角色。 年轻人之所以会陷入抑郁，其原因是他们缺乏明确的社会角色(如工作)及归属感。认识到自己能做什么，并因自己的作为受到尊重和欣赏，是获得自尊和社会地位最重要的保证。工作能为我们指明生活的方向，使我们对未来有所计划，还能提供给我们与他人接触的机会。如果没有工作，我们会感到自己不被社会所需要，没有明确的社会身份，没有生活目标，并且会感到孤独。 以凯丝为例，她想结婚，但——直没有遇到合适的人，她把全部的精力都投入到护理工作中去，工作成厂她生命的全部。在54岁那年，她患丁严重的疾病，不得不提前退休，这使她非常痛苦。渐渐地，她陷入了抑郁状态，断绝了与朋友的联系，尤其是那些仍在工作的朋友。 许多来治疗的人都面临这样的问题：他们无法找到工作，或者无法找到家庭生活以外能提高其自身价值的角色。其原因有时是因为他们太紧张，有时是因为父母不允许，还有些时候是因为困难太大。另外，目前西方人的生活方式，已经丧失了进化形成的适应功能，这些非自然的生活方式，导致了问题的出现。适应性的家庭模式是近亲杂居式的，孩子们不是被困在小家庭中，而是有更大的活动空间，亲戚、朋友都能帮助照看。妇女们也不像现在这样被隔绝于团体之外。我认为，现代人抑郁发生率如此之高，与我们异常的生活模式不无关系。 对导致抑郁的社会因素进行研究，其目的是让大家明白，罹患抑郁症并不代表你是一个很糟糕，或是很脆弱的人。也许是你的生活方式使你比别人更容易罹患抑郁症。一旦你放弃自我无能感、停上自责，你就会思考如何改变现状。值得注意的是，照顾孩子不一定会令你感到快乐。事实表明，孩子会减少夫妻生活的快乐。当然，这并不是说孩子不能带来乐趣，而是一旦孩子“离巢”后，你会更容易感到社会角色的丧失，从而陷入抑郁。 为什么女人更容易陷入抑郁 我们已经注意到：女人罹患抑郁症的几率比男人大2至3倍。 各种理论都对这一现象进行了解释。 生物学理论 该理论认为，导致这一现象的原因是，男女在生殖机能方面存在差异(例如某种激素水平的差异)。换句话说，女性的大脑与男性的大脑有所不同，这种差异提高了女性的患病率。近来，有研究表明，男性大脑与女性大脑在加工情感信息方面存在差异。 然而，是否这种差异提高了女性的患病几率， 目前尚不得而知。 心理学理论该理论认为，两性成长中“社会化”方向的不同，是导致女性更容易患抑郁症的原因。女性更容易被培养成顺服、温柔、自信心和竞争意识较低的个性。因此，受性虐待的女性要远高于男性。其次，男女认识和应付消极事件的方式也大不相同(例如，面临人际问题时，女性更倾向于关注情感因素，产生自责)，女人更关注自己的情感，更愿意暴露自己的悲伤和不幸，她们更需要亲密的关系，更喜欢思索自己的不幸(这可能是因为她们更孤独)；相反，男人在遇到问题时，习惯于责备他人，并且不愿表达自己的情感(例如，“男儿有泪不轻弹”，需要爱被认为是女人气的表现)，如果遇到情绪问题，他们更可能泡酒馆或向他人寻衅滋事。 社会学理论该理论认为，男女的这一区别，是社会条件和性别角色不同所造成的。女性在社会或家庭中，更易处于从属地位，常被限制于家庭中，服从男性的统治(如性虐待)。如果女人减少自己与他人接触的机会，并且维持自己的从属地位的话，婚姻对女人是没有帮助的。 我个人认为：男女患抑郁症的几率不同，是以上四种因素共同作用的结果。