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Current Understandings of Major Depression - Biopsychosocial Model

Rashmi Nemade, Ph.D., edited by Kathryn Patricelli, MA

In this next section of this center, we will be looking at factors that can contribute to the development of depression. There are many factors that have been identified.† The relationship between one factor and another is often complex. To help explain this, the mental health professions have adopted several models or theories that describe the way that various factors, which contribute to health and illness are related. We'll be discussing these models first, before going on to talk about the individual factors that "plug into" these models.

Biopsychosocial Model

The biopsychosocial model was first developed by cardiologist Dr. George Engel. Today is it widely accepted by the mental health professions. This model suggests that biological, psychological and social factors are all linked together and important with regard to promoting health or causing disease. In other words, the mind and the body are not independent and separate things as was previously thought. Instead, they are connected and dependent on each other. What affects the body will often affect the mind and what affects the mind will also often end up affecting the body. Wellness or illness is not just a matter of someone's physical state, but is also influenced by that person's psychological and social status as well.

The biopsychosocial model encourages clinicians to explain conditions, such as depression, by examining all relevant factors. These include body, mind, and social factors that might be contributing to the development or continuation of the condition.

With biological or bodily factors, it is known that people with depressive disorders are often significantly affected by their endocrine (hormone), immune, and neurotransmitter systems. Depression can make a person more likely to develop other physical conditions. A person who has a physical illness or condition is often more likely to develop depression as well. Research suggests that genes can influence the transmission of depression from generation to generation. This means that depression can run in families.

Psychological factors influencing depression include negative patterns of thinking and judgments and a lack of coping skills. Emotional intelligence is also a psychological factor that influences depression. Emotional intelligence is the ability to identify, understand, and show emotions. To some degree, these psychological factors can be influenced by biology. For example, peoples' personality characteristics can influence them to be more or less likely to act in ways that can lead to depression. Social factors, such as what coping behaviors are shown by their parents or teachers when they are growing up, can also come into play.

People can also become depressed as a result of social factors such as: experiencing traumatic situations, early separation from parents or caregivers, lack of social support, or bullying. Research has shown that stressful social events can lead to genes being turned on and off, which causes changes in brain functioning. A social stressor can trigger a physical cause of depression. Environmental and social causes of depression can also be far subtler than actual trauma. It is not necessary for people to have been abused as children to grow up feeling negatively about themselves or their future. This can occur because of how they have learned to think about their self-worth or their ability to successfully respond to the tasks and stress present in their daily lives.

The biopsychosocial model suggests, and the scientific evidence has tended to confirm, that these interdependent factors (biological, psychological and social factors) all end up influencing each other. Depression can be caused by any number of factors that could appear to be independent from one another, but are really related. As one factor tends to influence the other factors, it is possible to have a body reaction to social or mental stress. The opposite is also true where you can have a social or mental reaction to a bodily problem. The way that the various causes of depression affect one another make it very important that all factors be taken into account when trying to form a complete explanation of depression.

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