Internal and External Sources of Depression

Steven G. Rise, PhD, LCSW-R

In regard to some of the internal sources of depression, many prominent cognitive and behavioral clinicians believe that most human depression is caused by the person’s own attitude and behavior, and it is often rooted in the way in which that person deals with anger and guilt. Other emotional factors that may dispose a person toward depression include low self-esteem, the lack of intimacy with other people (a weak social support system), and the lack of intimacy with God. Again, even these factors may stem from the person’s internalized anger and guilt.

We may often see these factors collectively in action as the dark cloud of depression sets in, we often push away those people who are important to us, and our hearts harden and grow more angry, introverted, and isolated. In turn, we tell ourselves that “no one likes me anymore;” or “some friends they are, leaving when times get rough—fair-weather friends—who needs them anyway?” This, in turn, reinforces our initial negative thinking and behavior and continues the downward spiral. So then, as we start to make constructive changes in our thinking, and change our faulty behavioral responses to more positive ones, depression—atleast in its earlier stages—Is usually alleviated.

In some instances, genetic factors do contribute to depression as well. The depletion of certain chemical neurotransmitters in the brain may predispose some people when serious stress is added as the triggering mechanism. But many people who have these chemical imbalances and significant life stress manage to avoid clinical depression. This is probably due to the healthy choices they make in regard to the handling of their anger and guilt in regard to life’s problems.

Another important factor is simply sin. David shared a clear example of this as recorded in II Samuel chapter 11. His sin not only affected his life and relationship to God, but his entire family as well. A clear picture is painted in this text of what the consequence of sin is in our lives. But praise be to God! As we read Psalm 32: 3- 5, we find a solution to this innate problem. David said that day and night, God’s hand was heavily upon him and his vitality was drained from him, as long as he kept silent about his sin. But when David acknowledged his sin to God, exposing all of his iniquity, and confessed his transgressions to Him, God forgave him and removed the guilt of his sin. David’s forgiveness is also expressed in Psalm 51: 1-19.

External factors are situations that are, for the most part, outside of our control. Even so, we do have control over how we choose to respond to those difficult situations. According to Minirth-Meier(1), research suggests that the vast majority of depressions are precipitated by life’s stresses. The key words here are precipitated by, not caused by. A stressful event precipitates a response. That response, for the most part, is under our control. One possible exemption to this rule is a situation that is so massive or traumatic, or several moderately severe stressful situations at the same time, which may cause someone to hit an emotional overload—but this is usually not the case. Furthermore, this topic spans outside of the parameters of this paper and enters into the area of stress disorders.