Life Stress And Depression

Life event research has been a major topic in the aetiology of depression for more than 30 years. The idea is intuitively appealing, and this is exactly why there is a conceptual problem with this type of research. Humans try to make sense of their experience by identifying patterns of apparent cause and effect, and this applies to the relationship between social circumstances, feelings, and behaviour. People understand that individuals are often distressed when upsetting things happen. Sociologists and social psychiatrists developed the concept of significant life events from the upset that can be caused by rapid adverse changes in circumstances, while psychiatrists' conceptualization of affective disorders derives from the features that characterize distress. Distress is recognized from emotional and cognitive responses that, in severe or persistent forms, strongly resemble the symptoms of depressive disorder.

At a technological level, 'life events' differ from ordinary experience, and depressive disorder differs from ordinary distress only in degree. So what is the status of the assertion 'life events cause depression'? It could be regarded as definitional: things defined as being likely to distress people often do cause distress. At the very best, it is a hypothesis with low information value. Popper (1959) particularly admired theories (such as relativity) that were of inherently low a priori probability: the change in knowledge if they were corroborated, was thus great. However, our theory about life events has high a priori probability: everybody already believes it, not just the scientists, and thus corroboration does not add much to our knowledge. Given this preamble, it is not surprising that studies in both clinical and general populations, whether methodologically sophisticated or not, display remarkable consistency in finding that life events are associated with the onset of depressive disorder.

While this finding is not very interesting in itself, it does lead to more interesting questions. Thus, although there is an overall association, some people put up with considerable stress without becoming depressed. What is the nature of this resilience? People may vary in the way they handle events (coping), or particular individuals may have been exposed to events that happen not to be very threatening to them. Vulnerability itself may be the consequence of exposure to prior experiences that caused particular psychological predispositions. Alternatively, relevant temperamental variation may be under genetic control. Finally, genetic inheritance may influence the frequency with which individuals experience life events, even those that do not appear to be under their control.

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