Is Depression Hereditary?

Genetic factors influence depression, although that doesn’t imply that it’s solely hereditary. Like a lot of psychological disorders, depression can often be a result of a complex interaction of environmental and genetic factors. Research says that genetic factors are responsible for approximately 37-48% of the risk of developing depression (Daze, 2023). This implies that environmental factors also play a significant role in depression.  

Depression, or Major Depressive Disorder (MDD) is a serious condition that can affect behaviour, mood and daily life. It’s characterised by a persistent sadness, emptiness or irritability of severity to cause distress and disturbance, and usually exceeding 2 weeks’ duration. Loss of interest and pleasure in activities, decreased energy levels, and increased fatigue (even with minimal exertion) are some other important symptoms of MDD. 

Also read: Sadness vs depression: How to tell the difference?

Symptoms of depression include:

• Negative ideas about self, such as Low self-esteem and self-confidence
• Persistent feelings of guilt and worthlessness
• Persistent and unchanging sadness of mood experienced as painful, numbing and difficult to bear
• Bleak, pessimistic view of life and the future 
• Sleep disturbances resulting in unrefreshing sleep
• Difficulty concentrating and reduced attention
• Feeling lonely, unheard and unsupported by loved ones
• Changes in appetite (Diminished or increased)

Often, regular mood fluctuations as a response to life’s usual challenges shouldn't be mistaken for depression. It's a more severe and recurrent form and can adversely affect functioning in school, work and family settings.

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Depression and genetics

Having relatives with depression is indeed associated with a higher risk of developing depression. The risk increases with the number of relatives and the closeness of the relationship. This type of risk is termed ‘vulnerability’. It does not mean that depression as a disorder is inherited, but it means that the possibility of developing it is higher for people who do not have relatives with depression.

Linkage studies suggest that specific chromosomal regions may be associated with depression. Genetic factors can differ depending on whether the disorder is familial (occurring in multiple family members) or sporadic (present in an individual with no family history). Familial cases can often have a stronger genetic link, whereas sporadic cases have a weaker genetic influence concurrent with environmental factors. 

How genetics shapes depression

Brain chemical regulation

Certain genetic variations can impact how effectively the brain utilises neurotransmitters like serotonin. When these neurotransmitters, crucial for mood regulation, are not transported efficiently, it can increase an individual's susceptibility to depression.

Similarly, variations in genes affecting dopamine and norepinephrine levels can also contribute to the development of depressive symptoms.

Stress response system

Prolonged exposure to stress can lead to an overactivation of the hypothalamic-pituitary-adrenal (HPA) axis, resulting in elevated cortisol levels. This hormonal imbalance is frequently observed in individuals with depression, and genetic factors influence how the body manages stress responses.

Neurogenesis

The process of generating new brain cells, known as neurogenesis, is vital for maintaining healthy mood regulation. Genetic factors play a role in this process, and disruptions—often related to the brain-derived neurotrophic factor (BDNF)—can increase vulnerability to depression.

Inflammatory responses

Chronic inflammation, characterised by elevated levels of cytokines, can interfere with neurotransmitter systems and neurogenesis. Genetic predispositions can influence an individual's inflammatory response, thereby affecting their risk of depression.

Circadian rhythms

Genetic variations that regulate sleep-wake cycles, or circadian rhythms, have been associated with depression. Disruptions in these rhythms, influenced by genes like PER, CLOCK, and BMAL1, can contribute to mood disorders.

Familial and sporadic cases

Genetic variations can differ between individuals with a family history of depression and those without. This implies that different genetic factors may contribute to familial versus sporadic cases of depression.

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Environmental factors and depression

The occurrence of depression has been extensively studied with respect to social environmental factors and not so much in relation to physical environments. Environmental factors contribute significantly to the onset of depression, often interplaying with genetic predispositions.

• Social Environment: Social adversity, such as poverty, strife-torn neighbourhoods, adverse childhood experiences, hardship,s and exposures to war and disasters increase the risk of depression by almost 50% over those who do not face such conditions.
• Physical environmental factors such as pollution, lack of green natural elements, lack of beauty and aesthetics are found to be associated with low mood, but a decisive association is yet to be established.
• Pollution: Airborne pollutants and heavy metals interrupt brain function and neurotransmitter systems, increasing the risk of depression.
• Urbanisation: Environmental stressors like air pollution, noise, and social disparities in urban settings elevate the risk of depression, particularly in early life.
• Natural Disasters: Events like earthquakes, floods, and hurricanes cause acute stress, trauma, and socioeconomic losses, often leading to long-term depression.

Protective environmental factors, such as robust social support, exposure to nature and stress-relieving activities, can mitigate these risks.

Also read Overcoming depression: how therapy helped me?

Busting myths around depression and genetics

There are some myths associated with depression and its genetic roots.

If my family has depression, then I will have it too.

This isn’t entirely true. If many members of your family, and close family members, have depression, your vulnerability to developing depression is higher than that of persons who do not have family members suffering from depression. Yet this risk is only a comparative one, as the actual probability of not developing depression is much higher than that of developing it. Thus, even with an apparently adverse genetic legacy, in reality, the risk of actually developing depression is low, about less than 30%.

Depression is entirely genetic.

Depression is caused by a combination of genetic, biological and socio-environmental factors; only 40% of the risk can be attributed to genetic reasons.

Genetic predisposition to depression cannot be managed.

Genes only carry the material causing vulnerability to develop depression, not actually the disorder. Any average person, living a balanced, healthy life, is able to mostly offset this vulnerability. Thus, even having a higher risk of depression should not be a cause for worry or extraordinary care.

Types of Depression

There are many ways to describe depression. Historically, certain ‘types’ of depression have been described as follows:

Depression affects nearly 3.8% of the population (WHO, 2023). It can present itself in various forms, often differing in severity and with different underlying causes. Loss of interest and low moods are features that run across all types. 

Seasonal Affective Disorder (SAD) 

Symptoms often present themselves at specific times of the year, and most commonly during winter. A four-year-old boy from Scotland with a seasonal pattern of depressive symptoms dating back to infancy and meeting the criteria for Major Depressive Disorder by the age of three years. There was consistency in reports between informants and across contexts and improvements with light therapy (European Child & Adolescent Psychiatry, 2000)

Melancholia

An often extreme form of depression characterised by physical symptoms such as a complete loss of interest or slowed movement.

Major Depression

Also known as Major Depressive Disorder or clinical depression, presents a persistent low mood and other associated symptoms lasting most days for at least two weeks. A young Punjabi man, a high-achieving student in school, presented with low mood, energy, anhedonia, weeping spells, decreased appetite and talk. His parents believed it to be “black magic”, and he was taken to multiple faith healers before finally being diagnosed with MDD. With the right diagnosis and medication, he showed significant improvement over time (case study). 

Prenatal and Postnatal Depression

Prenatal depression occurs during pregnancy, while postnatal or postpartum depression can develop in the weeks or months after childbirth.

Also read What is postpartum depression?

Bipolar disorders

This mental health condition or mood disorder can include depressive episodes. Characterised by episodes of mania (elevated mood and activity) alternating with depressive episodes. 

Psychotic Depression

Involves psychosis, characterised by hallucinations (false sensory experiences) or delusions (fixed and often false beliefs).

While these types differ from one another in the way they present, they all significantly affect emotional, cognitive, and physical functioning.

By understanding the complex interplay of genetic, biological, and environmental influences, you can take the necessary steps to reduce your vulnerability to depression and build protective mechanisms for better mental health and a better life. 

References

Daze, G. (2023, May 8). Environmental factors and depression. BrainsWay. Retrieved from https://www.brainsway.com/knowledge-center/environmental-factors-and-depression/

World Health Organization. (2023, March 31). Depressive disorder (depression). Retrieved from https://www.who.int/news-room/fact-sheets/detail/depression

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FAQs

1. Is depression passed down in the family?

Depression can run in families, suggesting a genetic factor behind it, but its expression is always a combination of genetic, biological and environmental factors. People with a family history of depression are predisposed to developing it, with research evidencing that genetics accounts for almost 40% of risk, especially in severe cases. Environmental factors like childhood adversities, ill health and maladaptive coping mechanisms also play a significant role. 

2. What calms depression?

Calming depression entails a combination of self-care strategies, therapeutic techniques, and in some cases, medical intervention. Physical activities such as walking or yoga can boost endorphins and improve mood, while mindfulness practices like deep breathing or meditation can help reduce stress and promote relaxation. Engaging in enjoyable activities and doing other self-care activities like maintaining a regular sleep schedule, eating a well-balanced and nutritious diet, connecting with family and friends and journaling or other creative outlets can help. For continuous symptoms, therapy like CBT and medication such as antidepressants may be necessary to address underlying causes and allow the person to live a happier, more fulfilled life. 

3. Can a depressed person live a normal life?

A person with depression experiences significant impairment in quality of life when the symptoms are active. Most people are unable to eat or sleep properly and do not have enough energy or mental strength to carry through their activities. To the outside world, they appear preoccupied, irritable, striving, oversincere and morose. Some people can mask their symptoms by forcing themselves to work very hard (and therefore doing well), smiling and laughing in social settings and using substances to calm themselves. As depression reduces immunity and causes a general dysfunction, people are prone to frequent minor illnesses. Prolonged untreated depression is a known risk factor for chronic conditions like cardiovascular disorders, diabetes, pain disorders, obesity, hormone dysfunctions and cancers. However, most of these issues can be addressed or prevented by early and complete treatment of depression, which includes medication, psychotherapy and self-care.