How Can a Person Be Depressed for No Reason?

Causes and Treatments of Depression

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Wow, I read your bio, your poem, your accounts of depression and stared at your picture. I guess that I can't fully understand depression and who it effects. I am awaiting a liver transplant (four years) and I am on depression medication. How can someone with a beautiful face like yours and your health be so sad?  I just don't understand how a person can be depressed for no reason.  Sorry if it's hard for me to understand, but I want to.


I think many people struggle to understand. What makes it difficult for them is that when they become depressed, there is a visible reason like an illness or the loss of a job. So, it's difficult for them to comprehend why it doesn't work that way for other people. Like yourself, for example. You have a very good reason to be depressed. But, why would someone be depressed if everything in their life is good?

What Causes Depression

The reason is that depression can be caused by a defect within the brain that causes that person to not produce enough of certain chemicals, called neurotransmitters, which scientists believe are responsible for mood control. This could be compared to an illness like diabetes, where the body no longer produces enough insulin. There doesn't really have to be an outside reason. The reason is the chemical deficiency itself.

How It's Treated

The good news is that because it is a biologically-based illness, it is also very treatable.


The most commonly-used treatments for depression are antidepressant medications (for example,  Prozac, Effexor and Cymbalta) and psychotherapy, either alone or in combination with each other. Combined therapy is considered to be the most effective.  For most people, these treatments will be enough to achieve relief from their depression symptoms.

In some cases, however, medication and psychotherapy are not enough.  In these cases, a treatment called electroconvulsive therapy (ECT) can provide a rapid response.  ECT involves the brief application of an electrical pulse to the scalp in order to produce a seizure.

Finally, there are newer treatments, such as vagus nerve stimulation (VNS) and transcranial magnetic stimulation (TMS), which are proving to be effective for many patients who have not responded to medications and psychotherapy.  Vagus nerve stimulation involves the surgical implantation of a pacemaker-like device which provides periodic stimulation to the vagus nerve.  Transcranial magnetic stimulation involves the generation of short pulses of magnetic fields in order to stimulate an area of the brain thought to be associated with depression.

I'm really sorry you are going through what you are. I'm keeping you in my prayers that a transplant comes through for you. You sound like a really terrific lady. You could have been angry with me, but instead you wanted to understand.

Thank you for that.


Donovan, Charles E. Out of the Black Hole: The Patient's Guide to Vagus Nerve Stimulation and Depression St. Louis MO : Wellness Publishers, 2005.

"Neurostar TMS Therapy." . Neurostar TMS Therapy.  Neuronetics, Inc. Accessed: June 10, 2015.

Rush A.J., "Acute and Longer-term Outcomes in Depressed Outpatients Who Required One or Several Treatment Steps: A STAR*D Report." American Journal of Psychiatry 163.11 (2006): 1905-17.

The Practice of Electroconvulsive Therapy: Recommendations for Treatment, Training, Privileging. A Task Force Report of the American Psychiatric Association, 1990.

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