“How does a person become depressed? Remember, in some cases the sources of the condition are situational. In others, the sources are rooted in biology and genetics. Here are a few of the more common causes of a depressive episode:”

Stress. Pressure to perform in school, neurotic tendencies, worries about money or anxieties about the future or the well-being of friends— all of these can become burdens that weigh the mind down and drive it into a depressed state.

Transition or change. A major move, a change in job or school, or the readjustment that follows the death of a family member all have the potential to trigger a depressive episode.

Social conflict. This might include painful arguments with a family member or coach, a falling out with a friend, being bullied, being left out at school, or a breakup with a boyfriend or girlfriend.

Unstable environment. Depression can also arise in response to turmoil in the home, strained family dynamics, and any of those difficult circumstances that are called adverse childhood experiences. (For more on this topic, see pages 14–20.)

Identity struggle. In addition to an unstable external environment, kids—and teens especially—can struggle internally with their sense of identity.

Genetics. The neurochemical factors contributing to organic depression can be passed on from one generation to the next. If you or a first-degree relative suffer from clinical depression, your children’s chances of developing the condition are two to four times higher than the average.

Mental illness. Other forms of mental illness, such as severe anxiety, obsessive-compulsive disorder, eating disorders, substance abuse, schizophrenia, and psychosis can either cause depression or occur in conjunction with it.

Medical or physiological issues. Depression has also been linked to a wide variety of medical conditions, such as diabetes, heart disease, hypoglycemia, hypothyroidism, hypertension, mononucleosis, multiple sclerosis, arthritis, chronic pain, and kidney disease—just to name a few.