Clinical psychologist and psychotherapist specializing in depressive disorders

Depression can occur at any time in life. It often appears for no reason, and plunges the sufferer into a world of disquieting strangeness. 

It often sets in insidiously, with its own set of symptoms: dark thoughts, loss of pleasure in daily activities, difficulty getting up in the morning, sleep and eating disorders, and social isolation. 

Unless it's triggered by a specific event: the loss of a loved one, an accident or trauma, depression is often linked to the past. 

When depression is triggered by a specific event, it's known as reactive depression, which generally resolves itself once the emotional charge has been digested. 

However, if it persists over time, we speak of major depressive disorder. In this case, the causes are always more complex, and psychotherapy is imperative.

Depression has often been described as a "disease", as if it were just another fatality, hereditary and curable only by medication, which is often necessary for many years.

Even if drugs seem to be indicated for the most severe cases, this definition leaves little hope for sufferers, as it does not open the way to a possible cure. 

Where does suffering come from and why? 

In the end, too few mental health professionals ask these questions, as if the patient's history didn't matter. 

Yet depression cannot be cured by denying its complexity and without understanding its origins.

What is depression?

In the past, depression was called melancholia and defined as: "A psychic state characterized by a mood disorder in the sense of a decrease in vital drive, with sadness, ideomotor and psychomotor slowing, psychic and physical pain, neurovegetative disturbances." (Kraeplin, 1889). 

However, this definition is still relevant today, and is not far removed from current definitions such as that of the World Health Organization (WHO), which defines it as : "persistent sadness or lasting loss of the ability to experience interest or pleasure in activities that used to provide it" (2024). 

According to the WHO, "depressed mood must be present for most of the day and occur almost daily for at least two weeks. Depressed people may suffer from sleep disturbances and fluctuations in appetite. They may also have low self-esteem or suicidal thoughts, and feel hopeless about the future. Fatigue and difficulty concentrating are also common symptoms.

The loss of vitality and pleasure in daily life is at the heart of the problem. The individual is faced with major anxieties, a sense of failure and powerlessness, fatigue and intellectual slowdown. 

It is estimated that 10 % of the world's population is affected by depression. 

According to a study by Prévot (2022), between 1 and 1.7 million people in Belgium will suffer from depression during their lifetime. 

Depression is often difficult to identify 

Depression can take many forms. We often imagine the depressed person as passive and inert, prostrate, looking at the world around them with indifference and detachment.

However, depression can be masked, expressing itself in a state of great agitation where the person is perpetually on the move, overwhelmed by anguish or anxiety. 

It can manifest itself in outbursts of anger and aggression, or in the use of substances such as alcohol, medication or drugs. Many people don't know they're depressed, or don't want to admit it.

A severe form of depression is bipolar disorder, characterized by alternating states of euphoria and agitation, and periods of depression and withdrawal. 

All these constellations sometimes make identification more difficult. 

Where does depression come from?

In the course of our lives, we all face difficult events that call on our capacity for adaptation and resilience.   

Depression can be linked to the loss of a loved one, difficult living or working conditions, a persistent stressThe most common reasons for this are the following: an accident, failure, a painful or traumatic event, or bereavement. 

Faced with the sadness engendered by these events, we are not all equal. 

Not everyone experiences these events in the same way, and this is linked to each person's resources. Each person's degree of resilience has its origins in our past. 

Some will get through this difficult time without feeling completely overwhelmed. Even sad, they will be able to continue to function more or less normally in most areas of their lives until the storm subsides. 

Others will feel much more affected in their daily lives, to the point where moral suffering will become increasingly problematic and gradually invade all areas of life. 

Often, the event in question will bring back old memories and other difficult moments in the individual's life, plunging him or her into deep distress. 

We're not all equal when it comes to depression, because we don't all have the same past. 

Depression has its origins in childhood. 

Inequality in the face of depression often depends on our childhood and the quality of our relationships with parental and family figures.

An individual who has grown up in a secure environment and thus acquired a solid foundation on which to build, will be better able to get through more difficult times without falling apart. 

These are families where communication is fluid, where emotions can be expressed without causing anxiety to other members of the family group, and where difficulties are seen as an inherent part of life, without undermining confidence in the future. 

This daily regulation enables you to adapt your emotional feelings without being overwhelmed, and to find solutions on your own while knowing how to ask for help when you need it. 

On the contrary, an individual who grew up in a less secure family, where there were more secrets, where the parents themselves were more anxious and preoccupied, and where communication about negative emotions was not encouraged, will find it harder to regain hope in the face of a depressogenic event. 

In this case, the sadness experienced can go as far as collapse, leading to what is commonly referred to in psychoanalysis as melancholic depression. 

The loss is unbearable for the subject, threatening his or her own integrity.

Depression, a transgenerational legacy

Depression can also be transmitted from unconscious to unconscious. We all come from two beings, each with their own history. The history of one or both parents may have been difficult: war, trauma, bereavement, family secrets... 

The child senses negative emotions, but also understands that he or she is not allowed to talk about them, as this makes adults uncomfortable.

This suffering is not expressed directly within the family, either because the parent is not really aware of it, or because he or she wishes to protect the child from the emotional burden he or she imagines is too heavy to bear. 

Parents then minimize their own suffering, even if they bear the stigma, and very often it is passed on to the next generation in a masked form. 

The following generations then carry a melancholy burden that they understand nothing about and can't shake off. 

Quite simply, depression is hereditary. You don't need a gene to pass on suffering. That's why it's imperative to look at the transgenerational aspects of depression when we don't know where it comes from.

How do you get out of depression?

The main treatment for depression is psychotherapy. It is essential for treating the root of the problem and preventing the risk of relapse.  

Depression is an invitation to look at the past in order to change the present.

We need to identify what keeps us sad and prevents us from regaining confidence in the future.

In-depth work on the child and teenager you once were, on your own family and your transgenerational heritage, is a real opportunity to shed the weight of the past and free yourself from this feeling of heaviness for good. 

Working on the past always leads back to working on the present. Along the way, we realize that certain choices belong to the past, and new life arrangements are envisaged. You are then free to implement new projects or habits more in line with your deepest aspirations. 

Therapy for depression, though it represents a definite effort, is a therapy for renewal that can, far beyond expectations, breathe new life into a person and enable them to build their future on authentic, solid and lasting foundations.