The core experiences of depression – changes in energy, activity, thinking and mood – have been described for more than 10,000 years. The word “depression” has been used for about 350 years.

Given this long history, it may surprise you that experts don’t agree about what depression is, how to define it or what causes it.

But many experts do agree that depression is not one thing. It’s a large family of illnesses with different causes and mechanisms. This makes choosing the best treatment for each person challenging.

Reactive vs endogenous depression

One strategy is to search for sub-types of depression and see whether they might do better with different kinds of treatments. One example is contrasting “reactive” depression with “endogenous” depression.

Reactive depression (also thought of as social or psychological depression) is presented as being triggered by exposure to stressful life events. These might be being assaulted or losing a loved one – an understandable reaction to an outside trigger.

Endogenous depression (also thought of as biological or genetic depression) is proposed to be caused by something inside, such as genes or brain chemistry.

Many people working clinically in mental health accept this sub-typing. You might have read about this online.

But we think this approach is way too simple.

While stressful life events and genes may, individually, contribute to causing depression, they also interact to increase the risk of someone developing depression. And evidence shows that there is a genetic component to being exposed to stressors. Some genes affect things such as personality. Some affect how we interact with our environments.

What we did and what we found

Our team set out to look at the role of genes and stressors to see if classifying depression as reactive or endogenous was valid.

In the Australian Genetics of Depression Study, people with depression answered surveys about exposure to stressful life events. We analysed DNA from their saliva samples to calculate their genetic risk for mental disorders.

Our question was simple. Does genetic risk for depression, bipolar disorder, schizophrenia, ADHD, anxiety and neuroticism (a personality trait) influence people’s reported exposure to stressful life events?

You may be wondering why we bothered calculating the genetic risk for mental disorders in people who already have depression. Every person has genetic variants linked to mental disorders. Some people have more, some less. Even people who already have depression might have a low genetic risk for it. These people may have developed their particular depression from some other constellation of causes.

We looked at the genetic risk of conditions other than depression for a couple of reasons. First, genetic variants linked to depression overlap with those linked to other mental disorders. Second, two people with depression may have completely different genetic variants. So we wanted to cast a wide net to look at a wider spectrum of genetic variants linked to mental disorders.

If reactive and endogenous depression sub-types are valid, we’d expect people with a lower genetic component to their depression (the reactive group) would report more stressful life events. And we’d expect those with a higher genetic component (the endogenous group) would report fewer stressful life events.

But after studying more than 14,000 people with depression we found the opposite.

We found people at higher genetic risk for depression, anxiety, ADHD or schizophrenia say they’ve been exposed to more stressors.

Assault with a weapon, sexual assault, accidents, legal and financial troubles, and childhood abuse and neglect, were all more common in people with a higher genetic risk of depression, anxiety, ADHD or schizophrenia.

These associations were not strongly influenced by people’s age, sex or relationships with family. We didn’t look at other factors that may influence these associations, such as socioeconomic status. We also relied on people’s memory of past events, which may not be accurate.

How do genes play a role?

Genetic risk for mental disorders changes people’s sensitivity to the environment.

Imagine two people, one with a high genetic risk for depression, one with a low risk. They both lose their jobs. The genetically vulnerable person experiences the job loss as a threat to their self-worth and social status. There is a sense of shame and despair. They can’t bring themselves to look for another job for fear of losing it too. For the other, the job loss feels less about them and more about the company. These two people internalise the event differently and remember it differently.

Genetic risk for mental disorders also might make it more likely people find themselves in environments where bad things happen. For example, a higher genetic risk for depression might affect self-worth, making people more likely to get into dysfunctional relationships which then go badly.

What does our study mean for depression?

First, it confirms genes and environments are not independent. Genes influence the environments we end up in, and what then happens. Genes also influence how we react to those events.

Second, our study doesn’t support a distinction between reactive and endogenous depression. Genes and environments have a complex interplay. Most cases of depression are a mix of genetics, biology and stressors.

Third, people with depression who appear to have a stronger genetic component to their depression report their lives are punctuated by more serious stressors.

So clinically, people with higher genetic vulnerability might benefit from learning specific techniques to manage their stress. This might help some people reduce their chance of developing depression in the first place. It might also help some people with depression reduce their ongoing exposure to stressors.

If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.

Jacob Crouse, Research Fellow in Youth Mental Health, Brain and Mind Centre, University of Sydney and Ian Hickie, Co-Director, Health and Policy, Brain and Mind Centre, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Some children show signs of perfectionism from early on. Young children might become frustrated and rip up their drawing if it’s not quite right. Older children might avoid or refuse to do homework because they’re afraid to make a mistake.

Perfectionism can lead to children feeling overwhelmed, angry and frustrated, or sad and withdrawn.

And yet perfectionism isn’t considered all bad in our society. Being called a “perfectionist” can be a compliment – code for being a great worker or student, someone who strives to do their best and makes sure all jobs are done well.

These seemingly polarised views reflect the complex nature of perfectionism.

What is perfectionism?

Researchers often separate perfectionism into two parts:

1. perfectionistic strivings: being determined to meet goals and achieve highly
2. perfectionistic concerns: worry about being able to meet high standards, and self-criticism about performance.

While perfectionistic strivings can be positive and lead to high achievement, perfectionistic concerns can lead to a higher chance of children developing eating disorders or anxiety and depression, and having lower academic achievement.

Children and adolescents may experience perfectionism in relation to school work, sport, performance in art or music, or in relation to their own body.

Signs of perfectionistic concerns in children and adolescents may include:

• children being highly critical of themselves
• their reactions to mistakes seeming to be an overreaction
• intense preoccupation and worry over their standards and goals and/or procrastination
• significant change in performance, for example, lower academic results
• irritability and negative emotions, stress and feelings of worthlessness
• social problems with peers and friends, such as bullying and alienating themselves from peers.

A range of genetic, biological and environmental factors influence perfectionism in children. And as a parent, our role is important. While research evidence suggests we can’t successfully increase positive perfectionistic strivings in our children, harsh or controlling parenting can increase negative perfectionistic concerns in children.

Parents who are perfectionistic themselves can also model this to their children.

So, how can we walk the line between supporting our child’s interests and helping them to achieve their potential, without pressuring them and increasing the risk of negative outcomes?

Give them space to grow

A great metaphor is the gardener versus the carpenter described by psychology professor Alison Gopnik.

Instead of trying to build and shape our children by controlling them and their environment (like a carpenter), parents can embrace the spirit of the gardener – providing lots of space for children to grow in their own direction, and nourishing them with love, respect and trust.

We can’t control who they become, so it’s better to sit back, enjoy the ride, and look forward to watching the person they grow into.

However, there is still plenty we can do as parents if our child is showing signs of perfectionism. We can role model to our children how to set realistic goals and be flexible when things change or go wrong, help our children manage stress and negative emotions, and create healthy balance in our family daily routine.

Set realistic goals

People with perfectionistic tendencies will often set unattainable goals. We can support the development of flexibility and realistic goal setting by asking curious questions, for example, “what would you need to do to get one small step closer to this goal?” Identifying upper and lower limits for goals is also helpful.

If your child is fixed on a high score at school, for example, set that as the “upper limit” and then support them to identify a “lower limit” they would find acceptable, even if they are less happy with the outcome.

This strategy may take time and practice to widen the gap between the two, but is useful to create flexibility over time.

If a goal is performance-based and the outcome cannot be guaranteed (for example, a sporting competition), encourage your child to set a personal goal they have more control over.

We can also have conversations about perfectionism from early on, and explain that everyone makes mistakes. In fact, it’s great to model this to our children – talking about our own mistakes and feelings, to show them that we ourselves are not perfect.

Talk aloud practices can help children to see that we “walk the walk”. For example, if you burn dinner you could reflect:

I’m disappointed because I put time and effort into that and it didn’t turn out as I expected. But we all make mistakes. I don’t get things right every time.

Manage stress and negative emotions

Some children and adolescents have a natural tendency towards perfectionism. Rather than trying to control their behaviour, we can provide gentle, loving support.

When our child or adolescent becomes frustrated, angry, sad or overwhelmed, we support them best by helping them to name, express and validate all of their emotions.

Parents may fear that acknowledging their child’s negative emotions will make the emotions worse, but the opposite is true.

Creating healthy balance

The building blocks of healthy child development are strong loving family relationships, good nutrition, creative play and plenty of physical activity, sleep and rest.

Perfectionism is associated with rigidity, and thinking that there is only one correct way to succeed. We can instead encourage flexibility and creativity in children.

Children’s brains grow through play. There is strong research evidence showing that creative, child-led play is associated with higher emotion regulation skills, and a range of cognitive skills, including problem-solving, memory, planning, flexibility and decision-making.

Play isn’t just for young children either – there’s evidence that explorative, creative play of any kind also benefits adolescents and adults.

There is also evidence that getting active outdoors in nature can promote children’s coping skills, emotion regulation and cognitive development.

Elizabeth Westrupp, Associate Professor in Psychology, Deakin University; Gabriella King, Associate Research Fellow, Deakin University, and Jade Sheen, Associate Professor, School of Psychology, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.