This might not come as a surprise, but more people are reporting feelings of depression lately than they were in the year before COVID-19 took over the world. If you’ve been having a difficult time with your own mental health, it can be hard to talk about. There’s a lot of shame and stigma attached to depression and anxiety, even in today’s world.

But it’s important to understand the symptoms and causes of depression, so you can treat them. Your mental health isn’t separate from your physical health. It’s all just your health. Some of the symptoms of depression include:

  • Feelings of sadness and/or hopelessness
  • Fatigue
  • Feelings of guilt and/or worthlessness
  • A loss of interest in activities you once enjoyed
  • Regular irritability
  • Disruptions or changes in your sleep or appetite patterns
  • Difficulty concentrating
  • Moving or talking more slowly than normal
  • Unexplained aches, pains, headaches or cramps
  • Restlessness

Depression takes many forms, and can feel like different things to everyone. Some people will experience just one depressive episodes in their lives, while for others it can become chronic. Antidepressants are the right answer for some people. If you’re currently prescribed and taking antidepressants, you should not stop taking antidepressants without consulting your trusted medical doctor and receiving their regular support.

For some though, antidepressants aren’t the right answer. Some people find relief through other approaches, like a Functional Medicine approach.

The first step to a Functional Medicine approach to depression is understanding its root cause. Let’s walk through 10 possible causes.

  1. Blood sugar dysregulation When your blood sugar levels aren’t regulated properly, your body might experience insulin resistance. Insulin influences your central nervous system, impacts neuronal circuitry formation, and affects synaptic plasticity. That is to say—insulin’s a big deal! If your blood sugar’s not regulated the way it should be, everything might feel out of whack.
  2. Chronic stressHave you heard of fight-or-flight? Well, when your body stays in constant fight mode, it can really do a doozy on your nervous system. Your nervous system is the mediator between inflammation and immune response. When things are going well, stressful events trigger your sympathetic nervous system into action, which spurs your hypothalamus-pituitary-adrenal axis (HPA) to release stress hormones that can help you respond. When the stressor is over, your parasympathetic nervous system kicks back in, and decreases the activity in your HPA-axis which reduces that stress hormone production. When it feels like the stressful events are never-ending though, your HPA-axis always on. Unsurprisingly, this can lead to some pretty depressive feelings.
  3. Environmental factorsSometimes, something you’re living with can impact your mental health. Exposure to indoor mold could be triggering an inflammatory response, which leads to several cognitive side effects such as depression. Air pollution is another culprit causing inflammation, which increases your risk of depression. There’s also research suggesting that radiation produced by electromagnetic fields (EMFs) could be connected to depressive symptoms.
  4. GeneticsThis one might not surprise you. If your parents have a history of depression, you could have a spell with it yourself. Scientific understanding of the genetic risks associated with depression is still pretty limited though. Certain genetic variants have been associated with depression, but not confirmed—so don’t blame mom just yet.
  5. InfectionThere are several chronic infections that have been suggested to be associated with depression, including lyme disease, toxoplasma gondii, West Nile virus, and clostridium difficile. While depression might, again here, be a sign of the inflammation associated with these infections, some think the behavioral symptoms of depression could actually be responses to infection.
  6. Gut healthAgain, your physical health and your mental health are one-in-the-same. So it goes without saying that your gut health impacts your mental health. Think of it as a gut-brain axis. All along this axis, messages are transmitted back and forth from the gut to the central nervous system via inflammatory mediators, gut microbial metabolites, neurotransmitters, stress hormones, and the vagus nerve. This like leaky gut or gut dysbiosis can both lead to symptoms of depression. To keep your gut healthy, and therefore your keep your mind healthy, protect your intestinal barrier integrity as well as your gut microbiome.
  7. Loneliness and traumaFriends, loved ones, and family are crucial to maintaining our health. When people are socially isolated, they report greater incidences of depression and other serious health conditions. Trauma, too, puts people at risk for depression. Trauma during childhood can put people at risk for depression later in life, while trauma in adults from things like military service, caring for a sick loved one, or a natural disaster can alter the function of the HPA-axis in long-term ways. For many, the COVID-19 pandemic has been a traumatic event and the symptoms of depression triggered by it should not be discounted.
  8. Social determinantsAccess to things like healthy food, water, education, or shelter all have major impacts on our levels of depression. Things that should be considered essential human rights, when made difficult to access or simply denied, can put people of any age at risk for depression. Race, gender, and socioeconomic are also determinants of our health. Social inequality is a health issue, and when people experience racism or even spend time anticipating or fearing racist encounters, it can contribute to chronic stress or low-grade inflammation—both risk factors for depression.
  9. Sedentary lifestyleIt’s easier said than done, of course, but getting up and moving around is wonderful for your mental health. Regular exercise is linked to lower rates of depression, while a sedentary lifestyle is associated with depression in people of all ages.
  10. Exposure to artificial lightThere’s nothing we all love more than our screens, but our screens do not love us back. Exposure to the artificial light of our screens at nighttime suppresses our bodies’ abilities to produce melatonin, which leads to increased sleeplessness. When people can’t sleep, they are at a higher risk for depression. For your own sake, put the phones away an hour before bedtime.