Risk factors and triggers

Depressive disorders have a significant biological basis. One of the key factors is genetic predisposition: people with a family history of depression are at greater risk of developing it.

This vulnerability is related to the neurochemical functioning of the brain, particularly imbalances in neurotransmitters such as serotonin, dopamine, and norepinephrine, substances that regulate mood, sleep, appetite, and stress response.

When the body perceives a threat, the hypothalamic-pituitary-adrenal axis is activated, releasing cortisol, a hormone that prepares the body to respond to danger.

However, when stress is prolonged and cortisol remains elevated, the effects can be toxic to the brain.

Excess cortisol has been shown to decrease concentration, promote anxiety and depression, and can cause sleep disturbances, panic attacks, phobias, and even damage to brain regions such as the hippocampus.

In addition, low serotonin levels are directly linked to apathy, irritability, and suicidal ideation, while a lack of dopamine can lead to a lack of motivation, low sex drive, and a tendency toward social withdrawal.

Psychosocial factors

The psychosocial environment is another key component in the onset of depression.

Chronic work stress, for example, can trigger mood disorders, especially in high-demand, low-reward, or low-recognition contexts.

This is particularly visible in healthcare professionals, who during the pandemic faced increased workloads, lack of supplies, physical and psychological exhaustion, and a strong emotional impact. This situation made them a highly vulnerable group.

Family conflicts, domestic violence, and adverse childhood experiences—such as maltreatment, neglect, or emotional abuse—are also powerful triggers.

These psychosocial factors generate a state of constant internal tension that, if left unresolved, can lead to disorders such as major depression.

Somatization, where the body expresses what the mind cannot say, is common in this context: headaches, gastrointestinal problems, or persistent fatigue can be physical manifestations of emotional suffering.

Environmental factors

Finally, the environmental context plays a decisive role. Economic crises, for example, can lead to financial insecurity, unemployment, and precariousness, which directly affect mental health.

Prolonged uncertainty weakens support networks and can fuel feelings of hopelessness or worthlessness.

Another crucial environmental factor has been the prolonged isolation resulting from the COVID-19 pandemic.

According to recent data, up to 43% of the population in Spain has experienced symptoms of depression, and more than 56% has experienced anxiety.

This forced confinement disrupted routines, limited social contact, and exacerbated feelings of loneliness, all of which increased the risk of emotional disorders, especially in people with a history of mental health issues, adolescents, older adults, or individuals without strong support networks.

Together, these factors interact in complex ways. Biological vulnerability can be exacerbated by a dysfunctional family environment, which in turn can be aggravated by an adverse economic or social context.

The key is to recognize these elements early on, understand their implications, and act from a biopsychosocial approach that allows for comprehensive mental health care.