This document discusses factors that make some individuals more vulnerable to depression than others. It identifies several risk factors for depression including genetics, medical conditions, lifestyle factors like smoking and diet, socioeconomic status, and gender. The diagnostic criteria for a major depressive episode according to the DSM-IV-TR are outlined. Beck's cognitive theory of depression is explained, involving negative thought patterns and schemas. Islamic teachings on satisfaction, contentment, remembering God, good deeds, and prayer are presented as effective remedies for depression according to Prophet Muhammad.

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Who are vulnerable to Depression?
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DOI: 10.13140/RG.2.2.23250.02246
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2. Who are
vulnerable to
Depression?
Prepared by
Dr. Fatma Ibrahim Abdel-latif Megahed
Lecturer of Family and community
health nursing , Faculty of Nursing, Suez
Canal University , Egypt.

4. Depression is a mood disorder which prevents individuals
from leading a normal life, at work socially or within their
family. It is known as the common cold of psychiatry because
of its frequency of diagnosis. Depressive episodes may be
recurrent or chronic and have a substantial impact on life
functioning.

5. It is described by prolonged and constant unhappiness, lack of
interest in pleasurable events, increased or decreased desire
for food, disorganized sleep and tiredness, lack of
concentration and capability to perform at job as well as at
home along with the feeling of uselessness. It is a common
illness worldwide, with an estimated 3.8% of the population
affected, including 5.0% among adults and 5.7% among
adults older than 60 years.

6. Approximately 280 million people in the world have
depression. About 3.5% (2995824 cases) of Egyptian people
had depression according to world population review. It is a
leading cause of disability worldwide and is a major
contributor to the overall global burden of disease. At its
worst, it can lead to suicide. Over 700 000 people die due to
suicide every year. Suicide is the fourth leading cause of
death in 15-29-year-olds.

7. There is not an exact answer as to why some people are more
prone to depression than others. Existing evidence suggests that
it is a complicated disease caused by the interaction of genetic,
biological, and environmental factors, likely involving several
mechanisms. The risk factors include current or past smoking,
heavy alcohol consumption, low income, unemployment, low
social support, perceived stress, brain chemistry, certain medical
conditions, substance use, physical inactivity, sleep deprivation
and unhealthy diet.

8.  Genetic factors play a greater role in the etiology of major
depression in women than in men (Female gender).
 A recent meta-analysis found that the effect of low socio-
economic status on depression is greater for episode
maintenance than for onset.

9.  Lifestyle risk factors especially smoking and overall nutritional
inadequacy are more closely associated with depression risk in
women than in men.
 Adherence to the vegetarian diet. A new study reveals vegetarians
are two times more likely to suffer from depression than those who
eat meat.
 The links between late-life depression and the medical
comorbidities that are often associated with it can be divided into
two paths. The path from medical illness to depression and
Similarly the path from depression to medical illness.

10. The DSM-IV-TR diagnostic criteria for a major depressive
episode are as follows:
 A. Five (or more) of the following symptoms have been present
during the same two-week period and represent a change from
previous functioning; at least one of the symptoms is (1) depressed
mood or (2) loss of interest/pleasure.
Note: Not including symptoms that are clearly attributable to other medical conditions.
(1) Depressed mood most of the day, nearly every day, as
indicated by subjective report (e.g. feels sad or empty) or
observations made by others (e.g. appears tearful).

11. (2) Markedly diminished interest or pleasure in all, or almost all,
activities most of the day, nearly every day (as indicated by
subjective reporting or observations made by others.
(3) Significant weight loss when not dieting, or weight gain
(e.g., a change of more than 5 percent of body weight in a
month), or decrease or increase in appetite nearly every day.
(4) Insomnia or hypersomnia nearly every day.

12. (5) Psychomotor agitation or retardation nearly every day
(observable by others, not merely subjective feeling of
restlessness or being slowed down).
(6) Fatigue or loss of energy nearly every day.
(7) Feeling of worthlessness or excessive or inappropriate guilt
(which may be delusional) nearly every day (not merely self-
reproach or guilt about being sick).

13. (8) Diminished ability to think or concentrate, or indecisiveness,
nearly every day (by subjective reporting or as observed by
others).
(9) Recurrent thoughts of death (not just fear of dying), recurrent
suicidal ideation without a specific plan, or a suicide attempt or a
specific plan for committing suicide.

14.  The symptoms cause clinically significant distress or impairment in social,
occupational, or other important areas of functioning.
 The episode is not attributable to the physiological effects of a substance or
to another medical condition.
Note: The above criteria represent a major depressive episode.
 The occurrence of the major depressive episode is not better explained by
schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional
disorder, or other specified and unspecified schizophrenia spectrum and other
psychotic disorders.
 There has never been a manic episode or a hypomanic episode.
Note: This exclusion does not apply if all of the manic-like or hypomanic-like episodes are
substance induced or are attributable to the physiological effects of another medical condition.

15. Beck (1967) identified three mechanisms that he thought were
responsible for depression (Beck's Theory):
1-The cognitive triad (of negative automatic thinking).

16. The cognitive triad, As these three components interact (see
last figure), they interfere with normal cognitive processing,
leading to impairments in perception, memory and problem
solving with the person becoming obsessed with negative
thoughts.

17. 2-Negative self schemas.
Individuals possess a set of beliefs and expectations about
themselves that are essentially negative and pessimistic. Beck
claimed that negative schemas may be acquired in childhood
as a result of a traumatic event. Experiences that might
contribute to negative schemas include: Death of a parent or
sibling; parental rejection, criticism, overprotection, neglect
or abuse; bullying at school or exclusion from peer group.

18. 3-Errors in Logic (i.e. faulty information processing).
Beck identified a number of systematic negative bias' in
information processing known as logical errors or faulty
thinking. These illogical thought patterns are self-defeating,
and can cause great anxiety or depression. For example:
Arbitrary Inference; Selective Abstraction; Magnification and
Minimization; Personalization; Dichotomous Thinking.

19.  Beck believed these thoughts or this way of thinking become
automatic. However, a negative self-schema predisposes the
individual to depression, and therefore someone who has
acquired a cognitive triad will not necessarily develop
depression. Some kind of stressful life event is required to
activate this negative schema later in life. Once these
negative schema were in effect; they activated a number of
illogical thoughts or cognitive biases, which seem to
dominate thinking.

20. Regarding Cognitive behavioral therapy & counseling as the treatment for
depression, Prophet Muhammad (
‫صلى‬
‫هللا‬
‫عليه‬
‫وسلم‬
) peace be upon him put
in effective remedies that can wash this illness away. Prophet
Muhammad (
‫صلى‬
‫هللا‬
‫عليه‬
‫وسلم‬
) is the Messenger of Allah, and the final
Prophet of Islam. He is known as the final Prophet and messenger
according to the Qur'an. He has established the too many and most
profound solutions for depression like the following:
1- The Satisfaction ‫الرضا‬
‫بقضاء‬
‫هللا‬
‫و‬
‫قدره‬
‫يقول‬
‫النبي‬
_
‫وسلم‬ ‫عليه‬ ‫هللا‬ ‫صلى‬
_
" :
‫وبمحمد‬ ‫دينا‬ ‫وباإلسالم‬ ‫ربا‬ ‫باهلل‬ ‫رضي‬ ‫من‬ ‫اإليمان‬ ‫حالوة‬ ‫ذاق‬
‫رسوال‬
"
‫مسلم‬ ‫رواه‬
.
2- Contentment ‫القناعة‬
‫يقول‬
‫النبي‬
_
‫صلى‬
‫هللا‬
‫عليه‬
‫وسلم‬
_
"
‫ليس‬
‫الغنى‬
‫بكثرة‬
‫العرض‬
‫إنما‬
‫الغنى‬
‫غنى‬
‫النفس‬
"
‫رواه‬
‫مسلم‬
.

21. 3- Mention Of God ‫هللا‬ ‫ذكر‬
‫قال‬
‫سبحانه‬ ‫هللا‬
" :
ْ‫ن‬ُ‫ك‬َ‫و‬ َ‫ك‬ِّ‫ب‬َ‫ر‬ ِ‫د‬ْ‫م‬َ‫ح‬ِ‫ب‬ ْ‫ح‬ِّ‫ب‬َ‫س‬َ‫ف‬ َ‫ون‬ُ‫ل‬‫و‬ُ‫ق‬َ‫ي‬ ‫ا‬َ‫م‬ِ‫ب‬ َ‫ك‬ُ‫ر‬ْ‫د‬َ‫ص‬ ُ‫ق‬‫ي‬ِ‫ض‬َ‫ي‬ َ‫ك‬َّ‫ن‬َ‫أ‬ ُ‫م‬َ‫ل‬ْ‫ع‬َ‫ن‬ ْ‫د‬َ‫ق‬َ‫ل‬َ‫و‬
ُ‫ين‬ِ‫ق‬َ‫ي‬ْ‫ل‬‫ا‬ َ‫ك‬َ‫ي‬ِ‫ت‬ْ‫أ‬َ‫ي‬ ‫ى‬َّ‫ت‬َ‫ح‬ َ‫ك‬َّ‫ب‬َ‫ر‬ ْ‫د‬ُ‫ب‬ْ‫ع‬‫ا‬َ‫و‬ َ‫ين‬ِ‫د‬ِ‫اج‬َّ‫س‬‫ال‬ َ‫ن‬ِ‫م‬
( "
‫الحجر‬
:
97
-
99
.)
4- Achievement And Good Work ‫الصالح‬ ‫العمل‬ ‫و‬ ‫اإلنجاز‬
‫سبحانه‬ ‫هللا‬ ‫قال‬
" :
ً‫ة‬‫ا‬َ‫ي‬َ‫ح‬ ُ‫ه‬َّ‫ن‬َ‫ي‬ِ‫ي‬ْ‫ح‬ُ‫ن‬َ‫ل‬َ‫ف‬ ٌ‫ن‬ِ‫م‬ْ‫ؤ‬ُ‫م‬ َ‫و‬ُ‫ه‬َ‫و‬ ‫ى‬َ‫ث‬ْ‫ن‬ُ‫أ‬ ْ‫و‬َ‫أ‬ ٍ‫ر‬َ‫ك‬َ‫ذ‬ ْ‫ن‬ِ‫م‬ ‫ا‬ً‫ح‬ِ‫ل‬‫ا‬َ‫ص‬ َ‫ل‬ِ‫م‬َ‫ع‬ ْ‫ن‬َ‫م‬
ً‫ة‬َ‫ب‬ِّ‫ي‬َ‫ط‬
ْ‫م‬ُ‫ه‬َّ‫ن‬َ‫ي‬ِ‫ز‬ ْ‫ج‬َ‫ن‬َ‫ل‬َ‫و‬
‫ا‬َ‫م‬ ِ‫ن‬َ‫س‬ ْ‫ح‬َ‫أ‬ِ‫ب‬ ْ‫م‬ُ‫ه‬َ‫ر‬ ْ‫ج‬َ‫أ‬
‫وا‬ُ‫ن‬‫ا‬َ‫ك‬
َ‫ون‬ُ‫ل‬َ‫م‬ْ‫ع‬َ‫ي‬
"
(
‫النحل‬ ‫سورة‬
:
97
﴾
.

22. ‫عن‬
‫أنس‬
_
‫رضي‬
‫هللا‬
‫عنه‬
_
‫أن‬
‫رسول‬
‫هللا‬
_
‫صلى‬
‫هللا‬
‫عليه‬
‫وسلم‬
_
‫كان‬
‫كثيرا‬
‫ما‬
‫يقول‬
:
"
‫اللهم‬
‫إني‬
‫أعوذ‬
‫بك‬
‫من‬
‫الهم‬
‫والحزن‬
‫وأعوذ‬
‫بك‬
‫من‬
‫العجز‬
‫والكسل‬
‫وأعوذ‬
‫بك‬
‫من‬
‫الجبن‬
‫والبخل‬
‫وأعوذ‬
‫بك‬
‫من‬
‫ضلع‬
‫الدين‬
‫وغلبة‬
‫الرجال‬
"
.
‫رواه‬
‫البخاري‬
.
‫إن‬
‫ة‬‫الﺼﻼ‬
‫واإليمان‬
‫تجع‬
‫الن‬
‫ا‬
‫إل‬
‫نسان‬
‫أكثر‬
ً‫ا‬‫تحكم‬
‫في‬
‫ته‬‫انﻔعاال‬
..
‫قا‬
‫ل‬
‫تعا‬
‫لى‬
"
َّ‫ن‬ِ‫إ‬
َ‫ان‬َ‫س‬ْ‫ن‬ِ ْ
‫اإل‬
َ‫ق‬ِ‫ل‬ُ‫خ‬
‫ا‬ً‫ع‬‫و‬ُ‫ل‬َ‫ه‬
(
19
)
‫ا‬َ‫ذ‬ِ‫إ‬
ُ‫ه‬َّ‫س‬َ‫م‬
‫َّر‬‫ش‬‫ال‬
‫ا‬ً‫ع‬‫و‬ُ‫ز‬َ‫ج‬
(
20
)
‫ا‬َ‫ذ‬ِ‫إ‬َ‫و‬
ُ‫ه‬َّ‫س‬َ‫م‬
ُ‫ر‬ْ‫ي‬ َ‫خ‬ْ‫ل‬‫ا‬
‫ا‬ً‫ع‬‫و‬ُ‫ن‬َ‫م‬
(
21
)
َّ
‫ال‬ِ‫إ‬
َ‫ين‬ِّ‫ل‬َ‫ﺼ‬ُ‫م‬ْ‫ل‬‫ا‬
(
22
)
َ‫ين‬ِ‫ذ‬َّ‫ل‬‫ا‬
ْ‫م‬ُ‫ه‬
‫ى‬َ‫ل‬َ‫ع‬
ْ‫م‬ِ‫ه‬ِ‫ت‬ َ
‫ﻼ‬َ‫ص‬
َ‫ون‬ُ‫م‬ِ‫ئ‬‫ا‬َ‫د‬
(
23
")
‫سورة‬
‫المعارج‬
-
‫اآلية‬
19
-
23
‫عجبا‬
‫ألمر‬
‫المؤمن‬
‫فإن‬
‫أمره‬
‫كله‬
،‫خير‬
‫إن‬
‫أصابه‬
‫خير‬
‫شكر‬
‫فكان‬
‫خيرا‬
‫له‬
‫وإن‬
‫أصابه‬
‫شر‬
‫شكر‬
‫فكان‬
‫خيرا‬
‫له‬
.

23. Resources:
 https://www.simplypsychology.org/depression.html.
 https://www.who.int/news-room/fact-sheets/detail/depression.
 https://neurosciencenews.com/vegetarians-depression-21594/.
 https://www.researchgate.net/publication/51382747_Depression_and_
socio-economic_risk_factors_7-Year_longitudinal_population_study.
 https://mjmr.journals.ekb.eg/article_266139.html.
 https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-021-
02729-2.
 https://floridabhcenter.org/wp-content/uploads/2021/03/MDD_Adult-
Guidelines-2019-2020.pdf.
 https://www.verywellmind.com/common-causes-of-depression-
1066772
 https://www.researchgate.net/publication/11986045_Genetic_risk_fact
ors_for_major_depression_in_men_and_women_Similar_or_different_heri
tabilities_and_same_or_partly_distinct_genes.
 https://www.tandfonline.com/doi/full/10.31887/DCNS.1999.1.2/ikatz
 https://islam.fandom.com/wiki/Prophet_Muhammad_(%EF%B7%BA).
 https://almoslim.net/node/83234.

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