Social structures that in the past lent support in times of emotional crisis have deteriorated. In the article “The Age of Melancholy?”, Dr. Gerald Klerman attributes the current increase of depression to this change. He explains: “The three most common social support systems have been the family, the church, and the immediate neighborhood. . . . It is a characteristic of the present time that all three of those social support systems are in various degrees of disarray.”

However, the Bible reveals that one’s own “disquieting thoughts” also may be a cause.​—Psalm 94:19.

Most people who become depressed, like Marie, have encountered a number of painfully unpleasant experiences or stressful situations. Many feel like the psalmist: “My soul has had enough of calamities . . . They have closed in upon me all at one time. You [Jehovah] have put far away from me friend and companion; my acquaintances are a dark place.” (Psalm 88:3, 17, 18) So like the psalmist, they feel overwhelmed by problems or losses and view their life in general as hopeless. They may feel as if they were all alone in a dark place and that even God has cast them off.

Why do they reach such a discouraging conclusion, in effect developing a stricken spirit? It is not just because of their external problems; it is also due to painful feelings or misgivings about themselves. They feel inadequate to deal with the problem or loss. “Because of the pain of the heart there is a stricken spirit,” explains Proverbs 15:13. Such pain of heart would include feeling that one is a failure or that others think so. Even the first-century Christian Epaphroditus, after recovering from a serious illness during a mission arranged by his home congregation, became “depressed because [the congregation] heard he had fallen sick.”​—Philippians 2:25-30.

Since ‘a stricken spirit makes the bones dry,’ or undermines one’s very being, feelings of low self-esteem are often at the root of serious depression. (Proverbs 17:22) Pain of heart might also be brought on by too great a concern about how others view us, perfectionism, unresolved anger, resentment, unsettled conflicts with others, or guilt (real or exaggerated).

So the causes of serious depression are many.