Droplets of black bile? Development of vulnerability and resilience to depression in young age.

Major depressive disorder is predicted by enduring anxiety-related personality traits, in particular by neuroticism, which have genetic foundations. Neuroticism in turn is strongly related with the genetic risk for depression. Search for gene variants associated with neuroticism and depression has led to some good candidates, but the consistency of findings is very far from ideal. Adverse life events are causal to development of mood disorders, and often the vulnerability genes can be detected only when environmental impact has been objectively assessed. Yet the continuity of depression diagnosis from early childhood to adulthood is limited, while childhood depression increases odds of other affect-related disorders such as substance abuse and personality disorders. Whether specific genes have an impact seems to depend on the period of life both because of biological maturation and differences in major environmental factors, but also active engagement--or the failure to do so--of the vulnerable subjects with their environment. It is proposed that subjects with genetically determined neurotic tendencies are likely to attempt to select coping strategies that reduce events perceived as harmful and can by this means develop resilience towards affective disorders.