Traumatic event - miscarriage, death of child, separation from family, etc.

Learned response - acquired as past efforts have not met with success

Cognitive distortions - such as extreme pessimism, unrealistic expectations of life and love, and other unhealthy thought patterns

Traumatic event - miscarriage, death of child, separation from family

You become frightened - often while walking alone at night - and your spirit (bla) is jolted out of you - and then a ghost or witch latches onto the bla. You may not realize that you have lost your bla for a few days but you know when you get somatic symptoms as side effects of the ghost's hold on you. This is commonly called soul loss. (Desjarlais, 136)

In children it is almost always caused by a fright or an occasion of being hurt physically (ibid, 145)

Insufficient mourning of the death of loved one (ibid, 143)

Lack of connection-
social isolation due to frequent relocation of families, disintegration of families and extended families, increased time spent on computers

Women are more susceptible than men

Lack of connection - social isolation

No one can really know your heart-mind intimately.

Women are much more susceptible than men because they undergo the types of experiences that lead to spirit loss much more than men - mainly the trauma of leaving your immediate family and often your immediate village when you get married and the often rough transition and lowered status of joining the new family/community. (ibid, 121)

In general you are supposed to keep your strong emotions to yourself and not show them in order to keep the larger communal peace. You may share your strong emotions with your closest family members, e.g. mother, wife - but even then it is difficult to communicate what is inside you. The double trap is that people who have the deepest sadness are usually those who have lost or been separated from the very loved ones with whom they could have confided, thus making the tsher ka (heart ache) even harder to bear. (ibid, 116)

example from a Yolmo poem/song:

When the sun shone we were not pained,
when the sun was lost tsher ka fell
When friends gathered we were not pained,
when we parted tsher ka came. (quoted in ibid, p. 104)

Insufficent levels of serotonin, GABA and other neurotransmitters

Genetic factors

Poor diet and lack of exercise

Older people are more likely to become depressed as their bodies begin to fail. (ibid, 127)

You lose physical life-supports (srog) constantly and need to renew them

Ayurvedic tradition - body fluids aka humors (wind, bile and phlegm) must be in balance and not blocked from taking their actions

Bad karma from one's own previous life actions or from actions within one's own current life

Dasa graha - the planets are in an unlucky alignment (ibid, 53)

Harmful wishes (e.g. envy) or actions (e.g. gossip) from other people (ibid, 53)

Witches, ghosts, etc. are constantly trying to get you

Mix of Buddhist and Shaman view of causality