DEPRESSION:

CHARACTERISTICS OF DEPRESSION:

• DSM- 5 CATAGORIES OF DEPRESSION

• all forms of depression and depressive disorders are characterised by changes to mood

• the most recent version of the DSM recognises the following categories of depression and depressive disorders:

  • MAJOR DEPRESSIVE DISORDER - severe but often short term depression

  • PERSISTENT DEPRESSIVE DISORDER - long term reoccurring depression including sustained major depression

  • DISTRUPTIVE MOOD DYSREGULATION DISORDER - childhood temper tantrums

  • PREMENSTRUAL DYSPHORIC DISORDER - disruption to mood prior to and / or during menstruation

BEHAVIOURAL CHARACTERISTICS OF DEPRESSION

• behavioural changes that occur when we experience a period of depression

• ACTIVITY LEVELS:

• typically people with depression have reduced levels of energy

• this can lead to them becoming lethargic and withdrawing from work, education and social settings

• in some cases activity levels can change so much people cant get out of bed

• also in some rare cases depression can lead to the opposite ( known as psychomotor agitation ) which makes them hyperactive

• DISTRUPTION TO SLEEPING AND EATING BEHAVIOUR:

• depression is associated with changes to sleeping patterns

• a person may experience insomnia, premature waking or hypersomnia ( prolonged sleeping )

• similarly appetite and eating may increase or decrease leading to weight gain or loss

• AGRESSION AND SELF HARM :

• people with depression are often irritable and can be verbally or physically aggressive which can have a knock on effect on the rest of their life

• EG if they become aggressive at work they may lose their job

• depression can also lead to physical aggression towards the self in the form of self harm which may involve cutting or suicide attempts

EMOTIONAL CHARACTERISTICS OF DEPRESSION:

• LOWERED MOOD:

• depression is normally linked to a lowered mood or feeling sad

• in terms of clinical depression there is more to depression than just feeling sad

• lowered mood is normally more severe, people with depression normally describe themselves as worthless or empty

• ANGER:

• although people with depression tend to feel more negative emotions than positive ones, the negative emotions expand further than sadness and normally involve anger

• this anger can sometimes be extreme and be directed at themselves or others

• this anger can sometimes lead to angry behaviours so its a behavioural as well as an emotional characteristic

• LOWERED SELF-ESTEEM:

• self-esteem is the emotional experience of how much we like ourselves

• people with depression tend to report reduced self-esteem

• this can be extreme with some people describing feelings of self- loathing

COGNITIVE CHARACTERISTICS OF DEPRESSION:

• the cognitive aspect of depression is concerned with the ways in which people process information

• people with depression tend to process information about the world in different ways to what’s considered normal

• POOR CONCENTRATION:

• depression is associated with poor levels of concentration and people may find themselves not being able to focus on a task or make decisions they normally could

• poor concentration and decision making skills will probably interfere with the individuals everyday life

• ATTENDING TO AND DWELLING ON THE NEGATIVE:

• when experiencing depression people are more likely to focus on the negative parts of life and ignoring the positives

• they are also more likely to have a bias to recalling unhappy memories rather than happy ones which is the opposite to people who don’t have depression

• ABSOLUTIST THINKING:

• most situations are not all good or all bad but when people have depression they are more likely to think in these terms

• called black and white thinking

• this means when a situation is unfortunate they tend to see it as an absolute disaster

THE COGNITIVE APPROACH TO EXPLAINING DEPRESSION

• BECKS NEGATIVE TRIAD:

• American psychiatrist Aaron beck took a cognitive approach to explaining why some people are more vulnerable to depression than others

• in particular it is a persons cognitions that create this vulnerability

• he suggested three parts to this cognitive vulnerability

• FAULTY INFORMATION PROCCESSES:

• this when people with depression attend to the negative aspects of a situation and ignore the positives

• EG a depressed person who wins 1 million pounds in the lottery wouldn’t think about all the good things they could do with that money they would focus on the fact the winner the week before won 10 million pounds

• people also tend to blow small problems out of proportion and think in black and white

• NEGATIVE SELF- SCHEMA:

• a schema is a package of information that’s developed through experience

• they act as a mental framework for the interpretation of information

• a self schema is a package of ideas people have about themselves

• people use schema to interpret the world so if a person has a negative self schema they interpret all information about themselves in a negative way

• THE NEGATIVE TRIAD:

• beck suggested people develop a dysfunctional view of themselves because of three types of negative thinking that occur automatically regardless of the reality of what is happening at the time

• these three elements are called the negative triad

• when a person is depressed they have negative thoughts about the world, the future and themselves

• NEGATIVE VIEW OF THE WORLD - thinking about the world in a negative way and having no hope it will change EG the world is a cold hard place

• NEGATIVE VIEW OF THE FUTURE - thinking about the future in a negative way without hope that it will be different from the time they live in now EG the is no hope the economy will improve

• NEGATIVE VIEW OF THEMSELVES - negative thoughts about them personally which confirms the existing emotions of low self esteem EG thinking they are a failure

ELLIS’S ABC MODEL:

• albert Ellis suggested a different cognitive explanation of depression

• he proposed good mental health is the result of rational thinking defined as thinking in ways that allow people to be happy and free from pain

• Ellis believed conditions like depression and anxiety result from irrational thoughts

• he didn’t classify irrational thoughts as those that are illogical or unrealistic, but thoughts that prevent us from being happy and pain free

• Ellis used the ABC model to explain how irrational thoughts can affect our emotional state and behaviour

• A - ACTIVATING EVENT -

• Ellis focused on situations in which irrational thoughts are triggered by external events

• according to Ellis we get depressed when we experience negative events and these trigger irrational beliefs

• EG we fail an important test or end a long term relationship

• B - BELIEFS -

• Ellis identified a range of irrational beliefs

• EG musturbation is the belief we must always succeed and utopianism is the belief that life must always be fair

• C - CONSEQUENCES -

• when an activating event triggers irrational beliefs there are emotional and behavioural consequences

• EG if some believes they must always succeed but then fails a test this can cause them to develop depression

EVALUATION FOR BECKS NEGATIVE TRIAD:

• RESEARCH SUPPORT -

  • one strength generally of becks cognitive model of depression is the existence of supporting research

  • cognitive vulnerability refers to ways of thinking that may predispose people to develop depression, for example the negative triad, faulty information processing and negative self schema

  • a review by beck and clark in 1999 concluded that not only where these vulnerabilities more common in depressed people, but hey also preceded depression

  • a more recent study by cohen et al included 473 adolescents being tracked and regularly reviewed to measure for cognitive vulnerability and they found that showing cognitive vulnerability predicted later depression

  • this shows that there is an association between cognitive vulnerability and depression

• REAL WORLD APPLICATION -

  • a further strength of becks cognitive model of depression is its applications in screening and treatment in depression

  • cohen concluded that assessing cognitive vulnerability allows psychologists to screen young people to identify those at the highest risk of developing depression in the future and monitoring them

  • understanding cognitive vulnerability can also be applied to cognitive behaviour therapy

  • these therapies work by altering the kinds of cognitions that make people vulnerable to depression , making them more resilient to negative life events

  • this means that an understanding of cognitive vulnerability is useful in more than one aspect of clinical practice

EVALUATION FOR ELLIS’S ABC MODEL:

• REAL WORLD APPLICATION -

  • one strength of ellis’s ABC model is its use in the psychological treatment of depression

  • ellis’s approach to treating depression is rational emotive behaviour therapy (REBT)

  • the idea of it is that by vigorously arguing with the patient the therapist can alter their irrational beliefs that make them unhappy

  • there is evidence to support the idea that REBT can change negative beliefs and improve the symptoms of depression

  • this means that REBT has real world use

• REACTIVE AND ENDOGENOUS DEPRESSION -

  • one limitation of ellis’s ABC model is that it only explains reactive depression and not endogenous depression

  • there is no doubt that depression can be caused by triggers or activating events which is known as reactive depression

  • however many cases of depression cannot be traced back to specific life events and its not obvious what has caused the person to become depressed at a particular time, this is called endogenous depression

  • ellis’s ABC model is less useful for explaining endogenous depression

  • this means that ellis’s model can only explain some cases of depression and its therfore a partial explanation