Imbalance of certain neurotransmitters, specifically serotonin and norepinephrine.
Neurotransmitters
Serotonin:
Often referred to as the "PAPI hormone" (Presumably Acting on Psychological Improvement).
Controls a variety of functions including:
Sleep patterns
Aggression levels
Appetite
Mood
Norepinephrine:
Released during the fight or flight response.
Individuals in depressive episodes may not respond effectively to fight or flight situations.
Research Findings:
PET scans indicated that serotonin levels in the hippocampus of individuals with depression were lower than those without depression.
Autopsy studies also indicated:
Smaller hippocampi in depressed individuals compared to non-depressed individuals.
Fewer neurons that release norepinephrine in the autopsied brains of those with depression.
Relationship between serotonin and norepinephrine:
Low levels of serotonin can lead to low levels of norepinephrine, although the exact cause and interaction remain uncertain.
Psychological Explanations of Depression
Cognitive Theory:
Suggests that thought processes directly influence behavior.
The framing of the world through one's thoughts can determine one's experiences.
Importance of Schemas:
Traumatic childhood events can create negative schemas which color future experiences.
Individuals may expect negative outcomes based on these schemas.
Attributions:
How individuals explain the causes of their behavior:
Internal Attribution: Caused by dispositional factors (e.g., IQ, personality).
External Attribution: Caused by situational factors (e.g., lateness due to train delays).
Stable Attribution: Factors that are unlikely to change.
Unstable Attribution: Factors that can change.
Excessive reliance on internal, external, and stable attributions can lead to feelings of hopelessness and contribute to depressive thought patterns.
Treatments for Depression
Antidepressants
Function: Increase levels of neurotransmitters, mainly serotonin and norepinephrine.
Approximately 30 different types of antidepressants prescribed in the UK, including:
Groundbreaking historical context: First antidepressants included medical uses of gas from engine oil due to its behavioral effects.
Common Antidepressants:
SSRIs (Selective Serotonin Reuptake Inhibitors):
Mechanism: Inhibit reuptake of serotonin, allowing it more time to transmit messages.
Process of prescribing antidepressants typically involves trial and error.
Initial prescriptions often include SSRIs due to fewer side effects and effectiveness.
It is generally advised that long-term use of antidepressants is not recommended, although some may require ongoing treatment.
Cognitive Behavioral Therapy (CBT)
Based on cognitive theory regarding irrational thought processes.
Focus: Current thinking patterns instead of historical context.
Method:
Talk therapy involving 12 to 21 one-hour sessions, either individually or in groups, typically spread over a few months.
Follow-up sessions are encouraged.
Research Study (2013):
Objective: Investigate effectiveness of CBT for participants resistant to antidepressants.
Methodology: Longitudinal field experiment in a real-life setting with limited control over extraneous variables.
Sample: Participants aged 18-75 taking antidepressants for a minimum of six weeks with limited improvement.
Groups:
CBT Group: 234 participants received therapy sessions with trained therapists.
Control Group: 235 participants received just antidepressants and standard medical care.
Findings:
After six months, 46% of CBT participants showed improvement compared to 22% in the control group demonstrating the greater effectiveness of CBT for individuals not improving with medication.
Conclusion of Effects and Evaluations
CBT proves to be a more effective treatment when used alongside antidepressants for those unresponsive to medication alone.
Evaluation Insights:
CBT is powerful in reducing symptoms of depression.
Antidepressants also show effectiveness, particularly in severe depression where 22% of control participants did show improvement.
Other studies support CBT’s superior longevity effects (e.g., lower relapse rates).
Ethical Considerations:
Ethical concerns raised by preventing access to CBT for control group participants needing treatment.
Limitations in controlling extraneous variables may compromise results accuracy.
Final Notes
Reliability of study results may be affected by the percentage (32%) of participants not attending all sessions.
Importance of longitudinal study designs to observe true effects over time as opposed to short observations.