depression

• depression is a mood disorder which is consistent and a long lasting sense of sadness
• the three behavioural charachteristics of depression are:

  • reduction in activity level
  • a change in eating behaviour
  • an increase in aggression
• the three emotional charachteristics of depression are:

  • sadness
  • guilt
  • low self esteem
• the two cognitive charachteristics of depression are:

  • poor concentration
  • negative schemas
• cognitive approach - depression is due to irrational thoughts, resulting from maladaptive internal mental processes
• negative triad - three schemas with a persistent automatic negative bias
• the self - aka self schema’s, feeling inadequate or unworthy
• the world - thinking people are hostile or threatening
• the future - thinking things will always turn out badly
• the negative triad develops in childhood but provides the framework for persistent biases in adulthood, leading to cognitive distortions, perceiving the world inaccurately
• overgeneralisation - one negative experience results in an assumption that the same thing will always happen
• selective abstraction - mentally filtering out positive experiences and focusing on the negative
• ellis’s ABC model:

  A - activating event - it can be anything that happens to someone

  B - belief - for people without depression beliefs about A are rational. people with depression have irrational beliefs

  C - consequence - rational belief leads to positive consequences; irrational beliefs lead to negative consequences
• mustabatory thinking - the consequences of not accepting we don’t live in a perfect world
• the fact that we fail to achieve unrealistic goals other people don’t behave the way we want them to, or an unexpected event happens and ruins our plans leads to disappointment
• AO3(real world application):

  • cognitive theories that explain depression have led to highly effective cognitive therapies
  • march showed CBT had an effectiveness rate of 81% after 36 weeks of treatment, the same as drug therapy
  • the fact these treatments are successful suggests the underlying cognitive explanations are valid
• AO3(biological reasoning):

  • family studies and genetic research suggests a predisposition to depression is inherited, likely genes that influence the activity of neurochemicals like serotonin in the brain
  • also the effectiveness of drug treatments like SSRIs suggests the cognitive explanation is not complete and there is a biological aspect to depression
  • there is over emphasis of cognition as this explanation does not take into account the circumstances the patient is living in
• cognitive approach - both beck’s CBT and ellis’s REST attempt to change negative schemas and challenges irrational thoughts through cognitive restricting
• beck’s CBT involves: patient as a scientist, thought catching, homework tasks and behavioural activation
• patient as a scientist: the patient generates and tests hypothesis about the validity of their irrational thoughts when they realise their thoughts don’t match reality, this will change their schemas and the irrational thoughts can be discarded
• thought catching: identifying irrational thoughts coming from the negative triad of schemas
• homework tasks: include keeping a diary which is used to record negative thoughts and identify situations that cause negative thinking
• behavioural activation: taking part in activities that the sufferer used to enjoy e.g. sports, travelling or socialising
• ellis’s rest involves: dispute, effect and shame attacking exercises
• rational emotive behaviour therapy: development of the ABC model, adding D for dispute and E for effect
• dispute: the therapist confronting the client’s irrational beliefs. empirical arguments challenge the client to provide evidence for their irrational beliefs, while logical arguments attempt to show that the belief’s don’t make sense
• effect: reduction of irrational thoughts leading to better consequences in the future
• shame attacking exercises: the client to performs a behaviour they fear doing in front of others. this shows the client they can act against their emotions and cope with an unpleasant experience, and they can survive other people’s disapproval. and actually, most people don’t notice or care about our actions
• AO3(research support):

  • march (2007) randomly assigned 327 patients to one of three groups, VBT drug therapy and the third group was given a combined treatment of CBT and drug therapy
  • after 36 weeks, CBT and drug therapy had an effectiveness of 81%
  • CBT also had a more significant reduction in suicidal events than drug treatment
  • the best results came from the combination treatment , with an effectiveness rate of 86% and fewer suicidal events than either treatment alone
• AO3(application):

  • CBT assigns an active role to patients, giving them the responsibility to overcome their depression
  • advocates of CBT say this approach empowers patients and gives a sense of personal efficacy, enabling them to take control
  • in contrast, drugs often require a passive role where patients are reliant on biological interventions and may feel helpless
  • critics of CBT argue saying the client is responsible for the depression is victim blaming and suggesting depression is all in the mind and would go away if the client just thought differently.