depression

• depression

  mental disorder characterised by low mood and low energy levels
• behavioural characteristics of depression

  • activity levels
  • disruption to sleep + eating behaviour
  • aggression + self-harm
• activity levels

  people with depression have reduced levels of energy, making them lethargic.

  has a knock-on effect as people tend to withdraw from work, education + social life.

  in some cases, people with depression have psychomotor agitation where they struggle to relax.
• disruption to sleep + eating behaviour

  person may experience insomnia (reduced sleep) or hypersomnia (increased need for sleep)

  appetite and eating may increase or decrease leading to weight gain or loss.
• aggression + self-harm

  people with depression are often irritable and in some cases become verbally or physically aggressive

  can also lead to physical aggression directed towards themselves
• emotional characteristics of depression

  • lowered mood
  • anger
  • lowered self-esteem
• lowered mood

  lowered mood is the defining emotional element of depression

  people with depression have the daily experience of feeling lethargic and sad
• anger

  people with depression frequently experience anger

  it can be directed at themselves or at others
• lowered self-esteem

  people with depression like themselves less than usual.

  can be extreme as a feeling of self-loathing
• cognitive characteristics of depression

  • poor concentration
  • dwelling on the negative
  • absolutist thinking
• poor concentration

  people with depression may find themselves unable to stick with a task and find it hard to make decisions they would normally find easy.
• dwelling on the negative

  people are more likely to pay attention to negative aspects of a situation and ignore the positive ones.

  have a bias to recalling unhappy events rather than happy ones.
• absolutist thinking

  people with depression tend to think that situations are all-good or all-bad

  black and white thinking
• which approach explains depression?

  the cognitive approach
• what are the two ways of explaining depression?

  • Beck's negative triad
  • Ellis's ABC model
• what did Beck suggest were the 3 parts of cognitive vulnerability?

  • faulty information processing
  • negative self-schema
  • negative triad
• faulty information processing

  selective attention to the negative aspects of situations
• negative self-schema

  people will interpret information about themselves in a negative way
• the negative triad

  a negative view of the world, future and self
• strength of Beck's theory - research evidence

  Research conducted by Clark and Beck concluded that not only were negative thinking styles more common in people with depression, they have also been shown to precede depression.
• strength of Beck's theory - research evidence

  Cohen et al. Carried out a prospective study which tracked the development of 473 adolescents, regularly measuring their cognitive vulnerability. It was found that showing cognitive vulnerability predicted later depression.
• Ellis's ABC model

  proposed that depression is caused by irrational thoughts.

  A = activating event - negative life event

  B = beliefs - irrational interpretations make us overreact to the life event

  C = consequences - emotional and behavioural outcome is depression.
• types of irrational beliefs

  'mursturbation' - belief we must always succeed

  'I-can't-stand-it-itis' - belief that is a major disaster if something doesn't go smoothly.

  'utopianism' - belief that life is always meant to be fair
• strength of Beck and Ellis's theories - real-world application

  Treatments like CBT which are based on cognitive theories are effective for many people. They aim to identify people’s negative and irrational thinking patterns and change them to more functional ones.
• limitation of Ellis's theory - explanatory power

  Ellis’s theory only focuses on reactive depression, depression that happens after a life event, but it struggles to explain endogenous depression, where depression cannot be traced back to any particular event.
• limitation of Beck + Ellis's theories - alternative explanations

  A biological explanation for depression may be better. Research has found that patients with depression have a lower level of serotonin than a control group.
• cognitive behavioural therapy

  psychological therapy that combines behavioural and cognitive approaches

  challenges negative thinking
• Beck's cognitive therapy

  identifies the negative beliefs of the world, future and self from the negative triad and then challenges them.

  aims to help patients challenge the reality of their negative beliefs.

  homework is set to record positive events
• Ellis's REBT

  extends the ABC model to ABCDE

  D = dispute - challenging the irrational belief through vigorous argument (empirical or logical)

  E = effect - change of the irrational belief
• strength of CBT - evidence for effectiveness

  March et al. (2007) compared CBT to antidepressants and to a combination of both. The study used 327 adolescents. After 36 weeks, 81% of the CBT group, 81% of the antidepressant group and 86% of the CBT plus antidepressant group were significantly improved.
• strength of CBT - cost-effective

  CBT is usually a fairly brief therapy requiring 6 to 12 sessions, making it cost-effective for the NHS and free of charge for the client.

  makes it an appropriate treatment
• limitation of CBT - severity of depression

  In some cases, depression can be so severe that clients cannot motivate themselves to engage with the cognitive work of CBT. They may not even be able to pay attention to what is happening in a session.

  this means CBT may not be appropriate for all people with depression
• limitation of CBT - relapse

  A recent study (Ali et al., 2017) assessed depression in 439 clients every month for 12 months following a course of CBT. 42% of the clients relapsed into depression within six months of ending treatment and 53% relapsed within a year. Doesn't have strong long-term effects