Depression: cognitive explanation

• Depression is a common mental health disorder, affecting around one in five adults in the UK and over 4 in 10 women aged 16 to 29.
• Depression can be explained and treated using a cognitive approach, suggesting that depressed people's thinking is disturbed or their cognitions are in some way broken or maladaptive.
• Psychologists use a term called a schema, a mental framework built from experience, as a mental shortcut to understand the world and objects in the world.
• These schemas, or automatic assumptions, can lead to biases and are particularly problematic when these biases are negative and about ourselves and the events in our lives.
• Beck's negative Triad and Alice's ABC model explain depression as due to faulty negative thinking and suggest the best way of treating depression is to challenge and change this negative bias.
• Aaron back argued that people who are depressed have three types of schema with an automatic negative bias: self schemers, negative schemers about the world, and negative schemers about the future.
• These negative thought patterns can lead to negative behaviors such as avoidance, withdrawal, and inaction.
• Beck calls these biases cognitive distortions.
• Overgeneralization is when an individual has one negative experience and assumes this will always happen.
• Selective abstraction is a process of mental filtering, focusing on the negative.
• Albert Ellis used the ABC model to explain how some of depression responds to stress, adversity, and unpleasant events in a way that leads to unhealthy emotions.
• The A in the ABC model refers to the activating event, which can be something major like the end of a relationship or as small as missing a bus.
• The B in the ABC model refers to the belief, which could be rational or irrational.
• Many patients prefer CBT's drug treatments due to the lack of side effects and a belief that CBT addresses the root cause of depression, not just reducing symptoms.
• Cognitive Behavioral Therapy (CBT) is effective in the long term, meaning once treated people can return to work as a productive worker and continue contributing to the economy.
• Empirical arguments challenge the client to provide evidence for their irrational beliefs, while electrical arguments attempt to show that the beliefs don't make sense.
• In Alice's rebt, the therapist explains the irrationality of the fault directly to the patient through distributation.
• The results of the study showed that CBT was effective, with an effectiveness rate of 81 percent, but the best results came from the combination treatment with an effectiveness rate of 86 percent.
• Cognitive Behavioral Therapy (CBT) is worth the expense from a cost benefit analysis as it can lead to better outcomes and a reduction in healthcare costs.
• The counter approach to treating depression is Cognitive Behavioral Therapy (CBT), which has been evaluated in a randomized controlled trial involving 327 patients.
• The form of the therapist confronting the client's irrational beliefs is through empirical and logical arguments.
• Beck's CBT involves the client helping to figure out the rationality of their thoughts themselves by acting as a scientist.
• Cognitive Behavioral Therapy (CBT) is significantly more expensive for Health Services like the NHS to fund a course of treatment, which can take 16 to 20 one-to-one sessions with a trained therapist.
• Rebt also includes what's known as shame attacking exercises, where the client is asked to perform the behavior they fear doing in front of others.
• In the REBT model, the effect is the reduction of a rational forwards leading to better consequences in the future.
• The C in the ABC model refers to the consequence, which is different for individuals with and without depression.
• Cognitive theories depend on the assumption that the thoughts of someone with depression are irrational, but it could be that their lives are objectively bad and depression is a reasonable response.
• In Alice's Rational Emotive Behavior Therapy (REBT), clients are taught how to dispute these schemas and irrational thoughts, using the ABC model, which adds D for dispute and E for a fact.
• The cognitive strategy to treat depression is to change these schemas and challenge the irrational thoughts.
• Research supports the role of rational thoughts and depression, with Grizzoli and Terry recording the thinking styles of 65 women before and after childbirth, finding that the women with negative thinking styles were the most likely to develop depression, especially if they had difficult children.
• There are two cognitive therapies, Cognitive Behavioral Therapy (CBT) and Rational Emotive Behavior Therapy (REBT), which treat the patient as a scientist, generating and testing hypotheses about the validity of their rational thoughts.
• In Cognitive Behavioral Therapy (CBT), clients are first taught how to gather data through fall catching, identifying irrational thoughts coming from the negative Triad of schemas.
• Many people with depression also experience anger and people with bipolar depression experience manic phases, which can't be explained by cognitive theories.
• Alice uses an amusing term that explains the source of irrational beliefs, masturbatory thinking, which comes from not accepting that we don't live in a perfect world.
• A person with a rational belief would likely look for a new healthy relationship, while the person with an irrational belief might either avoid relationships altogether or get into an unhealthy relationship feeling they can't do any better.
• Current explanations of depression focus on the cognitive theories, which have led to highly effective cognitive therapies, such as Cognitive Behavioral Therapy (CBT), which has an effective rate of 81% after 36 weeks of treatment, the same as drug therapy.