depression

• Depression


  A category of mood disorders, where sufferers are required to display at least five symptoms every day for at least two weeks
• Characteristics of Depression


  • Reduction in energy and constantly feeling tired
  • Disturbed sleep pattern with some sleeping significantly more, while others experience insomnia
  • Inability to sleep
  • Depressed mood, feelings of worthlessness and lack of interest or pleasure in everyday activities
  • Diminished ability to concentrate making it difficult to pay or maintain attention and are often slower in making decisions
  • A tendency to focus on the negative, while ignoring the positives and in some cases experience recurrent thoughts of self-harm, death or suicide
• Cognitive Approach to Explaining Depression

  Beck's Negative Triad Explanation of Depression
• Beck's Negative Triad Explanation of Depression

  • Cognitive biases and negative self-schemas maintain the negative triad, a negative and irrational view of ourselves, our future and the world around us
  • These thoughts occur automatically and are symptomatic of depressed people
• Components of the Negative Triad

  • Negative views about the self
  • Negative views about the world
  • Negative views about the future
• Example of the Negative Triad


  • Greg believes that he is worthless and that his friends don't enjoy spending time with him, as a result he ignores their phone calls. He thinks that this will always be the case so there is no point in trying as all his friends are only inviting him out of politeness and they don't really want him there because he ruins everything.
• Cognitive approach to explaining depression

  Based on the assumption that negative and irrational thinking is the cause of depression
• Cognitive approach to treating depression

  • Aims to challenge unhelpful thoughts and replace them with more rational ones
  • Includes therapies like CBT and REBT
• CBT


  1. Therapist teaches clients to identify distorted cognitions

  2. Clients learn to discriminate between their own thoughts and reality

  3. Clients learn the influence of cognition on their feelings

  4. Clients are taught to recognise, observe and monitor their own thoughts

  5. Behavioural aspect involves setting homework to challenge irrational beliefs
• Beck's approach to CBT


  • Patient and therapist work together to clarify the patient's problem and identify the negative thoughts that would benefit from challenge
  • Negative thoughts must be challenged by the person taking an active role in their treatment
  • Therapeutic relationship is important and the patient is seen as a scientist
• Ellis' REBT


  Adds D-disputing (where the thoughts are challenged) and E-effects (the change in feelings following the change in the rational belief)
• Techniques used in CBT to challenge irrational thoughts/beliefs

  • Disputing
  • Restructuring
  • Behavioural Activation
  • Data Gathering
• Homework is set following a CBT session and this is also part of the 'behavioural' aspect of CBT
• Depression is a category of mood disorders, to be given a diagnosis of depression, sufferers are required to display at least five symptoms, every day, for at least two weeks
• Characteristics of Depression


  • Reduction in energy and constantly feeling tired
  • Disturbed sleep pattern
  • Depressed mood, feelings of worthlessness and lack of interest or pleasure in everyday activities
  • Diminished ability to concentrate making it difficult to pay or maintain attention and are often slower in making decisions
  • A tendency to focus on the negative, while ignoring the positives and in some cases experience recurrent thoughts of self-harm, death or suicide
• Beck's Negative Triad


  Negative and irrational view of ourselves, our future and the world around us
• Example of Beck's Negative Triad


  • Greg believes that he is worthless and that his friends don't enjoy spending time with him as a result he ignores their phone calls. He thinks that this will always be the case so there is no point in trying as all his friends are only inviting him out of politeness and they don't really want him there because he ruins everything.
• CBT may not be an appropriate treatment for severely depressed individuals


  Patients with severe depression may not engage with CBT or even attend the sessions and therefore this treatment is not effective
• Antidepressant treatments


  May be more effective for severely depressed patients as they do not require the same level of motivation
• CBT cannot be used as the sole treatment for severely depressed patients and is not the most appropriate treatment in these cases
• Research by March et al (2007) found that CBT was as effective as antidepressants, in treating depression
• Combination of CBT plus antidepressants

  May be more effective than CBT alone
• Depression has significant economic implications, absence from work due to mental illness currently costs the UK £15 billion a year
• CBT is as effective as antidepressants in the short-term


  But is more effective in the long-term due to addressing the underlying negative thoughts contributing to the disorder
• CBT is time consuming, it's claimed that clients would need an average of 27 sessions to complete the treatment
• The cost of CBT to the NHS is prohibitively high but the longer-term benefits will have significant economic implications if the treatment has long term effects
• Some psychologists have criticised CBT, as it suggests that a person's irrational thinking is the primary cause of their depression and CBT does not take into account other contributing factors such as low levels of serotonin
• SSRIs are as effective as CBT, implying a biological treatment is also effective in treating depression
• Combination of antidepressants and CBT

  May be a better alternative treatment rather than CBT on its own
• Strengths of CBT


  • Aims to address the cause of depression and not just the symptoms
  • Challenges the negative thoughts that are assumed to be the cause of depression, rather than just reducing the symptoms like drug therapy
  • Offers a long term solution to managing depression as well as providing individuals strategies to deal with depression as it aims for clients to recognise their negative thoughts
• Cognitive Therapy treats the underlying cause of depression and this is a strength of the treatment
• The endocrine system is made up of glands that secrete hormones into the bloodstream.
• Hormones are chemical messengers produced by the body which travel through the blood stream to target organs or tissues where they produce an effect.
• Hormones are chemical messengers produced by various organs or tissues, including the pituitary gland, thyroid gland, adrenal glands, pancreas, ovaries (in females), testes (in males), and placenta during pregnancy.
• US ABC MODEL EXPLANATION OF DEPRESSION

  • Es took a different approach from Beck (negative triad) to explaining depression
  • Es started by explaining what is required for good mental health
• Good mental health


  The rest of king which allows people to be happy and pain free
• Depression


  Irrational thinking which prevents us from being happy and pain from
• 1. B-C three stage model

  1. Activating Event

  2. Beliefs

  3. Consequences
• Activating Event


  • You pass a friend in the corridor at school and he pores despite the fact you said 'hello'
• Beliefs


  Your interpretation of the event, which can either be rational or irrational