Depression

• Depression


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


  • Lethargy (Reduced levels of energy),
  • Changes to eat/sleep patterns (disruptions to their sleeping behaviour and eating behaviour),
  • Aggression and self-harm (Physical aggression directed at the self – (self-harm), Verbal aggression)
• Emotional characteristics of depression

  • Lowered mood (feeling of lethargy and sadness daily)
  • Lowered self-esteem (Reduced self-esteem)
  • Loss of enthusiasm (Loss of interest)
• Cognitive characteristics of depression

  • Poor concentration (Difficulty in maintaining attention)
  • Dwelling on negative (Inclined to pay more attention to negative aspects of a situation and ignore the positives.)
  • Absolutist thinking (Black and white thinking – unfortunate situation is seen as an absolute disaster)
• Aaron Beck's cognitive theory of depression


  Faulty thinking leads you to see things differently in a bias way
• Schemas

  A package of ideas and information developed through experience
• Three parts to cognitive vulnerability


  • Faulty information processing
  • Negative self-schemas
  • The Negative triad
• Faulty thinking


  • Polarised or selective thinking
• Negative self schemas


  • Interpret all information about ourselves in a negative way. Come from negative experiences developed during childhood/ teenage years
• Negative triad


  • Negative view of the world (Perceive the world in a negative manner)
  • Negative view of the future (Perceive the future in a negative manner)
  • Negative view of the self (Perceive yourself in a negative manner)
• Ellis's ABC Model


  Anxiety and depression are the result of irrational thoughts
• Good mental health


  The result of rational thinking- thinking that allows happiness and no pain
• Ellis's ABC Model


  1. Activating event (A)

  2. Irrational belief (B)

  3. Emotional consequence (C)
• Activating event


  Focuses on situation in which irrational thoughts are triggered by external events. Depression occurs when we experience negative events and trigger irrational beliefs
• Beliefs


  Irrational beliefs
• Consequences


  When an activating event triggers irrational beliefs there are emotional and behavioural consequences
• Cognitive explanation for depression

  Depression is due to faulting thinking and irrational thoughts
• Becks' cognitive vulnerability towards developing depression


  • Faulty information processing
  • Negative self-schemas
  • The cognitive triad of automatic negative thoughts
• Beck explanation eval - Good supporting evidence

  • Depression associated with faulty information processing. Research on this topic and concluded that there was solid support for all these cognitive vulnerability factors. These cognitions can be seen before depression develops, suggesting that cognition could cause depression.
  • Grazioli and Terry(2000) assessed  (BDI) 65 pregnant women for cognitive vulnerability and depression before and after birth. Found that those women were judged to be high in cognitive vulnerability and thus more likely to suffer from post-natal depression. 
• Beck explanation eval - Practical application (CBT)

  • It forms the basis of cognitive behaviour therapy (CBT), therefore it has real-life application and usage. All cognitive aspects of depression can be identified and challenged in CBT. Includes components of the negative triad- easily identifiable. It translates into a successful therapy and demonstrates that irrational thoughts can be a cause of depression
• Beck explanation eval - Support from attachment

  • Studies of attachment have shown that those infants that develop insecure attachments to their parents are more vulnerable to depression in adulthood. Beck’s explanation of negative schema supports this.
• Beck explanation eval - Doesn’t explain all aspects of depression

  • Fails to explain this extreme emotion of deep anger/ bipolar depression, hallucination, or bizarre beliefs. Beck’s theory cannot explain all these cases so further explanation is needed. As a result, the theory is weakened as it doesn’t offer a full in-depth explanation as all aspects of depression aren’t considered – solely focuses on one aspect.
• Beck explanation eval - Chicken or egg?

  • We are not sure if faulty thinking causes depression or depression causes faulty thinking, therefore it may suggest that other points such as genes and neurotransmitters can be the cause of depression.
• Beck explanation eval - Ignores biological factors

  • It overemphasises the important of thought processes and ignores biological explanations. Research suggesting genes and neurotransmitters cause depression e.g. low level neurotransmitter serotine found in the brain of depressed patients.
  • Furthermore, drug therapies, increasing the level of serotonin is effective in treatment of depression suggesting that biological explanations could be correct.
• Ellis explanation eval - Practical application in CBT

  • Led to successful therapy. The idea that by challenging irrational negative beliefs a person can reduce their depression is supported by research evidence (Lipsky et al 1980) Supports the theory as it suggests that the irrational beliefs have a role in depression.
• Ellis explanation eval - Partial explanation

  • Some cases follow activating agents – reactive depression. Fails to provide an explanation of depression that arises without an obvious cause, so is a partial explanation for depression and further explanations are needed.
• Ellis explanation eval - Doesn’t explain all aspects of depression

  • Explains why some people may be more vulnerable to depression than others due to their cognitions. Doesn’t explain the anger associated with depression or hallucinations and delusions.
• Beck explanation evals

  • Good supporting evidence - Grazioli and Terry (BDI)
  • Practical application (CBT)
  • Support from attachment
  • Doesn’t explain all aspects of depression
  • Chicken or egg?
  • Ignores biological factors
• Ellis explanation evals

  • Practical application in CBT
  • Partial explanation
  • Doesn’t explain all aspects of depression
• Cognitive behaviour therapy (CBT)

  The therapy aims to deal with thinking, such as challenging negative thoughts. Also includes behavioural techniques such as behavioural action.
• Beck's cognitive therapy


  Identify automatic thoughts about the world, the self and the future – this is the negative triad.
• Correcting a person's negative thoughts


  1. Client learns to identify irrational thoughts

  2. Therapist challenges the thoughts

  3. Validity testing
• Identifying irrational thoughts


  Keep record of events that trigger negative thoughts (BDI completed to identify emotions)
• Challenging thoughts


  Use of logical questioning techniques to bring about cognitive restructuring so they think differently
• Validity testing


  'patient as scientist' test validity of negative thoughts by behavioural task in real world. Outcome discussed in follow up session
• Cognitive restructuring and behaviour tasks


  Result in a person's cognition changing to a more positive one and thus alleviating their depression
• Ellis's rational emotive therapy (REBT)

  REBT extends the ABC model ABCDE model – D stands for dispute and E for effort.
• Central technique of REBT

  1. Identify the clients irrational beliefs

  2. Irrational beliefs disputed

  3. Homework

  4. Behavioural activation
• Identifying irrational beliefs


  Therapist identifies the client's irrational thoughts that is causing depression
• Disputing irrational beliefs


  Therapist is to dispute the patient's irrational beliefs and replace them with rational beliefs (logical, empirical, pragmatic - serve no purpose)