OCD & depression

• forms of depression:

  • major depressive disorder
  • persistent depressive disorder
  • disruptive mood dysregulation disorder
  • menstrual depressive disorder
• behavioural characteristics:

  • activity, lethargic and struggling to relax
  • sleeping, insomnia
  • eating, increased or decreased eating
  • aggression, irritability, aggression or self-harm

  cognitive characteristics:

  • concentration, stray from tasks and a lack of focus
  • focusing on the negative, pessimistic outlook
  • absolutist thinking, bias recalling negative events

  emotional characteristics:

  • low mood, worthless or empty
  • anger, directed at self or others
  • self-esteem, like themselves less
• Beck's cognitive triad: explaining depression

  • suggests that it is all down to faulty information processing. - selective attention to negatives
  • depressed patients had a negative self-schema (process of information about oneself)
  • cognitive vulnerability, way of thinking that might be more likely to expose someone to depression - almost always lead to depression
• evaluation of beck's cognitive triad:

  
  

  strength:

  • Terry (2000), assessed 65 pregnant women for cognitive vulnerability and depression - found that women who suffered more from cognitive vulnerability were more likely to suffer postnatal depression
  • practical value, forms a basis of CBT as each aspect of the triad can be easily identified

  weakness:

  • cannot explain why some people feel extremely angry if they have depression - some people suffer with hallucinations
• Ellis' ABC model: suggesting that depression was the result of irrational thoughts.

  • an activating event may be trauma, loss or grief, illness. This event triggers and slowly forms depression as underlying issues
  • the person then has either irrational or rational beliefs
  • finally, they will either face positive or negative consequences dependent on their beliefs
  • they may develop musterbatory thinking, a type of irrational thinking that involves rigid expectation for oneself or others
• Ellis' ABC model evaluation:

  
  

  strengths:

  • application to therapy, used to develop treatments for depression - CBT. - identify thoughts and treat people with depression
  • Bates (1999) found that patients with depression who were given negative automatic thought statements became more depressed - negative thinking leads to depression

  weakness:

  • alternative explanation - biological element
  • does not explain origin of irrational thoughts, unable to determine if these thoughts cause depression or if depression causes these thoughts
• CBT; cognitive treatment for depression

  • Homework – the patient investigates the reality of their irrational negative beliefs. This can be through keeping a diary, being given a task to complete, or to record evidence.
  • Behavioural action – the patient is encouraged to engage in pleasurable activities. – there are attempts to reduce avolition symptoms (avolition meaning lack of motivation or desire to participate in goal-orientated activities/ behaviours).
  • Unconditional positive regard – the therapist convinces the patient of their value as a human being.
• evaluation of CBT:

  
  

  strengths

  • come in a range of formations - online, face to face, apps, groups, making it mort suitable for patients needs and is adaptable
  • cost-effective

  weakness:

  • requires commitment and motivation to engage with the therapy - problematic with those who have severe depression
  • relies on patients recording their thoughts and feelings - may not be honest and may downplay their thoughts - difficult to verify and may reduce effectiveness of the therapy
• OCD: an obsessive-compulsive disorder that involves repetitive behaviour and obsessive thoughts
• OCD

  behavioural characteristics:

  • compulsions, repetition of specific acts to reduce anxiety, handwashing, counting and repeating phrases
  • avoidance - removing yourself from the presence of triggering events to help reduce anxiety

  cognitive characterstics:

  • obsessive thoughts - reoccurring thoughts that are unpleasant towards others or yourself - linked with contamination of their environment
  • cognitive coping strategies - ways of dealing with their obsessions - counting, meditation
  • insight - awareness behaviour is not rational, become very aware of their surroundings
• OCD

  emotional characteristics:

  • anxiety - repetitive behaviour that can be considered overwhelming
  • depression - low mood and a lack of enjoyment when carrying out small task
  • guilt and disgust - developed irrational thoughts over small issues
• neural mechanisms: suggesting OCD is linked to the imbalanced levels of serotonin and dopamine.

  • serotonin - contributes to our overall well-being and enjoyment in life, helping the sleep cycle and digestive regulation - controlling our moods
  • dopamine - contributes to our own feelings of pleasure, repetition of behaviours can help the release of dopamine - controlling our pleasure

  low levels of serotonin = linked with OCD because it leads to anxiety, obsessions

  
  

  dopamine could possibly be released due to repetitive compulsions
• PET scans; have showed that people with OCD have an increased amount of anxiety in the orbitofrontal cortex - OFC

  
  

  worry circuit: the OFC identifies any worries, sending a worry signal to the caudate nucleus. From here, it filters the worry and determines whether it's a fear or not.

  This needs serotonin to function properly, otherwise the efficiency may affected - without serotonin, the worry passes through and sends it into the thalamus.

  As a result, the thalamus then becomes overwhelmed as it cannot determine whether the worry is a minor or major issue.
• treating OCD:

  • drug therapy, aiming to increase or decrease levels of neurotransmitters in the brain to either increase or decrease brain activity
• SSRI's: antidepressant, working to increase levels of serotonin in the synapse.

  • serotonin is released by presynaptic neurons and travels across a synapse
  • the neurotransmitter then chemically conveys the signal to the postsynaptic neuron where it is broken down.

  SSRI's are often used alongside CBT to treat OCD because they help to reduce a person's emotional symptoms - allowing a more engaging and cooperative CBT session
• evaluation of SSRI's:

  strength:

  • Soomro (2009) reviewed 17 studies that used SSRI's and compared them to placebos. -found that all 17 studies showed better outcomes for treatment when using SSRI'S.
  • cost-effective and non-disruptive to people's lives.

  weakness:

  • potential negative side effects, indigestion, blurred vision and damage to sex drive - reduced quality of life