Depression

• Depression


  A prolonged feeling of helplessness, hopelessness, and sadness

  
• Major depressive disorder


  A mood disorder in which a person experiences, in the absence of drugs or a medical condition, two or more weeks of significantly depressed moods, feelings of worthlessness, and diminished interest or pleasure in most activities.
• Persistent depressive disorder


  A form of depression that is not severe enough to be diagnosed as major depressive disorder

  
• Disruptive mood dysregulation disorder


  A childhood disorder marked by severe recurrent temper outbursts along with a persistent irritable or angry mood

  
• Premenstrual dysphoric disorder


  A disorder marked by repeated episodes of significant depression and related symptoms during the week before menstruation

  
• Behavioural characteristics of depression

  - Activity levels

  - Disruption to sleep and eating behaviour

  - Aggression and self harm

  
• Psychomotor agitation


  Increased motor activity associated with restlessness, including physical actions (e.g., fidgeting, pacing, feet tapping, handwringing).

  
• Emotional characteristics of depression

  - Lowered mood

  - Anger

  - Lowered self-esteem

  
• Cognitive characteristics of depression

  - Poor concentration

  - Attending to and dwelling on the negative

  - Absolutist thinking

  
• Beck's negative triad


  Three kinds of negative thinking that lead to depression

  1. negative view of the world - cold, hard place

  2. negative view of the future - things will always be this way

  3. negative view of the self - failure
• Faulty information processing


  - When depressed we attend to the negative aspects of a situation and ignore the positives.

  - We also tend to blow small problems out of proportion and think in 'black and white' terms.
• Negative self-schema


  - A schema is a 'package' of ideas and information developed through experience.

  - Act as a mental framework for the interpretation of sensory information.

  - A self-schema is the package of information people have about themselves.

  - People use schema to interpret the world, so if a person has a negative self-schema they interpret all information about themselves in a negative way.
• Strengths of Beck's negative triad

  Research support

  - Cohen et al (2019) tracked the development of 473 adolescents, regularly measuring cognitive vulnerability.

  - Found that showing cognitive vulnerability precited later depression.

  
  

  Real-world application

  - Understanding cognitive vulnerability can be applied in cognitive behaviour therapy.
• Ellis' ABC Model


  An explanation that sees depression occurring through an activating agent, a belief and a consequence.
• A Activating Event


  The A in the ABCDE model of cognitive therapy; the occurrence that initiates the sequence of mental events that may prompt illogical cognitions or beliefs
• B Beliefs


  The thoughts that occur after the activating event, may be rational or irrational
• C Consequences


  - When an activating event triggers irrational beliefs there are emotional and behavioural consequences.

  - For example, if a person believes that they must always succeed and then fails at something this can trigger depression.
• Strength of Ellis' ABC Model

  Real-world application

  - Rational emotive behaviour therapy (REBT)
• Limitation of Ellis' ABC Model


  Partial explanation

  - It only explains reactive depression and not endogenous depression.

  
  

  Ethical issues

  - It locates responsibility for depression purely with the depressed person.
• Cognitive behaviour therapy


  A popular integrated therapy that combines cognitive therapy (changing self-defeating thinking) with behaviour therapy (changing behaviour).
• Irrational thoughts


  - Also called dysfunctional thoughts.

  - In Ellis's model and therapy, these are defined as thoughts that are likely to interfere with a person's happiness.

  - Such dysfunctional thoughts lead to mental disorders such as depression.
• Beck's cognitive therapy


  A type of cognitive therapy, in which the therapist works to develop a warm relationship with the person and has the person carefully consider the evidence for his or her beliefs in order to see the errors in his or her thinking.
• Ellis' Rational Emotive Behaviour Therapy


  A type of psychotherapy that is based on the view that events do not directly cause emotions, but rather our beliefs about events influence our emotional responses.
• Behavioural activation


  - A therapy for depression focusing on encouraging patients to engage in those activities they are avoiding.

  - The goal of the intervention is to increase environmental reinforcement.
• Strengths of cognitive behaviour therapy

  Evidence for effectiveness

  - March et al (2007) compared CBT to antidepressant drugs.

  - After 36 weeks, 81% of the CBT group and 81% of the antidepressants group were significantly improved.
• Limitations of cognitive behaviour therapy

  Suitability for diverse clients

  - May only be appropriate for a specific range of people with depression.

  
  

  Relapse rates

  - Ali et al (2017) - 42% of clients relapsed into depression 12 months after CBT.