Depression

• DSM-V categories of Depression:

  • Major Depressive Disorder
  • Persistent Depressive Disorder
  • Disruptive Mood Dysregulation Disorder
  • Premestrual Dysphoric Disorder
• Characteristics of Depression:

  • Emotional - Lowered mood/self-esteem, anger
  • Behavioural - aggression (self-harm), disruption to sleep/eating
  • Cognitive - poor concentration, absolutist thinking
• Cognitive Approach to Explaining Depression:

  Individuals have distorted (Beck) and irrational thinking (Ellis) which causes the disorder than the problem itself
• Beck's Model of Depression:

  • Faulty information processing (errors in logic)
  • Negative self-schema (thinking)
  • negative triad (self, world, future)
• Weissman and Beck (1978):

  Aim: investigate the thought process of depressed people

  Procedure: thoughts were measured using the Dysfunctional Attitude Scale (DAS) by filling out a questionnaire of agree/disagree statements

  Results: depressed ppt have more negative assessments than non depressed ppts
• Ellis' ABC Model:

  • Activating event (irrational thoughts)
  • Belief (musterbation)
  • Consequences
• Musterbation - setting standards so high to the point where failure is inevitable
• Cognitive Approach to Treating Depression:

  • Cognitive Behaviour Therapy (CBT)
  • Ellis' Rational Emotive Behaviour Therapy (REBT/ABCDE)
  • 'Patient as scientist'
• Ellis' Rational Emotive Behaviour Therapy (REBT): DEF

  • Disrupting (irrational thoughts)
  • Effects (of disrupting)
  • Feelings (new feelings produced)
• Beck's Cognitive Therapy:

  • Assessing the severity of the condition
  • Therapist establishes a baseline and uses reality testing on the patient
  • the therapist will then set homework for the client to demonstrate their ability to succeed
• Cognitive Behavioural Therapy (CBT):

  • CBT is the most common treatment it uses both behavioural (Ellis) and cognitive (Beck) methods
  • CBT consists of 5-20 sessions weekly/fortnightly of 30-60 minutes of both Beck and Ellis techniques
• Major Depressive Disorder - severe but often short-term depression
• Persistent Depressive Disorder - long term/recurring depression including sustained major depression
• Disruptive Mood Dysregulation Disorder - intense, frequent childhood temper tantrums
• Premenstrual Dysphoric Disorder - Disruption to mood prior to/during menstruation
• Biological Approach to Treating Depression:

  • Drug Therapy
  • Selective Serotonin Reuptake Inhibitor (SSRI's)
• Selective Serotonin Reuptake Inhibitors (SSRIs) - increase the level of serotonin available in the synapse by preventing it from being reabsorbed into the sending cell. This increases the level of serotonin in the synapse and results in more serotonin being received by the receiving cell 
• Alternatives to SSRI's:

  • Tricyclics
  • SNRI's
  • Anti-anxiety drugs (GABA)
• Anti-anxiety Drugs (GABA) - tells neurons in the brain to ‘slow down’ and ‘stop firing’; around 40% of the neurons in the brain respond reducing anxiety caused by obsessive thoughts
• Serotonin Norepinephrine Reuptake Inhibitors (SNRI's) - also work similarly to SSRI's, however, they also block the reuptake of norepinephrine aswell as serotonin
• Patient as Scientist:

  Patients are made to reality test their irrational belief, and are set homework to counterprove their irrational thought