depression

• Depression is a mood or affective disorder and involves prolonged disturbances of mood and emotion. Involves low mood or energy and loss of interest.
• emotional characteristics of depression

  Lowered mood and low self esteem.
• Behavioural characteristics for depression

  Low levels of energy sometimes lethargic

  Disruption to sleep like insomnia or hypersomnia

  Verbal aggression
• Cognitive characteristics of depression

  Poor levels of concentration

  Paying more attention to negative aspects of a situation and ignore the positives
• cognitive primacy= depression being caused by negative and irrational thought processes
• Becks proposed that one has a cognitive vulnerability towards developing depression, through faulty information processing, negative self-schemas and the cognitive triad of automatic negative thoughts. Through faulty information processing, the patient blows small problems out of proportion, attending to and dwelling on the negative, whilst thinking in ‘black and white’ terms.
• Through negative self-schemas, the patient interprets all information about themselves from the world in a negative light, further lowering their self-confidence. Through the cognitive triad, the patient suffers from negative automatic thoughts about the self, the future and the world.
• A range of evidence supports that depression is associated with faulty info processing, negative self schema and the negative traid .E.g. Grazioli et al found that women with pre-existing cognitive vulnerabilities were more likely to develop post-natal depression than women without. Therefore, all of the supporting evidence suggests that beck may be correct in the assumption of cognitive primacy. This evidence gives his explanation scientific credibility.
• Another strength is that it has practical applications. All cognitive aspects of depression can be identified in CBT. these include components of the negative triad. The therapist can challenge these thoughts and encourage them to be replaced with more accurate and positive thoughts. This is a strength of the explanation because explanation can be transferred into a therapy. And helps to improve the patients quality of life.
• One problem with Becks explanation is it doesnt explain all aspects of depression. It only seems to explain the cognitive symptoms and ignores emotional and behavioural factors. However, depression is more complex and some patients are deeply angry or suffer hallucinations that cant be explained by becks ideas alone. Therefore Becks theory cannot explain the more complex cases of depression
• Ellis also focused on irrational beliefs as the source of depression. He defined irrational thoughts as those that interfere with us being happy and free of pain. It is not what happens to someone that causes depression but how they deal with it.
• ABC model

  A=Activating Event. like getting fired

  B=Belief. these can be rational or irrational

  C=Consequence. Rational beliefs lead to happy and positive emotional response whereas irrational beliefs lead to a negative emotional response that may develop into depression.
• One strength of Ellis's ABC model is its real world applications in the treatment of depression. REBT designed by Ellis aims to alter irrational beliefs into rational beliefs b y using the ABC approach. Supporting evidence from David et al found it can change negative beliefs and relieves symptoms of depression. Suggesting it is an effective treatment.
• One limitation of Ellis's model is that it only explains reactive depression and not endogenous depression. Life events can cause reactive depression because we respond to negative life events. Some types of depression is not linked to life events and is difficult to identify the cause. This means that the model is only a partial explanation for causes of depression.
• CBT

  Becks aims to change the way a client thinks by challenging irrational/negative thought processes. This can lead to change in behaviour as a response to new thinking patterns known as thought restructuring.
• CBT applies Becks theory of depression. Firstly, it begins with the therapist working with the patient to assess the problem. The aim is to identify automatic thoughts about the world, future, self (negative triad). Once these thoughts have been captured they are challenged through reality testing. It can be investigated through setting 'homework' which logs situations, this helps test the reality of negative beliefs and use it as evidence to challenge patients irrational beliefs.
• Ellis Rational Emotional Behavioural Therapy (REBT)

  It involves disputing irrational thoughts and beliefs, the therapist challenges them and encourages the client to think of alternative explanations. The aim is to replace irrational beliefs with more rational interpretations of events. This ay be through logical argument or empirical argument. This breaks the negative links between negative life events and depression.
• One strength is the supporting evidence for the effectiveness of CBT for treating depression. March et al compared effects of CBT with anti depressants and a combination of the two in adolescents with depression. After 36 weeks 81% CBT group were equally improved a the anti depressant group. This shows that CBT is just as effective as medication and there is is a good argument for making it first choice treatment in NHS.
• A further limitation of CBT is its high relapse rate. IT seems to be effective in tackling symptoms of depression, but there is an uncertainty of how the benefits last. Early studies looking at the long term outcomes found 42% relapsed into depression within six months of ending treatments and 53% relapsed within a year. This means CBT may need to be repeated more frequently.
• One limitation of CBT is the lack of effectiveness for severe cases and for clients with learning disabilities. severe cases of depression may cause patient to be de-motivated and not being able to engage in CBT. They may not pay attention to what is happening in the session. This suggests that CBT alone wouldnt be used as a sole treatment and may not be appropriate for a specific range of people with depression.