Abnormal Psychology

Depression and its Treatments

 Types of Depression

Unipolar - this is sometimes caused a major depressive episode. Symptoms

for this type include having a depressed mood for most of the day,
diminished pleasure in most activities undertaken, some weight loss,
insomnia or hypersomnia, some psychomotor agitation, fatigue, feelings of
worthlessness and a reduced ability to concentrate on tasks.
Bipolar - this used to be referred to as manic depression. Symptoms for this
type include having episodes of manic behavior that cannot be accounted
for by a physical condition, having some episode that is similar to unipolar
depression (although this is not necessary for a diagnosis) and having some
change in polarity of behavior between mania and depression.
 Causes

Biological - There may be a genetic cause. The genetic argument follows the
idea that depression may well run in families and be encoded in genetics. Also
linked with production of neurotransmitters like serotonin and norepinephrine.
Cognitive - Beck ( L976) was interested in examining the irrational thought
processes involved in depression. He believed that there were three factors
which make people cognitively vulnerable to depression.
negative view of self
negative view of the world
negative view of the future.
Depressives may also have negative self-schemas (packets of
information about themselves) that have developed since
childhood by having negative experiences and/or overly critical
parents, peers or teachers.
 Causes

Learned helplessness/attributional style: Learned helplessness is about individuals becoming

passive because they feel they are not in control of their own life. It is caused by unpleasant
experiences that they have tried lo control in the past (unsuccessfully). This gives people a
sense of helplessness which in turn leads to depression. Weiner et al ( 1971) noted three levels
of
attribution that can affect people's views of their own behaviour:
1. internal (personal) or external (environmental)
2. stable or unstable
3. global or specific.
 Treatments of Depression - Biological

Selective serotonergic re-uptake inhibitors (SSRIs): are a class of drugs that are typically used as
antidepressants in the treatment of major depressive disorder and anxiety disorders. SRIs are believed
to increase the extracellular level of the neurotransmitter serotonin by limiting its reabsorption into the
presynaptic cell, increasing the level of serotonin in the synaptic cleft available to bind to the
postsynaptic receptor.

Monoamine oxidase inhibitors (MAOls) these work by inhibiting monamine oxidase (this breaks
down neurotransmitters such as norepinephrine and serotonin) which means more serotonin and
norepinephrine is available in the synapse

Electro-convulsive therapy: is a procedure, done under general anesthesia, in which small electric
currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause
changes in brain chemistry that can quickly reverse symptoms of certain mental illnesses.
 Treatments of Depression Cognitive Restructuring

The idea of this therapy follows Aaron Beck's cognitive triad approach
to the potential causes of depression. It is a six-stage process as
follows:

1. The therapist explains the rationale behind the therapy and what its
purpose is.
2. Clients are taught how to monitor automatic negative thoughts and
negative self-schemata.
3. Clients are taught to use behavioural techniques to challenge
negative thoughts and information processing.
4. Therapist and client explore how negative thoughts are responded to
by the client.
5. Dysfunctional beliefs are identified and challenged.
6. The therapy ends with clients having the necessary "cognitive tools"
to repeat the process by themselves.
 Treatments of Depression Cognitive Restructuring

Hans & Hiller (2013) conducted a meta-analysis on the effectiveness of CBT on adults
with unipolar depression. A total of 34 studies formed the analysis and they had to
assess the effectiveness of individual or group CBT as well as drop-out rates. The
studies also had to have at least a six-month follow up. CBT was effective in reducing
depressive symptoms and these were maintained at least six months after the CBT
ended. The average drop-out rate was 24.63 per cent.

Cuijpers et al (2013) also conducted a review examining CBT in relation to depression

and comparing it to other treatments. A total of 115 studies were used and they had
to be a CBT study that either had a control group or a comparison other treatment
(e.g. psychotherapy or therapy). CBT was effective at reducing depression in adults but
the effect size was lower compared to other types of treatments
Treatments of Depression Rational Emotive Behavior Therapy

Albert Ellis (1962) stated that rationality consists of thinking in ways that allows us to reach our
goals; irrationality consists of thinking in ways that prevent us from reaching our goals. Humans
do not get emotionally disturbed by unfortunate circumstances, but by how they construct their
views of these circumstances through their language, evaluative beliefs, meanings and
philosophies about the world, themselves and others. The idea behind the therapy follows the
model:
Activating event - this refers to a fact, behaviour, attitude or an event.
Beliefs - the person holds beliefs about the activating event.
Cognitive - this is the person's cognitive response to the activating event as well as
emotions.
When utilizing cognitive restructuring in rational emotive therapy (RET), the emphasis is on two
central notions: (1) thoughts affect human emotion as well as behavior and (2) irrational beliefs
are mainly responsible for a wide range of disorders.
 Treatments of Depression Rational Emotive Behavior Therapy

The REBT framework assumes that humans have both innate rational (meaning self-helping,
socially helping, and constructive) and irrational (meaning self-defeating, socially defeating, and
unhelpful) tendencies and leanings.

REBT differs from other clinical approaches like psychoanalysis in that it places little emphasis on
exploring the past, but instead focuses on changing the current evaluations and philosophical
thinking-emoting and behaving in relation to themselves, others and the conditions under which
people live.

Szentagotai et al (2008) examined the effectiveness of REBT, CBT and drug therapy for the
treatment of a major depressive episode. There were 170 participants randomly assigned to
either the REST (n=57). CBT (n=56) or drug therapy (n=57) groups. In terms of depressive
symptoms, there were no significant differences between the three groups but the REBT groups
had an average score significantly lower than the drug therapy group.