CBT for Depression Flashcards
What is a single episode depressive disorder?
Single episode depressive disorder is characterised by the presence or history of one depressive episode when there is no history of prior depressive episodes.
What is considered a depressive disorder?
A depressive episode is characterised by a period of depressed mood or diminished interest in activities occurring most of the day, nearly every day during a period lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue.
What is a recurrent depressive disorder?
Recurrent depressive disorder is characterised by a history or at least two depressive episodes separated by at least several months without significant mood disturbance.
What are the different levels of severity of depression and what do each of these mean?
Mild: No dramatic interference with daily life, maybe long-term “low level” symptoms
Moderate: Symptoms interfere with daily life to a considerable degree
Severe: Serious interference with all of life
Psychotic features: So severe that grasp on reality is lost, might experience delusions or hallucinations etc.
What are three of the things we’re aiming to achieve in CBT for depression?
1) Increase engagement in meaningful and rewarding activity
2) Overcome avoidance of problems and promote active engagement in problem-solving
3) Develop ability to identify and challenge negative patterns of thinking
What does Ferster’s (1973) behavioural approach to depression propose?
-Depression seen as primarily being a disorder of avoidance
Depressed behaviour is typically centred on escaping an aversive environment (internal/external) or avoiding aversive conditions
This avoidance in turn reduces the likelihood of coming into contact with positive reinforcement from the environment and prolongs the depression
What is an aversive environment?
In psychology, aversives are unpleasant stimuli that induce changes in behavior via negative reinforcement or positive punishment.
Outline the typical chain of the behavioural model of depressions?
1) There is a negative stressful life event?
2) Life is then experienced as being less rewarding
3) Feel sad, tired, indifferent,
4) Stop all key activities
5) Social/societal problems occur
Last 3 stages repeat in a vicious cycle.
Briefly outline the getting stuck in a depression loop?
Avoidance, isolation, rumination.
Explain the being stuck in depression analogy via the maintenance factors?
Avoidance, isolation, rumination are like digging to get out of a whole?
Explain the action before emotion idea if overcoming depression?
We often wait to feel better before doing something
BUT – anxiety and depression are self-protective processes that try to keep us safe by making us avoid or isolate. So as long as we follow the lead of the anxiety or depression, we’ll continue to feel less motivated and want to avoid/isolate even more. We can’t rely on our brain to give us the motivation to get moving!
So, ACTIVATE FIRST! Activity changes our brain-state and can make us feel instantly a bit better
What are the two main types of activities we’ll want to initiate in BA?
Pleasure tasks such as…
Achievement tasks…
What are up and down activities in BA?
Up activities are activities that lift mood and that we want to increase. Down activities are activities that lead to low feelings (Decrease).
In a CBT (depression) assessment what areas might we want to learn about?
Negative, thought/beliefs
Rumination and self-attacking thoughts
Emotional distress
Withdrawal/avoidance
Unhelpful behaviour
Motivation + physical symptoms
What themes are thought to characterise depression mode?
loss, defeat, failure, worthlessness and unlovability