Depression

Question 1

Unipolar Depression

Answer 1

Individual has no history of mania

Behaviour returns to normal when the depression lifts

Question 2

Bipolar Disorder

Answer 2

Experiences periods of mania that alternate with periods of depression.

Question 3

How common is Unipolar Depression?

Answer 3

15% worldwide population will experience a severe episode.
Twice as many women (but milder).
Dramatic increases in younger ages.
White Americans have higher rates than African-Americans.
85% recover without treatment but 40% will have a further episode.

Question 4

Unipolar Depression Symptoms

Answer 4

Feeling miserable, empty, humiliated
Poor memory
Headaches, indigestion, dizziness
Appetite and Sleep Disturbances
7-15% commit suicide
Perform as well as non-depressed people but think they have done a lot worse.

Question 5

The 5 Functioning Areas Affected by Depression

Answer 5

Emotional - Feeling miserable, empty, humiliated
Motivational - Lacking Drive and Spontaneity
Behavioural - Less active, less productive
Cognitive - Pessimistic, blames themselves
Physical - Headaches, general pain

Question 6

Diagnosing Unipolar Depression

Answer 6

A major depressive episode is a period of two or more weeks marked by 5 or more symptoms of depression.
In extreme cases, symptoms are psychotic such as hallucinations.

Question 7

DSM-5 list several types of depression…

Answer 7

Major Depressive Disorder - People who experience a major depressive episode with no history of mania.
Dysthymic Disorder - People who experience a longer lasting (2 years +) but less disabling pattern of depression.
Premenstrual Dysphoric Disorder - Women who repeatedly experience depressive symptoms during the week before menstruation.
Disruptive Mood Regulation Disorder - A combination of persistent depressive symptoms and recurrent outbursts of severe temper.

Question 8

Stress and Unipolar Depression

Answer 8

People with depression experience a greater number of stressful life events during the month before their onset of symptoms.

Question 9

Biological Model of Unipolar Depression

Answer 9

Genetic Factors - twin studies, family lineage

Biochemical Factors - neurotransmitters, hormone release

Question 10

Biological Treatments of Unipolar Depression

Antidepressant Drugs:

Answer 10

MAO Inhibitors:
Works by slowing down the body’s production of MAO. MAO breaks down norepinephrine and inhibitors stop this breakdown occurring. This leads to a rise in norepinephrine activity and a reduction in depressive symptoms. 50% of patients are helped by these.

Question 11

Biological Treatments of Unipolar Depression

Antidepressant Drugs:

Answer 11

Tricyclics:
To prevent neurotransmitters from remaining in the synapse for too long, a pump-like mechanism recaptures the NT and draws it back into the presynaptic neuron. This reuptake process draws in too much NT for some people and this reduction is thought to cause depression. Tricyclics block the reuptake process, thus increasing NT activity in the synapse.

Question 12

Biological Treatments of Unipolar Depression

Antidepressant Drugs:

Answer 12

Second Generation Antidepressants:
Structurally different from tricyclics and MAO inhibitors.
These drugs increase the activity of serotonin specifically and no other NT.
Named SSRI’s.

Question 13

Biological Treatments of Unipolar Depression

Brain Stimulation:

Answer 13

Vagus Nerve Stimulation
Transcranial Nerve Stimulation
Deep Brain Stimulation

Question 14

Psychological Models of Unipolar Depression

Answer 14

Psychodynamic Model - no research
Behavioural Model - modest research
Cognitive Model - considerable research

Question 15

Psychodynamic Model

Answer 15

Link between grief and depression.
When a loved one dies, an unconscious process begins and the mourner regresses back to the oral stage. They merge their identity with that of the lost person, symbolically regaining them. This reaction is temporary but if grief is severe, then depression results.

Question 16

Psychodynamic Treatment

Answer 16

Only occasionally helpful for unipolar depression.
Limiting Reasons:
Depressed clients may be too passive to fully participate in subtle therapy discussions.
Depressed clients may become discouraged and end treatment too early when quick relief isn’t provided.

Question 17

Behavioural Model

Answer 17

Depression results from the changes in rewards and punishments people receive in their lives.
Positive rewards in life dwindle for some people, leading them to perform fewer constructive behaviours and spiral towards depression.

Question 18

Behavioural Treatment

Answer 18

Reintroduce clients to pleasurable activities, often using a weekly schedule. Help improve their social skills and appropriately reinforce their depressive and non-depressive behaviours.
Technique results are limited unless more than one is applied.

Question 19

Cognitive Model

Learned Helplessness and Negative Thinking

Answer 19

Learned Helplessness: People become depressed when they think that they no longer have control over the reinforcements in their lives and that they are responsible for this helpless state.
Theory is based on Seligman’s work with lab dogs.

Negative Thinking: Self-defeating attitudes that develop during childhood. Dysfunctional beliefs lead to the triad - negative view on 1) themselves 2) the world 3) the future

Question 20

Cognitive Treatment

Answer 20

Beck’s Cognitive Therapy: Helps clients recognise and change their negative cognitive processes.

Question 21

The Socio-Cultural Model of Unipolar Depression

Answer 21

Depression is greatly influenced by the social context that surrounds people.

Question 22

Sociocultural Views

Answer 22

Family-Social Perspective

Multicultural Perspective

Question 23

The Family Social Perspective:

Answer 23

The belief in the connection between declining social rewards and depression. People who are separated/divorced display three times the depression rate.
Treatment - interpersonal therapy, couple therapy

Question 24

Multicultural Perspective

Answer 24

The belief that gender and cultural background have big links to depression.
Women are twice as likely as men to be diagnosed with depression.
Non-western countries are more likely to suffer from physical symptoms of depression than cognitive ones.