Unipolar Depression Flashcards
Symptoms
1.affective symptoms - emotions such as tearful irritable
2. Cognitive symptoms - difficulty concentrating, negative thoughts
3.social symptoms - isolation , leaving work
4. Physical symptoms - weight gain , insomnia
Persistent sadness
Lack of pleasure
Hopelessness
Features
DSM-7% of population of USA have depression - uk is also 7%
WHO(2018)-350 million worldwide
Relatively common
Covid raised rates to 8-9%
Can effect any age
Women more likely
Reduced life span
Biological explanation AO1
•Monoamine hypothesis - depression is caused by abnormally low levels of monoamine neurotransmitters (serontonin, noradrenaline and dopamine) -> deregulation of monoamine neurotransmitters specifically low amounts of serotonin as serotonin regulates other neurotransmitters
•these neurotransmitters regulate the function of the brains limbic system including amygdala ,hypothalamus and hippocampus (Brains emotional centres)
•monoamine oxidase takes up these neurotransmitters -> people with depression have too much monoamine oxidase (enzyme that removes monoamine from synapse, should help to recycle neurotransmitters but for people with depression removes too much)
•tryptophan - amino acid that helps to create serotonin
Biological explanation AO3
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•Meyer et al -> pet scans showed an increase in MAO activity in key areas of the brain of depressed patients
•antidepressants increase monoamine neurotransmitters alleviate depression symptoms -> reduced monoamine are a possible cause
•delagado et al -> used special diet to lower tryptophan and found depressive symptoms returned for 67% of ppts-> can create special diets
•twin and adoption studies show clear evidence of a genetic aspect to depression - even in case of people who didn’t grow up around depressed relatives (wender et al)
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•biological explanation is not complete explanation -> twin and adoption studies do not show 100% concordance ( reductionist)
•thase et al - found that those with depression (especially severe) had mixed levels of monoamine neurotransmitters.
•may be possible that hormonal changes in cortisol , oestrogen and testosterone may be more significant to regulating mood then monoamine neurotransmitters .
•antidepressants take weeks to work plus 30% of people treatment resistant
Psychological explanation (cognitive)
Ao1
•becks explanation -> faulty or irrational thinking may be the root cause of depression (ie . Someone believes everyone dislikes them -> may develop feelings about themselves -> reinforces perception that everyone dislikes them)
•according to beck faulty cognitions stem from childhood (pessimistic , irrational beliefs) depressed people make major cognitive errors (cognitive triad)
• Ellis abc theory - activating event (external factors) , beliefs ( personal beliefs about events , consequence (irrational beliefs have emotional and behavioural consequences)
Psychological explanation cognitive AO3
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•Jonathan et al- measured self beliefs of 12000 pregnant women - those with most negative beliefs were more likely to become depressed then those with positive self beliefs -> cognitions occurred before onset of depression so supports becks view that negative beliefs cause disorders
• led to effective therapies such as CBT -> cognitive techniques are a part of successful treatment for depression which implies faulty info processing may be root of the disorder
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•dohr et al - negative self beliefs usually become positive once episode is over
•Brown -> substantial evidence that negative thinking accompanies depression but little evidence that it causes it
• neither Beck nor ellis theories can explain all aspects of depression -> mostly symptoms and features -> hard to see how negative cognitive triad and dysfunctional beliefs explain all differences ( reductionist)
• lacks predictive validity - doesn’t identity risk factors or who is most likely to become depressed -> better explanation for how depressive episodes are triggered
Unipolar depression - biological treatment AO1
•1st gen - monoamine oxidase inhibitors -> inhibits activity of monoamine oxidase -> prevents monoamine oxidase from breaking down monoamine neurotransmitters so more monoamine neurotransmitters are available -> initiators bind to monoamine oxidase -more serotonin available -> not used anymore
•2nd gen trycilic-> increases serotonin and moderates noradrenaline - no longer used due to symptoms it causes .
•3rd gen SSRI’s (selective serotonin reuptake inhibition) - most prescribed antidepressant (ie.setraline) -> serotonin is usually absorbed at the synapse -ssris block inhibiting reuptake -> more serotonin available -> selective ( only effects serotonin as seratonin manages noradrenaline and dopamine)
Side effects : dry mouth , tiredness , weight gain , dependence on meds
Unipolar biological treatment AO3
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• drugs can help people live a normal life
• antidepressants can be easier to take and less time consuming then CBT and psychotherapy
•drug therapy is supported by the monoamine hypothesis
• drugs are cheaper to produce and cheaper for clients compared to cbt
•kirsch et al- reviewed 47 trials of patients with mild and severe depression who were prescribed SSRIs or a placebo -> ssri’s were more effective then placebo for severely depressed patients but not mildly depressed
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•side effects such as weight gain , emotional numbing , suicidal thoughts
•treats symptoms rather then cause ( palliative rather then curative)
•30% are treatment resistant -> criticised theory and medication
• antidepressants can cause dependancy rather then learning healthy coping mechanisms in therapy
Unipolar depression - psychological treatment AO1 CBT
•one or two hour sessions
•40 sessions , set goal and hmwk
• cbt aims to change and challenge behaviours -> avoid helpless behaviour and reinforce positive behaviours + replace faulty schemas with positive and logical ones + change / challenge beliefs + make clients aware of own thought patterns (psychoeducation) + create better coping mechanisms and challenge how they view cognitive triad
•beck hypothesised that depression comes from irrational beliefs when faced with difficult situations -> challenging these beliefs will alleviate symptoms of depression
•cbt combines Beck and Eliss therapy -> make clients aware of own belief and work out what sort of events can trigger unhelpful thoughts -> challenge unhelpful thoughts -> create good coping strategies
•smart targets and large targets
•psychometric tests such as Beck’s depression inventory
Unipolar depression - psychological treatment - AO3
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•Dobson - meta analysis of 115 studies of adults with unipolar depression and showed that it’s highly affective
• constructive validity - cognitive approach is well researched and uses psychometric tests -beck
•gives people life long skills and coping mechanisms
•cure rather then palliative
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• requires motivation and commitment of patient
•expensive and time consuming
• too much emphasis on thought patterns being responsibly (reductionist)
• puts blame on patient (ethical issues)
