Depression - MAO1', and tricylic anti-depressants (developed in the 1960's, less are being used nowadays and they take a while to work) It is found that they have serious side effects with long term use (heart problems)
Today SSRI's (makes you use the serotonin better, circulates) are more popular. These drugs all raise levels of serotonin in the brain.
Anxiety disorders - minor tranquillizers called BZ's and Valium, they have a calming effect on the nervous system and relax muscles (They are addictive but are good of OCD)
Anti-psychotic drugs - minor tranquillizers sedate and alleviate symptoms such as hallucinations and delusion in disorders such as schizophrenia (Dophine)
AO2's of drug treatment
- Side effects, sometimes side effects can be worse than the actual symptoms. Long term dependancy can be a problem. (Can't drink alcohol, low sex drive, eat more, sleepy, addiction)
- Treating symptoms not looking at the cause - drugs cause a changed reaction to unchanged circumstances.
- Placebo effect - the drugs work because we expect them to
- Ethics - drugs can been seen as a way of making patients behave
ECT involves passing a current (70-130 volts) throught the brain for approximately half a second. Nowadays unilateral ECT is more common, this is done by only shocking one side of the brain (normally the right) as it reduces side effects such as memory loss. The patient doesn't recall any of the procedure when they come around from the anaesthetic.
Efficacy - it is a 'quick fix' and it can work short term for depression in 60-70% of patients. However 60% of the patients will become depressed again in the next year
Ethical issues - it is used in mental hospitals as a means of controling patients
The aim of this method of treatment is to:
- Bring repressed memories into conscious awareness
- Cure neurotic symptoms such as phobias, anxieties, depression and eating disorders
According to the iceberg theory the unconcious is revealed in dreams, therefore patients are asked to keep a record of their dreams and then the theorpist will look for symbols in the dreams that could be a repressed memory.
The aim of this is to also bring unconcious thoughts to the concious mind. Clients are encouraged to let their thoughts wander and say whatever comes into their heads without editing or censorship. The analyst must not give any direction therefore mustn't say anything and must stand out of view of the patient. He/She will then piece together patterns of association and offer an interpretation of the clients words and behaviour.
The client will sometimes transfer (or project) onto the analyst the characteristics that are associated with the parents or other important people. This helps the cilent to recognise these repressed feelings and be free of them. This will normally be by getting angry but they must not leave the room still feeling angry. It is also important that the analyst doesn't allow countertransference.
- Expensive and very long
- Not suitable for psychotic disorders, more suited for anxiety and depression
- The success rate is only 30-60%
- It is difficult to do research to see if it works,as concepts ae vague and difficult to measure
- Behaviourists would argue that the symptom is the problem and its better to get on and deal with the symptoms (more time spent on now)
- False memories, Loftus showed us that false memories can be invoked and suggested this theropy may create false memories.
This would be used for phobias rather than depression. This therapy is based on classical conditioning.
There are 5 steps
- Relaxation - the client is taught how to relax
- Create a hierarchy of anxiety provoking situations, starting with the least.
- In a relaxed state imagine themselves in the anxiety provking situations starting with the least.
- Clients only progress to the next one once they are completely comfortable with the one before. If any discomfort is caused they must go back a step.
- Eventually they are able to complete the hierarchy and imagine themselves in the most feared situation, but remain relaxed
The theroy behing this is that relaxation and fear/anxiety cannot exist at the same time so they overcome the fear.
The next step is go out out into the real world in a relaxed state when fronted with the feared situation
- There is evidence that this works, that the ability to tolerate an imagined stressful situation reduces anxiety in real life
- Not everyone is good at vividly imagining situations - might not work for everyone
- There are quicker alternatives such as flooding.
CBT is aimed at encouraging people to examine the beliefs and expectations underlying their unhappiness and to replace irrational, negative thoughts with a more positive and adaptive pattern of thinking. Therapists and clients work together to set new goals for the clients in order that more realistic and rational beliefes are incorporated into their ways of thinking
ABC model, the therapist attempts to make the client aware of beliefs that contribute to anxiety or depression.
Behavioural Element: The client and therapist decide together how to test the clients beliefs with experimentation. This can be done through role play or homework assignments (acting out getting on a busy bus or homeone to go on one) Through setting realistic goals the client replaces irrational beliefs with moe realistic ways of thinking
- Economical and popular - this method is used in the NHS and there is lots of research to support it. Its is seen as more cost effective and better for the client than drug theropy
- Empowers the client to take control of their own lives
- Effective in treating depression
- Effective in treating OCD
- Can be argued that it is "sticking a plaster" good for the symptoms but doesn't look at the cause.