Depression (Psychological side)

Freud's essay 'mourning and melancholia' explains that after the death of a loved one people go through a stage of mourning before life returns to normal. However, some people may never stop mourning which Freud called permanent melancholia (we now call it depression). He claimed that mourning is linked to the loss of a loved one whereas melancholia was a pathological illness. After the 'desertion' of a loved one we try and seperate ourselves from them. However feelings of hate and anger may be turned inwards instead leading the depression.

Beck believed that depression is developed through negative schema during childhood. he said that depression was a mixture of a negative view of self, the world, and the future. This was called Beck's cognitive triad.

Seligman suggested the learned helpnessness theory.

Depression may be learned when a person tries but fails to control negative life experiences. As a result they aquire a sense of being unable to exercise control over their life, and so they become depressed. The learned helpnessness then impairs their performance in situations that can be controlled- a characteristic of many depressives who fail to initiate coping strategies in times of stress.

Abramson et al modified the learned helpnessness theory into the hopelessness theory. This explains depression on the basis of pessimistic expectations of the future. The hopeless person expects bad rather than good things to happen in important areas of their life and doesn't believe they have the resources to change that situation.

Life events may act as a trigger for depression.

Kendler et al found that women were both genetically inclined to and had a greater vulnerability to develop depression than men.

Other studies have proved that women are twice as likely to suffer from depression as men (20%-women) (10%-men)

Originally developed by Beck

CBT emphasises the role of maladaptive thoughts and beliefs and maintenence of depression. The aim of CBT is to identify these dysfunctional thoughts and change them into positive, happy ones. CBT mainly consists of thought catching and behavioural activation.

Psychodynamic Interpersonal Therapy was devloped by Robert Hobson.

It was an attempt to move away from the typical psychoanalytic approach of a one-sided relationship between therapist and client. Hobson believed that the quality of the relationship between client and therapist was crucial.

Componants of PIT:

-Exploratory rationale

- Shared understanding

- Staying with feelings

- Focus on difficult feelings

- Gaining insight

- Sequencing of interventions

- Change

Freud developed this as a way of exploiting the depressive emotions which would then enable the depressed individual to change their current thought schemas that could've been damaged during childhood or any stage in psychosexual development (which is usually oral).

Stages of psychoanalysis:

- Free assosiation

- Word transferrence

- Dream analysis

- Transferrence of emotions/feelings

- Projective tests

Exercise releases endorphins, a hormone known for boosting someones mood and is likely to relieve some of the depressive symptoms an individual may be experiencing.

In order for someone to be classified as depressed they must constantly fullfil at least five of the following nine symptoms for longer than two weeks:

•  Sad, depressed mood- as indicated by other subjective report (feeling sad or empty) or observation made by others (ie appears tearful)
• Loss of interest of pleasure in usual activities- as indicated by either subjunctive account or observation made by others
• Difficulties in sleeping (insomnia)- in some patients a desire to sleep all the time (hypersomnia)
• Shift in activity level, becoming either lethargic or agitated- observable by others, not merely subjective feelings or restlessness or being slowed down
• Poor appetite and weight loss, or increased appetite and weight gain- significant weight loss when not dieting or a significant decrease (or increase) in appetite
• Loss of energy and great fatigue
• Negative self-concept, feelings of worthlessness and guilt- feelings of worthlessness or excessive or innapropriate guilt (which may be delusional)
• Difficulty in concentrating- such as slowed thinking and indeciveness 
• Recurrent thoughts of death or suicide- major depressive disorders accounts for about 20-35% of all deaths by suicide (Angst et al)