The psychodynamic approach is interested in the ways in which childhood experiences, particularly those involving relationships with parents, affect psychological well being in later life. The main assumption of the psychodynamic approach is that our early experiences are retained in the unconscious mind and affect our feelings and relationships in later childhood and adulthood. (Jarvis, Putwain, and Dwyer, 2002, P. 81).
The psychodynamic approach to depression focuses on the emotional impact of childhood relationship based experiences, like significant loss or insecure attachments. Freud draws a comparison between the grieving that occurs when a loved one dies and the symptoms of depression. In Mourning and Melancholia (Freud 1917) Freud claimed that an important aspect of adult mourning is anger he also proposed that the same anger is important in a Childs response to loss. Children’s anger at being abandoned through separation or rejection is repressed, turning inwards and causing feelings of guilt and low self esteem. The reason for this is that an outward expression of anger is unacceptable to the super ego.
Freud argued that there are 2 types of loss, the first being actual loss. This is the death of a loved one; a person may interpret the death as desertion or rejection. The second is symbolic loss such as the loss of a job or social prestige. A person may interpret a short tempered answer from a loved one as a sign that affection will no longer be returned.
Although Freudian theory may be appear outdated it is still helpful in the modern approach to depression as it draws attention to the links between loss and depression and it links depression to anger (Champion and Power 2000). Research has been conducted into the relationship between loss in early childhood and later depression and generally the results have supported Freud’s theory that early loss predicts later depression (Jarvis, Putwain, and Dwyer, 2002, P. 165). Maier and lachman (2000) surveyed 2998 adults aged between 30 and 60 using questionnaires and telephone interviews. They found that symptoms of depression were more common in those who had lost a parent in childhood through divorce or death. Research into the link between anger and depression by Swaffer and Hollin (2001) produced partial support for Freud. They gave 100 young offenders questionnaires to assess anger and health. Depression, along with general health, was associated with levels of anger. Those who were found to have suppressed their anger having a greater tendency for depression.
The positive points to the psychodynamic approach are that depression is linked with early trauma and some sort of disruption in early childhood relationships. Also Freudian theory is that early experiences of loss predicts depression in later life. However some research suggests that the psychodynamic approach in inadequate in explaining depression. There is no direct evidence that people who are depressed interpret the death or loss of a loved one as desertion (Davidson and Neale, 1990). Evidence suggests that depressed people direct excessive amounts of hostility towards people who are close to them, you would not expect this to happen if the anger is turned inward (Wissman and Paykel (1974). Although depression is associated with suppressed anger, Freud’s idea that anger at early loss becomes turned inward against the self is unfalsifiable. It can’t be directly tested.
The bio-medical approach focuses on mental disorders being caused by the disruption or malfunction of biological processes. It looks at the role of genes and the biochemistry of the nervous system to explain mental disorders. One of the main assumptions of the bio-medical model is that mental disorder is an illness and can be classified, diagnosed and treated by a medical person in much the same way as a physical illness.
The bio-medical approach explains depression as an imbalance of biochemical substances in the brain, such as serotonin. A theory suggested by Schildkraut (1965) was that too little noradrenalin at certain sites resulted in depression. Later research suggested that a similar role was played by serotonin. Animals given drugs that diminish noradrenalin production become sluggish and inactive; these are two of the symptoms of depression (Wender and Klein, 1981). Drugs that are used to treat depression increase levels of noradrenalin and serotonin. Research conducted by Teuting et al, 1981 suggests that lower than normal levels of compounds that are produced when noradrenalin and serotonin are broken down by enzymes are found in the urine of depressed people. (Gross, McIlveen, 2000, p. 57).
Although there is substantial evidence from drug trials and post mortem studies that depression is associated with biochemical abnormalities there is little evidence to suggest that biochemical and neurological abnormalities are causes rather than just features of depression.
The bio-medical approach also suggests there is a genetic element to depression. “We have long known that the children of depressed parents are more vulnerable to depression than comparable children without depressed parents”. (Jarvis, Putwain, and Dwyer, 2002, P. 160). Evidence for the genetic element to depression comes from twin studies. McGuffin et al (1996) studied 214 pairs of twins, at least one of whom was being treated for major depression. They found 46% of monozygotic twins and 20% of dizygotic twins of the patients had also suffered major depression. This suggests that there is a moderate genetic influence. The findings of Silberg et al (1999) who studied 902 pairs of twins suggest that there is not a gene that causes depression but rather genetic factors make some people particularly susceptible to the depressing effects of life events.
Although twin studies have shown that depression is more likely to be shared by identical twins they suggest only a moderate genetic influence especially in milder cases of depression. Twin studies suggest that rather than causing depression our genes merely make us more susceptible to it.
The biggest advantage to this approach is that it takes the stigma out of mental illness. It says that something is going wrong; it is not the patients fault for getting ill. It takes away the blame. However a criticism of this approach is perhaps people are not taking responsibility for their illness.
In conclusion, depression is a serious mental disorder with many distinct characteristics. Many explanations have been put forward to explain depression. A psychodynamic approach explains it as unconscious conflicts to do with loss and grief leading to anger being turned inwards on the self. A bio-medical approach explains depression as genetic factors and faulty functioning of neurotransmitters in the brain. Although both of these explanations have received support from various research studies it is clear that there is no one single explanation for depression.
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REFERENCE LIST
Gross, R.,& McIlveen, R. (2000). Aspects of psychology, psychopathology. Berkshire: Cox & Wyman.
Jarvis, M., Putwain, D., & Dwyer, D. (2002). Angles on atypical psychology. Cheltenham: Nelson Thornes LTD.
Gross, R. & McIlveen, R. (1996). Abnormal psychology. Wiltshire: Redwood Books.
