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What is Depression? Discussion
Use these discussion topics to help you learn more about the different explanations surrounding depression and to give you more ideas for your own work.
Receiving a diagnosis for depression can be beneficial because it allows appropriate treatment to be given to the individual. However, it can also lead to labelling of the individual and the possibility of the person taking on a ‘sick role’. This will affect the behaviour of the person as they begin to behave in line with their diagnosis and the expectations from family, friends or themselves. Depression is often co-morbid with other disorders, particularly social phobias and anxiety which can create issues for diagnosis. It is very important that the primary disorder is identified so the appropriate treatment can be given.
Differences in gender diagnosis may be due to the amount of males and females that seek treatment and receive a diagnosis as opposed to an actual difference in the number who suffer from the disorder. Women are more likely to visit their doctors with symptoms and thus statistics appear to show more females diagnosed with depression. Cultural relativism can also be a problem with diagnosis. Sufferers of depression in different cultures may present with different symptoms, which the ICD and DSM manuals struggle to recognise. For example, Davidson and Neal (1994) found that Asian cultures tend to display physical symptoms e.g. abdominal pains or headaches as opposed to typical symptoms listed in the diagnostic manuals.
Essays regarding mental health
The genetic explanation for depression is widely supported by research studies. It is investigated by using family, twin and adoption studies in attempt to untangle the role of genetics and environmental causes in depression. Twin studies examine the concordance rates of depression between monozygotic twins (MZ/identical twins) and dizygotic twins (DZ/non-identical twins). This will show the strength of the genetic link, as MZ twins share 100% of the same genetics and thus should be more likely to both suffer from depression compared to DZ twins who only share 50% of their genetics. McGuffin (1996) found that there was a 46% concordance rate for MZ twins being treated for depression compared to 20% for DZ twins- supporting the role of genes in developing depression. One adoption study also found that adopted people who suffer with depression were 7 times more likely to have biological relatives who have also suffered in comparison to their adoptive parents (Wendler et al. (1986)). This study enables us to conclude that the genetic basis of depression has a stronger influence than the environment. Unfortunately this theory does not directly lead to an appropriate treatment for depression. However, when considered in conjunction with the neurochemical explanation it can prove a powerful source of information.
The neurochemical explanation of depression is also strongly supported by research. Many studies have found that increasing the levels of serotonin availability in the brain using drugs such as Selective Serotonin Reuptake Inhibitors (SSRIs) can lead to improvements in mood, implying that serotonin plays a crucial role in the disorder. Evidence using PET scans to examine brain activity, has also shown that people with depression have fewer serotonin receptors throughout their brains compared to controls, demonstrating a possible reason for their depleted serotonin transmission (Mintun et al., 2004). The Catecholamine Hypothesis is also supported by studies that show drugs taken to increase levels of nor-adrenaline (nor-adrenaline reuptake inhibitors (NRIs)) are more effective at minimising symptoms of depression and preventing relapse, compared to placebos (Versiani et al., 1999).
However, it has been argued that the results seen when taking anti-depressants may be due to the placebo effect and that there is only a slight difference between the effect of anti-depressants and placebos (Kirsch et al., 2002). It is also the case that low levels of nor-adrenaline are not always seen in people suffering with some types of depression, particularly reactive depression and thus cannot be the only explanation for the symptoms seen.
There is a large amount of supportive research in favour of the role of negative cognitions in depression. For example, Evans et al. (2005) found support for Beck’s theory that people suffering with depression have faulty thinking processes and that the severity of someone’s depression is associated with the number of maladaptive cognitions an individual has. He also conducted research measuring the dysfunctional self-beliefs of pregnant women and found that women with the highest scores were 60% more likely to develop depression at a later date than those with the lowest scores and this could also be used as a predictor of depression 3 years later (Evans et al. 2005).
However, there are issues with accepting the cognitive approach as a complete explanation of depression. The main problem is with cause and effect relationships. Unfortunately, cognitive psychologists are unable to determine if depression is directly caused by maladaptive thought processes or whether the faulty thinking comes as a result of the disorder itself. It also ignores the possibility of a third variable contributing to the development of the disorder. For example, the dysfunctional thinking seen in someone suffering from depression could be a result of low levels of neurochemicals in the brain.
Essays related to cognitive behaviour
Compare and contrast the person-centered approach and cognitive-behavioural approaches to understanding and working with fear and sadness. Which of these two approaches do you feel more drawn to and why?
The psychodynamic approach to explaining depression has got very little evidence to support its claims and is often regarded as unscientific for this reason. The theory could be considered “unfalsifiable” because Freud’s claims cannot be tested scientifically either to prove or disprove their credibility. A large majority of the research he conducted was also not generalizable to the wider population as it was conducted on a very limited sample of middle-aged Viennese women.
This theory proposes that the only people that should suffer from depression are those that experienced fixation in the oral stage of childhood and also experienced the loss of a significant caregiver. However, not everyone who has lost a parent whilst young develops depression and less than 10% of sufferers have actually experienced the loss of a parent (Bonanno, 2004). This refutes the theory quite significantly, as it demonstrates that there must be other, more convincing, factors contributing to the development of this disorder.
Psychodynamic related studies
How useful is psychoanalytical approach to understanding a person? Choose one of Freud's case studies. How credible and useful do you find Freud's way of making sense of this person's problem? Which, if any, limitations of the theory do you see?