Discuss two biological therapies for depression. You should refer to research evidence in your answer.

(8 marks + 16 marks)

Drugs are the first port of call for individuals suffering from depression and there are three main drug therapies that are used to treat the mood disorder. Monoamine-oxidase inhibitors (MAOIs) are used for treating depression as they are effective in treating the symptoms of depression but they do cause unwanted side effects that can, in extreme cases, could be life threatening. Individuals that are prescribed MAOIs need to restrict their diets to exclude foods that react adversely with the drug. They are usually prescribed when other medications have proved ineffective for the particular patient.

Another type of antidepressant that is used to treat depression is tricyclic antidepressants. They work by raising levels of serotonin and noradrenaline in the brain. The specific effects depend on the mechanisms targeted. They have been shown to be quite effective in alleviating symptoms of depression and have fewer side effects than MAOIs.

Selective serotonin reuptake inhibitors (SSRIs) are drugs such as fluoxetine hydrochloride (Prozac), were originally though to be free of side effects and were prescribed extensively. In the last few years, doubts were raised about their safety and in particular, there were reports linking Prozac to suicidal behavior.

Despite drugs having a 60% effectiveness rate within individuals with depression, there are a few limitations to this method of therapy. Firstly, all drugs work as a ‘chemical straightjacket’. The drugs do not provide a complete cure from depression, as there is some evidence that symptoms return when the drugs are ...

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Another criticism of using drugs to treat mood disorders such as depression is that all drugs have side effects, and the problem is some of these side effects could be fatal, and therefore the decision to prescribe them must not be taken lightly. Even the most highly qualified clinician cannot determine which side effects will occur in each patient, therefore careful monitoring is required in order for these side effects to be checked for.

A further criticism of using drugs to treat depression is that anti-depressants take effect immediately, but there is no therapy that takes effect immediately. Although the individual may be given a dosage of a certain drug, they will normally not start to feel better earlier than two weeks afterwards.

An additional negative effect of using drug therapy is that it is very hard to determine when an individual is ‘cured’ of their illness. It is hard to access this as it is hard to know at which point during treatment do you access this, and how do you access it? There is no measurement that you can use to determine whether someone has recovered or not.

In spite of these limitations there is substantial evidence that suggest that drug therapy is very effective in depressed individuals and it has also been found that placebos do not work as effectively as real drugs and this therefore shows that the drugs have the desired effect.

A number of studies have reported a much higher rate of reduction of symptoms when medication is used opposed to placebos (Thase and Kuffer 1996). It is also unknown whether drugs actually ‘cure’ depression as most patients are kept on drugs indefinitely as ‘maintenance therapy’ significantly reduces the risk of a relapse (Kessler et al 2002).

Although drug therapy has been proven to significantly reduce the symptoms of depression and other mood disorders other therapies are often used, one of them being electro-convulsive therapy (ECT). ECT involves a severely depressed individual being strapped to a hospital bed, given sedatives and muscle relaxants, lubricant and electrodes are placed either uni or bi-lateral and small shocks are passed through the brain.

Lerer et al 1995 suggested that it wasn’t the amount of ECT that was given which was important, but there were fewer cognitive side-effects in the twice-weekly programme. It is thought that ECT increases blood flow in the front part of the brain where the ‘emotions’ are found. It is extremely effective in cases of severe depression particularly where there are psychotic features or suicidal intent (Sackheim and Rush 1995), so it has become the treatment of choice for these patients.

ECT has been proven to be significantly effective in people with depression but it is an invasive assault on the brain and no one is entirely clear on how it works. It has been found that electro-convulsive therapy often causes short-term memory loss, and therefore this side effect should be taken into account before it is undertaken.

A limitation with this therapy is that it is questionable whether severely depressed people really understand the procedure or the implications of the treatment. Individuals who receive ECT are usually severely depressed and do not care if they live or die, and therefore they are in no state of mind to make informed decisions on the type of treatment they may receive.

Peer Reviews

Here's what a star student thought of this essay

sydneyhopcroft

30th of Jun 2012

Quality of writing

The Quality of Written Communication is excellent. The candidate masterfully uses the complex terminology of Psychology and shows the examiner they are proficient at applying it to their essays. There are very few spelling or grammatical errors and no causes for concern in terms of conveying the intention of the essay.

Level of analysis

The Level of Analysis is good and is indiciative of a candidate operating at a high B grade. But to achieve the lost marks and pull the grade up to a strong A grade, all the candidate needs to do is concentrate on getting a better analysis of the ECT argument. There are two good strengths and two good weakness provided for the drugs treatment argument, as well as a good level of description about the effectivity of such treatments, but there is only one strength and one weakness for the ECT argument, meaning the discussion is not balanced. Candidates should look to monitor their time better in accordance with the marks available; perhaps try to cut down on some of the description of the drug treatments as there are only 8 marks available for AO1 (knowledge and understanding) and 16 for AO2 (analysis), so logically, less would need to be written for AO1. As it stands, this essay can expect to achieve 6 + 10, making a total of 16 marks out of 24.

Response to question

This is a very strong essay, although there is, as with a lot of questions in this format, a clear bias of time and knowledge towards one of the biological therapies to treating an affective disorder. The drugs treatment argument here is a brilliantly-written discussion, though the ECT argument suggests the candidate may have run out of time as they have not discussed it in quite the same level of detail. This is why time management is so important for long essay questions like this. If time management is not considered then the answer can, as this one does, veer into an unbalanced argument with one superfluously-described therapy and one average one.

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