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What is Depression? Key explanations
How can you spot depression? What are the signs and symptoms? How can we define depression? Find out more with our key explanations.
Clinical characteristics and diagnosis
For an individual to receive a diagnosis of depression the patient must display a persistent low mood for at least a 2 week period, they must also show at least 5 of the additional symptoms nearly every day. These symptoms can generally be broken down into four main categories: cognitive symptoms, behavioural symptoms, physical symptoms and emotional symptoms.
· a lack of pleasure or interest in activities (can included day to day activities of hobbies that the individual previously derived pleasure from),
· significant change in weight and/or appetite,
· changes to sleep patterns e.g. failure to sleep (insomnia) or a want to sleep all the time (hypersomnia),
· fatigue/loss of energy,
· feelings of worthlessness or guilt that are disproportionate for the situation,
· physical agitation that can include twitches or pacing, in order to remove restlessness, or the opposite i.e. a lack of physical movement,
· a reduced ability to concentrate or make decisions,
· Regular thoughts of death/suicidal ideation/suicide attempts or devising a specific plan for committing suicide.
This approach to explaining the cause of depression focuses on the hereditary nature of the disorder, with a large amount of research to support this claim. The disorder has been shown to have a strong genetic basis and individuals with a first degree relative (e.g. a parent) who has suffered from depression are more at risk of developing clinical depression themselves, compared to those who do not have close relatives with the disorder. Inheriting these genes can lead some people to have a predisposition for depression. More recently, there has also been research that has identified a specific gene mutation that increases the likelihood of developing depression. The gene 5HTT plays a role in the transportation of the neurotransmitter serotonin in the synapses of the brain and if this system is not working effectively the individual will be starved of the neurotransmitter responsible for mood regulation, resulting in the symptoms of low mood seen in people with depression.
This explanation of depression focuses on the levels of important neurotransmitters e.g. serotonin and noradrenaline in the brain. When biochemicals such as these are altered it can result in significant changes in mood- ‘mania’ when levels are too high, or depression when levels are too low. For example, taking recreational drugs like Methylenedioxymethamphetamine (MDMA/ecstasy) can lead to euphoric feelings of happiness and this is due to an increase in the amount of serotonin available in the neurons of the brain. The focus of research support is for the role of low levels of serotonin as a cause of depression. A diagnosis of depression might result, if a person is unable to regulate their levels of serotonin and consequently experience significant changes in their mood. Similarly, the catecholamine hypothesis proposes that low levels of certain neurotransmitters, particularly nor-adrenaline, have been linked to depressive symptoms and could be a contributing factor when considering the role of neurochemicals in the development of this disorder.
Cognition refers to the way we think about certain events. According to Beck (1996), depression is the result of faulty or maladaptive cognitive processes. Beck’s theory of the cause of depression is based around the concept of a “cognitive triad”. The cognitive triad refers to the way we think about 3 elements: ourselves, the future and the world. The interaction of these elements determines how we think, feel and respond to events in our lives. If a person has a more negative triad they will think very differently to someone with a more optimistic attitude, often causing them to experience depression as they get stuck in a cycle of negative thinking. For example, if a person applies for 22 jobs and receives rejection letters from all of them, despite having the correct qualifications and experience, an individual with a negative triad might think about themselves “I am useless”, about the future “I will never be able to get a job”, and the world “if these companies think I am useless then so does everyone else”.
Another contributory factor to the negative cognitive triad concerns how depressed people process information in a maladaptive way. They are prone to distorting and misinterpreting information, and as a result they can feel at fault for something out of their control (personalisation) or exaggerate the severity of an event (catastrophising), which ultimately enhances their low mood and passivity. Other examples of these “Errors in logic” include: overgeneralisation (drawing sweeping conclusions based on a single incidence) and selective thinking (focusing on negative details or events and ignoring positive ones).
Freud, the leading theorist for this approach, argues that the development of depression is the result of an interaction between early childhood experiences, particularly the loss or separation from a caregiver, and our unconscious feelings of negativity that we hold towards people we love.
The process begins when the child is between 0-1 years. At this age the child will be in the oral stage of psychosexual development and will gain pleasure from oral gratification (putting objects in their mouths). During this stage, a child relies on a caregiver, usually a parent, to meet their needs (feed them) and can sometimes be overfed/over gratified by this person. If over gratification occurs the child will develop an oral fixation and will become overly dependent on others to maintain their self-esteem.
The second phase in the development of depression occurs when the caregiver, who the child is dependent on, is taken away from them. This leads the child to “introject” (take on the personality) of the person they have lost. Therefore, after introjection, the undesirable feelings we hold in our unconscious minds about those we love will transfer to the individual and result in feelings of hatred towards oneself. Eventually, this becomes the precursor to depression as the person will enter a negative cycle of self-blame and self-abuse.