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32 Cards in this Set
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What are the symptoms of unipolar depression? |
• Reduced ability to think • Repeated thoughts of death • Inability to sleep/sleeping too much • Fatigue • Depressed mood most of the day * • Reduced interest in most activities * • Significant weight loss/gain without effort • Feelings of worthlessness/inappropriate guilt • Psychomotor agitation *One of these for two weeks plus four others from the list |
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What are the manic symptoms of bipolar depression? |
• Rapid speech/unusual talkativeness • Less than usual amount of sleep needed • Inflated self-esteem (ie belief that one has special powers) • Increase in activity levels socially, sexually, or in work • Racing thoughts • Excessive involvement in pleasurable activities |
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What is the genetic explanation of depression? |
Some people inherit a genetic predisposition to developing depression. |
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Genetic AO2s |
• MacGuffin (1996), 214 pairs of twins, concordance rates of 46% for MZ and 20 % for DZ. • Not 100%. • MZ treated more similarly. • Difficult to identify a single gene – there may be more than one involved. • Bipolar depression has a stronger genetic component than unipolar; Weissman found that families of sufferers were more likely to develop the disorder than the families of those with unipolar depression. Bipolar concordance rates are 80% in MZ and 16% in DZ. • Not all who are predisposed to depression will develop it; social factors such as unemployment and divorce also play a role. • Silberg et al (1999), 902 pairs of twins given a psychiatric interview to measure depression during adolescence, life events measured with questionnaire and parental interviews; more girls suffered than boys, and were also more susceptible to depression after life events.Depressed girl's twin often had depression. Interaction between genes and environment. |
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What is the neurochemical explanation of depression? |
People with depression have lower levels of serotonin, dopamine and noradrenaline. |
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Neurochemical AO2s |
• Anti-depressant drugs increase the levels of neurotransmitters and relieve the symptoms of depression. Prozac, for example, prevents the re-uptake of serotonin and can decrease symptoms. • Blood pressure medication such as reserpine can lower levels of serotonin and noradrenaline, and this causes symptoms of depression. • The role of noradrenaline is supported by the fact that new drugs such as reboxetine, which increases noradrenaline, can be effective in treating depression. • Direction of cause-effect is unclear. |
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What is the neurological explanation for depression? |
A post-mortem study found significant differences in brain structure in an area of the brain which produces noradrenaline compared to the control group, suggesting neurological links to depression. The frontal lobes, which are involved in thinking, are also smaller in people with depression. |
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Neurological AO2s |
• Research comparing the size of frontal lobes in depressed patients with a control group using MRI scans found that, on average, people with depression had smaller frontal lobes, supporting this as an explanation for depression. • Research by Milo (2000) found that the frontal lobes do not regulate the blood-flow in the brain appropriately in people with depression. Blood-flow to the frontal lobes also improves after electro-compulsive therapy, which might explain why ECT can be an effective treatment. |
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What is Beck's Cognitive Triad Explanation of Depression? |
Cognitive explanations suggest that our thoughts influence our behaviour. Beck proposed that three types of negative thoughts were involved in depressed patients – negative views of the self, the world, and the future. These thoughts are spontaneous and linked to faulty processing. People with depression tend to selectively attend to the negative aspects of situations, leading to an overestimate of the downsides. Beck also suggested that people with depression have negative self-schemas which develop during childhood due to critical parents. They then interpret new information about themselves in a negative way. |
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Cognitive Triad Theory AO2s |
• Perez et al (1999), sad mood induced in depressed and non-depressed people who were then shown a mixture of happy and sad words. Depressed group paid more attention to sad words. • Parker (2000), 96 patients with depression who reported negative self-schemas were activated in situations such as feeling trapped. There was a significant link between negativity in childhood and faulty schemas. • Cause-effect is unclear. |
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What is the learned helplessness explanation of depression? |
This suggests that depressed behaviour might be a result of learning that any effort to change the environment is useless. A person therefore develops an expectancy that they are unable to to make any difference to external events. |
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Learned Helplessness AO2s |
• Seligman gave dogs painful electric shocks which they couldn't escape from. The dogs initially tried to escape the shocks, but eventually gave up. • Applies to humans, where repeated experiences of failure lead to depression. • Generalising from animals to humans. |
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What are attributions? |
The idea of learned helplessness has been extended by the proposal that it is the type of attributions which people make about uncontrollable events that determine whether or not they become depressed. Someone with an internal, stable, and global attributional style will be pessimistic and at risk of depression. |
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What are the psychoanalytic explanations of depression? |
Psychoanalytic explanations suggest that depression is linked to the real or imagined loss of a parent. The child is angry at being abandoned but cannot take this out on their parent and so they repress it, causing low self-esteem and guilt. |
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What are the psychoanalytic explanations of bipolar depression? |
Bipolar depression is a result of the id, ego and superego. The superego is in control during the depressed state, making the person feel worthless, and the ego tries to gain control. causing the manic phase. |
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Psychoanalytic AO2s |
• Maier & Blackman, 3000 adults aged 30-60 given questionnaire and some were interviewed. Symptoms of depression were more likely in those who had lost a parent through death or divorce. • Depressed people often take their anger out on others, which challenges the idea that the anger is repressed and turned inward. |
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What is Bowlby's explanation of depression? |
Children fail to develop an internal working model of themselves as lovable, and so have low self-esteem, see others as hostile and rejecting, and expect this in their relationships, and so depression is simply a reaction to a world without love. |
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Bowlby AO2s |
• It could just be that depressed people view all relationships as negative, rather than negative relationships causing depression. • Most evidence comes from retrospective studies of childhood experiences which rely on memories, some of which being unconscious, and this is difficult to investigate scientifically. • Current experiences could cause depression instead of childhood experiences. • This explanation is similar to the cognitive explanation of negative schemas from critical parents. |
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What is Imipromine? |
Imipromine is a tricyclic which blocks the re-uptake of noradrenaline and serotonin. |
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Imipromine AO2 |
Side effects include dryness of the mouth and constipation. Imipromine is also linked to suicidal ideation in people under 24, and for some patients with bipolar it can trigger manic episodes. |
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How do Monoamine Oxidose Inhibitors (MAOIs)? |
MAOIs work by inhibiting the breakdown of neurotransmitters, and may be used with atypical depression. |
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MAOI AO2 |
These are not often the first choice of treatment due to negative side effects such as bleeding in the brain and dangerous interactions with certain foods. |
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How do Selective Serotonin Reuptake Inhibitors work? |
SSRIs work by blocking certain receptors, making more serotonin available. |
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SSRI AO2 |
There are fewer side effects than with other anti-depressants, although there are concerns that SSRIs might be addictive. |
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How does lithium carbonate work? |
Lithium Carbonate helps to regulate levels of serotonin and dopamine and is more effective at treating manic phases than depressed phases. People with bipolar depression will need to take this drug all their live to avoid manic episodes. |
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Lithium carbonate AO2s |
• Unpleasant side effects include blurred vision, difficulty concentrating and potential kidney problems. Because of their side effects, people often stop taking their medication, leading to relapse. • Kerman et al (1994), lithium carbonate or a placebo, double-blind test, independent doctors assessing the patients for signs of improvement, lithium was more effective at treating the symptoms of mania than the placebo. • However, there were individual differences, and 40% of those on lithium carbonate showed no improvement. •A repeated measures design by Abou Saleh (1992) also shows that lithium carbonate can be successful at treating manic depression. Manic symptoms in patients reduced while taking lithium and increased when on the placebo. |
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Drug Therapy AO2s |
• Drugs reduce the number of hospital visits as they allow people to be treated by their GP and carry on with their lives. • Not all drugs work for everyone so someone might have to try multiple types. • Drugs fail to deal with the cause and only treat the symptoms. They may work best with therapy. |
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What is electro-convulsive therapy (ECT)? |
ECT is an extreme therapy where electricity is passed through the brain to cause a seizure. The patient is given an anaesthetic and muscle relaxant before electrodes are placed on their head and an electric shock is given. Shocks last for about a minute and typical treatments involve 6-12 sessions. It is only used as a last resort with severely depressed patients. |
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ECT AO2s |
• Fink, successful in 50% of cases. • Relapse rate is high and 80% will need further treatment. • Can lead to permanent memory loss unless unilateral ECT is used. • Many people see ECT as unethical, particularly as it can be carried out without consent if the person is sectioned. However, if someone is at risk of suicide, ECT is a quick and effective form of intervention. |
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How does Beck's cognitive therapy work? |
Beck’s cognitive therapy aims at changing the negative thoughts about one’s self, the world and the future. The therapist makes the client aware that thoughts influence emotions and behaviour and so to feel better, one must think positively. Therapy often involves four phases: increasing confidence; challenging automatic negative thoughts; identifying negative thoughts; and changing key attitudes and beliefs. Clients might be asked to keep a diary where they record and monitor their thoughts to identify situations where they might think negatively. They are also asked to do something to demonstrate that they can succeed in the hope that irrational thoughts will change into more positive rational beliefs. CBT might also be used, where clients are set homework to alter their behaviour. |
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How does Ellis' Rational Emotive Therapy (RET) work? |
This helps to uncover unrealistic cognitions and allow people to replace these irrational beliefs with more realistic ones. Ellis identified a number of emotionally self-defeating beliefs (such as ‘I must never make mistakes otherwise I’m worthless’) which can lead to psychological problems. In RET, clients are challenged to prove that these beliefs are true. |
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Cognitive Therapy AO2s |
• Hollen et al (2006), people with severe depression given drugs, placebo or cognitive therapy. Relapse rates of 40% over a year for those who had cognitive therapy, compared to 45% for those on drug therapy. •Although cognitive therapy might be useful for an articulate, motivated person who likes to think their way through problems, not all people do this (especially those who have bipolar depression and may need drugs to stabilise their moods as well as the therapy). • Cost-effective (can be done in groups). • 60-70% how improvement in 10-12 weeks. However, there is a very long waiting list in some places. • Unethical as the therapist decides which thoughts are acceptable. • Only treats symptoms. However, therapists don't claim to cure, only to provide them with strategies for dealing with depression. •Cognitive therapy deals with the conscious thoughts of depression, whereas psychoanalysis deals with the unconscious cause of depression. Also, cognitive therapy focuses on changing a person’s conscious thoughts in the present, rather than uncovering an unconscious past. |
