Depression
Genetics (depression is primarily due to biological factors)
-38% concordance rate --There is some genetic component of acquiring depression
According to Beck, a person may be going along fine in life, but then certain experiences will trigger depression? What is there about these experiences that causes them to have this effect?
-Activation by events that seem related to schemas: --Schemas can be activated by events that seem related to the schema ---Ex: Suzy's schema becomes activated when she interprets the boy's message "I cannot be with you tonight because I have to study", as her being unlovable --Under what conditions are schemas activated producing depression? ---Yes: ----If the person has experienced these symptoms, than they have a faulty info processing, and they have depression ---No: ----If the person has not experienced any of these things than they do not have depression
Arbitrary inference
-Actual evidence unrelated to inference --If something happens, and the person draws an inference, although given the evidence, the conclusion is totally arbitrary and not based on concrete information ---Ex: a friend of Suzy's believes that the way she is feeling is so arbitrary because they believed that the girl and boy were perfect for each other
Phase 3: Identify negative thinking and biases (four phases of cognitive therapy)
-As people begin to recognize the flaws in their automatic thoughts, the therapists show them how illogical thinking processes are contributing to these thoughts --The therapists also guide clients to recognize that almost all their interpretations of events have a negative bias and to change that style of interpretation
What is the ABC diagram presented in class basically saying about what causes emotions
-Beck's Theory of Depression: --Applies to depression and many other disorders -General Cognitive Principle: --People act and react in light of how they perceive and interpret reality -Ellis' A-B-C Diagram ---A --> B --> C --Event. Interpret Reaction -There is not a direct reaction between reactions and events; there is something in-between: how the person interprets the events (the meaning the place behind it) --Ex: Suzy came into the counseling center and she was very distressed because a boy she has been seeing recently told her "I cannot be with you tonight because I have to study". She interpreted this as "this is the beginning of the end" because he already wanted space and to not be with her
The leading biological theories of depression stress factors having to do with brain chemistry. What two biochemical factors are stressed by these theories?
-Caused by a deficit of the neurotransmitters norepinephrine and serotonin. Most people focus on serotonin --There is not enough of these neurotransmitters
According to your text, which types of treatment are most effective in reducing depressive symptoms?
-Cognitive-behavioral, interpersonal, and biological therapies are all effective treatments for unipolar behavior --Best if all paired together -ECT is more effective than antidepressants
According to Beck, what is a "schema?"
-Deeply held beliefs --Early experiences of rejection: ---Ex: I am unlovable --These first impressions are very lasting: ---Ex: having an early loss of a parent can lead to the belief that nothing good in life can last --I have these experiences and I form logical conclusions based off of them about myself and how the world works
Behavioral symptoms
-Depressed people are usually less active and less productive. They spend more time alone and may stay in bed for long periods --Depressed people may also move and even speak more slowly
Cognitive symptoms
-Depressed people hold extremely negative views of themselves --They consider themselves inadequate, undesirable, inferior, perhaps even evil --They blame themselves for nearly every unfortunate event, even things that have nothing to do with them, and they rarely credit themselves for positive achievements -Pessimism: --Sufferers are usually convinced that nothing will ever improve, and they feel helpless to change any aspect of their lives ---Because they expect the worst, they are likely to procrastinate. ---Their sense of hopelessness and helplessness makes them especially vulnerable to suicidal thinking People with depression frequently complain that their intellectual ability is very poor. ---They feel confused, unable to remember things, get easily distracted, and unable to solve even the smaller problems
Motivational symptoms
-Depressed people typically lose the desire to pursue their usual activities --Report a lack of drive, initiative, and spontaneity
According to Seligman's learned helplessness theory, what basically causes depression?
-Depression is due to a state of learned helplessness. --Depressed person has learned from own history that, when bad things happen, they are helpless to control them ---It results in a schema: this is the kind of world I live in, where bad things happen to me all the time and I can do nothing to control it ----Person becomes unmotivated; what's the point in trying? -Impacts their learning: --They do not learn from positive experiences
According to psychoanalytic theory, what causes depression?
-Depression=Anger turned inward --Anger directed against the self ---Case "Sharon" and her auto accidents ----Sharon had three automobile accidents in a short period of time, and she was very depressed ----She met a hippie that made her drop out of school and live up in the mountains in the middle of nowhere ----She gets depressed because she often found herself alone when her boyfriend left for work -----She then gets pregnant and becomes even more depressed because she has no one to help her take care of the baby -----She left after 6 months because she could not stand being so alone -----A year later, she is involved in three automobile accidents -----She went into counseling and the counselor made her confront herself and get all of her anger out at herself. Once she got a chance to vent all of her anger out at herself, she felt much better being able to get it all out there
What is ECT? How effective is it? What are some of the potential risks associate with it?
-Electroconvulsive therapy (ECT) is a procedure, done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental health conditions. --50-80% improved by treatment
How does learned helplessness relate to unipolar depression?
-Feelings of helplessness are at the center of depression --Learned helplessness theory: ---People become depressed when they think they no longer have control over the reinforcements (the rewards and the punishments) in their lives, and that they themselves are responsible for this helpless state -Attribution-helplessness theory: ---When people view events as beyond their control they ask themselves why this is so
Body dissatisfaction explanation (theories used to explain this ratio of men to women who suffer from depression)
-Females in Western society are taught, almost from birth, but particularly during adolescence, to seek a low body weight and slender body shape-goals that are unreasonable, unhealthy, and often unattainable --However, it is not clear that eating and weight concerns actually cause depression; they may instead be the result of depression
Emotional symptoms (Characteristics of depression)
-For a depressed person, life becomes a point of just "going through the motions" --Sadness --Anhedonia: ---Anti-pleasure
Hormone explanation (theories used to explain this ratio of men to women who suffer from depression)
-Hormone changes trigger depression in many women, particularly during puberty, pregnancy, and menopause --Research suggests that the social and life events that accompany these developmental milestones are also profound and may account for experiences of depression as well as, or event better than, hormone shifts
Bad events are attribute to factors that are... "Insidious Attributional Style"
-Internal (vs external) --A person's first thought is to think that it is there fault; this happened because of who they are ---Ex: My boyfriend broke up with me because I am ugly and unlovable -Stable (vs unstable) --These are thoughts that are likely to be stable ---Ex: I will always be unlovable -Global (vs specific) --These thoughts are something that is going to impact not only this one situation, but many other situations in the person's life too ---Ex: This thought of me being unlovable and ugly will not only effect this relationship, but it will impact all other relationships that I engage in too
Motivational symptom (Cognitive Characteristics of depression)
-Lack of motivation --The depressed person is demotivated --Cannot make themselves do things --No desire to do anything
Name the three targets of negative thinking according to the cognitive triad.
-Later in people's lives, upsetting situations may trigger an extended round of negative thinking --The individuals repeatedly interpret: ---Their experiences ---Themselves ---Their futures -People experience these in negative ways that lead them to feel depressed
Which type of drugs are often utilized for depression? Do they work for everyone?
-MOA Inhibitors: --Approximately half of depressed people that take MOA are helped by them ---It is dangerous to take because you must have a very strict diet -Tricyclics: --Around 50-60% of patients that take tricyclics are helped -Second-generation antidepressants: --Selective serotonin reuptake inhibitors (SSRIs) ---Fails to help at least 40% of clients
Bipolar
-Manic depression: --The person is depressed, and then they transition to a completely different state of immaculate energy; mania
In their research, what biological change did Weiss and Wu observe in animals who had learned helplessness? What does this suggest about the respective roles of biological and psychological factors in the causation of depression?
-Many studies: helpless animals have depleted norepinephrine and serotonin levels --One group of rats was put in dangerous/helpless situations, while the other group was put in a safe area -Helpless rats became very depressed: --Even when the doctors showed them how to escape, they did not learn how to escape very well --They exhibited low levels of norepinephrine -Rats that escaped: --These rats exhibited normal rates of norepinephrine It is only when the rats had a history of helplessness when they exhibited depression
Emotional symptoms
-Most people who are depressed feel sad and dejected. They describe themselves as feeling empty and humiliated. They tend to lose their sense of humor, report getting little pleasure from anything --Anhedonia: ---Inability to experience any pleasure at all -A number of people experience anxiety, anger, or agitation
How are the symptoms of depression different in non-Western countries compared to Western countries?
-Non-Western Countries: --More likely to be troubled by physical symptoms such as fatigue, weakness, sleep disturbances, and weight loss ---Depression in these countries is less often marked by cognitive symptoms such as self-blame, low self-esteem, and guilt
Which neurotransmitter chemicals are strongly linked to unipolar depression?
-Norepinephrine --Low activity -Serotonin --Low activity
Phase 2: Challenging automatic thoughts (four phases of cognitive therapy)
-Once people are more active and feeling some emotional relief, therapists begin to educate them about their negative automatic thoughts --The individuals are instructed to recognize and record automatic thoughts as they occur and to bring their list to each session ---The client and therapist then test the reality behind the thoughts, often concluding that they are groundless
Many studies: helpless animals have depleted norepinephrine and serotonin levels (depression is primarily due to biological factors)
-One group of rats was put in dangerous/helpless situations, while the other group was put in a safe area --Helpless rats became very depressed: --Even when the doctors showed them how to escape, they did not learn how to escape very well ---They exhibited low levels of norepinephrine -Rats that escaped: --These rats exhibited normal rates of norepinephrine ---It is only when the rats had a history of helplessness when they exhibited depression
Physical symptoms
-People who are depressed frequently have such physical ailments as headaches, indigestion, constipation, dizzy spells, and general pain --Many depressions are misdiagnosed as medical problems ---Disturbances in appetite and sleep are particularly common ---Most depressed people eat less, sleep less, and feel more fatigued than they did prior to the disorder
Selective extraction
-Pick one event that corresponds to view and ignore conflicting ones --When you do something selfish, you selectively pick which one you were being selfish in
Despite a lack of empirical evidence for its effectiveness, what type of treatment is still widely used for unipolar depression?
-Psychodynamic therapy: --Seeks to help clients bring these underlying issues to consciousness and work them through ---Encourages clients to associate freely during therapy; suggest interpretations of the client's associations, dreams, and displays of resistance and transference; and help the person review pas events and feelings ----Psychodynamic therapists expect that in the course of treatment depressed clients will eventually gain awareness of the losses in their lives, become less dependent on others, cope with losses more effectively, and make corresponding changes in their functioning
Personalization
-Relating irrelevant events to self --The event has no reference to you, but you take it as having a reference to you, personally ---Ex: you think people are laughing at you but they are laughing at something else
Rumination theory (theories used to explain this ratio of men to women who suffer from depression)
-Rumination is related to depression --Research reveals that women are more likely than men to ruminate when their mood darkens, perhaps making them more vulnerable to the onset of clinical depression
Treatments for postpartum depression
-Self help support groups have proved extremely helpful for many women who are at risk for postpartum depression. -Many respond well to treatments that are used to treat forms of depression-antidepressant medications, cognitive-behavioral therapy, interpersonal psychotherapy, or a combination of these approaches
Appetite disturbance (Characteristics of depression)
-Serious depression: --Among the things of emotional interest is food ---They have no interest in eating and will typically lose weight -Mild depression: --The person will over eat
Minimization
-Significance of good event --Has a certain significance that seems significant, but the person minimizes it ---Ex: a guy kept going to this woman's work and speaking with her, and people said that this guy was interested in her and she said "no way, I am not good enough, he does not like me". She minimized the situation
Physiological and behavioral symptoms (Characteristics of depression)
-Sleep disturbances: --Person suffers from insomnia --Person suffers from early morning waking and are unable to fall asleep after they wake up
The "Insidious Attributional Style"
-The depressed person has a specific thinking style -Thinking in ways that lends self to depressive thinking style, when confronted with negative events
Negative view of the future (Cognitive Characteristics of depression)
-The depressed person is typically pessimistic -They view the future as having nothing good for them, they will never be happy again; hopelessness -This feeling is tied mostly towards suicide
Negative view of self (Cognitive Characteristics of depression)
-The depressed person views him or herself in a very negative light -The person will blame themselves for any bad things that happen
Unipolar
-The person is only getting depressed. --When they are out of their depression, they are back to normal
Low activity level (Characteristics of depression)
-The person just does not feel like doing much -They will lie in bed all day -They do not have the energy to do much
Phase 4: Changing primary attitudes (four phases of cognitive therapy)
-Therapists help clients change the maladaptive attitudes that set the stage for their depression in the first place --As part of the process, therapists often encourage clients to test their attitudes
Postpartum Depression
-Typically begins within four weeks after the birth of the child; many cases actually begin during pregnancy. This disorder is far more sever than simple "baby blues" Depressive symptoms continue and may last up to a year or more --Symptoms include extreme sadness, despair, tearfulness, insomnia, anxiety, intrusive thoughts, compulsions, panic attacks, feelings of inability to cope, and suicidal thoughts. The mother-infant relationship and the psychological and physical health of the child may suffer as a result
Overgeneralization
-Uses event to confirm schema --Ex: a man breaks up with a woman and the woman thinks "No one will ever be with me now"
Phase 1: Increasing activities and elevating mood (four phases of cognitive therapy)
-Using behavior techniques to set the stage for cognitive dimensions of treatment, therapists first encourage clients to become more active and confident --Clients spend time during each session preparing a detailed schedule of hourly activities for the coming week ---As they become more active from week to week, their mood is expected to improve
Positive events explained opposite way.. "Insidious Attributional Style"
-When a positive event occurs, the person believes that it happened due to external reasons --Ex: I got an A in chemistry but it's because my professor was super easy. Next time, I might not get so lucky with an easy professor
Responds to drugs (depression is primarily due to biological factors)
-When you take drugs that increase norepinephrine, nearly 50% of depressed patients feel better or have relief --However, they can have a lot of nasty side effects -SSRI's are much safer, but they have a lower success rate
Artifact theory (theories used to explain this ratio of men to women who suffer from depression)
-Women and men are equally prone to depression but that clinicians often fail to detect depression in men --Perhaps depressed women display more emotional symptoms, such as sadness and crying, which are easily diagnosed, while depressed men mask their depression behind traditionally "masculine: symptoms such as anger ---Research indicates that women are actually no more willing or able than men to identify their depressive symptoms and to seek treatment
Life stressors theory (theories used to explain this ratio of men to women who suffer from depression)
-Women in our society are subject to more stress than men --Women face more poverty, more mental jobs, less adequate housing, and more discrimination than men-all factors that have been linked to depression
Lack of control (theories used to explain this ratio of men to women who suffer from depression)
-Women may be more prone to depression because they feel less control than men over their lives -Women in our society are more likely than men to be victims across various domains
How much relapse occurs after cognitive-behavioral and interpersonal therapies?
30%
Depression
A low, sad state in which life seems dark and its challenges are overwhelming
Is there an accepted theory for the ratio of men to women who suffer from depression
Each explanation for the gender difference in unipolar depression offers food for thought
Negative view of the experience (Cognitive Characteristics of depression)
Ex: you see the glass half full, a depressed person sees it half empty
According to Beck's theory, what sorts of early experiences are often involved in persons later being prone to depression
Loss, rejection, criticism
Magnification
Magnify the importance of the event
Why don't women with PPD seek help
Many women who would benefit from treatment do not seek help because they feel ashamed about being sad at a time that is supposed to be joyous and are concerned about being judged harshly
Chronic fatigue (Characteristics of depression)
Person is overly tired all the time, having no energy
According to behaviorists, what causes unipolar depression?
Significant changes in the number of rewards and punishments people receive in their lives
Mania
The opposite of depression, is a state of breathless euphoria, or at least frenzied energy, in which people may have an exaggerated belief that the world is theirs for the taking
What is the ratio of men to women who suffer from depression
Women are at least twice as likely as men to receive a diagnosis of unipolar depression