Depression Flashcards
(32 cards)
What is depression
Many different definitions for depression depending on the perspective. The DSM-5 states unipolar depression to be Five or more symptoms for 2 weeks or longer
What are the symptoms of depression?
Depressed mood for most of the day OR
Diminished pleasure in activities
Significant differences in gaining/ loosing weight
Insomnia / hypersomnia
Aggitation
Fatigue / loss of energy
Feelings of worthlessness / guilt
suicide attemps / thoughts
Prevalnce of depression in the west?
Lifetime prevalence = 18%
1 year prevalence = 8%
almost twice as common in women than men
However men are less likely to seek help so stats are off there.
Describe the Onset (age where depression begins) -kessler 2003
Kessler et al 2003, states that as depression has become more common over the years, the onset has become earlier.
Co-mordibity rates
Depression is rarely the only health disorder a person has, often in conjuection with anxiety, substance missuse, and personality disorders such as impulsibility.
depression = 4th most common death in 15-30 year old (WHO)
4 Types of Risk factors within depression
-Biological risk factors
-Cognitive risk factors
-Social risk factors
-behavioural risk factors
Describe biological risk factors of depression
-genetic vulnerability
-Potential role of neurotransmitters (monoamine hypothosis)
-Serotonine deficiancy
Describe the monoamine hypothesis
Monoamine hypothesis proposes that people with depression have a chemical imbalance of neurotransmitters such as serotonin and norepinephrine.
Serotonin = regulation of hormones
Norepinephrine = regulation of arousal, attention, cognitive function, and stress reactions.
Low levels of these neurotransmitters = low mood / lack of pleasure as seen in depressed patients
Support of the monoamine theory
SSRI’s
serotonin selective reuptake inhibitors.
Block the reuptake of neurotransmitters responsible for regulation of mood by keeping them in the synapse for longer = increased effects of serotonin.
Supports monoamine theory as people who suffered with depression saw improvements of mood in comparison to non-depressed participants.
Evidence against the monoamine hypothesis
SSRI’s take a while to work
Not everyone reacts to them
Conclusion: “no consistent evidence of there being an association between serotonin and depression, and no support for the hypothesis that depression is caused by lowered serotonin activity or concentrations.”
Limitation of SSRI’s for depression
important that people take control over their mood otherwise people think taking their medication is the only solution = people end up being on medication for the rest of their lives
-influences decisions about whether to take or continue antidepressant medication
-may discourage people from discontinuing treatment, potentially leading to lifelong dependence
Support for Social factors of depression
ACES study
-found that people have experiences a number of different life experiences in past or present.
The more of these experiences faced, the more likely you were to be prescribed antidepressant medications - as close to identifying cause and effects as we can get.
Social risk factors include:
- Austerity
- Abuse and bullying
- Prejudice, discrimination and oppression
- Social disadvantage
- Early relationships with caregivers - Attachment, stresses on parents
- Isolation
- Gender and different social experiences
Migration
Interpersonal problems and depression:
Social relationships are really important factor.
Those who have strong social relationship you have less of a chance to get depressed.
However, it is arguably a reverse case whereby if you are depressed, you are more likely to have interpersonal problems, isolate yourself. So is it that people who are not depressed have better social lives or is it that people who have a good support system are less likely to be depressed?
Can social support be considered a protective factor of depression
To some extent…
Poor quality of close interpersonal relationships as a vulnerability factor
Not everyone who has a negative life event becomes depressed…
Difficult to disentangle cause and effect
○ Patients with depression tend to become withdrawn
○ They may also rate their interpersonal relationships negatively
○ Others may react negatively to the person with depression
However, research does show a ‘dose effect’: the more ACES you experience, the increased likelihood of developing mental health problems.
What does the cognitive model of depression propose?
Depression is due to faulty information processing about self and situations
○ Negative cognitive biases
○ Negative interpretations of self, world and future
○ Experienced as ‘negative automatic thoughts’ which are believed to be accurate representations of reality - stand out thought (NATS)
○ Driven by underlying cognitive structures or ‘core beliefs’(‘schema’) that come from our experiences .
§ Develop based on experiences
§ Influence how we view the world
§ Act like a filter through which we interpret events (experience life)
What are some common unhelpful biases
All-or-nothing thinking: seeing things in black-and-white. If your performance isn’t perfect, you see yourself as a complete failure
Overgeneralisation: tendency to see a single negative behaviour or event as a never-ending pattern or characteristic: ‘Jack got sent home from school, so I must be a bad mother’
Personalisation: seeing yourself as the cause of an external event for which you couldn’t be responsible: ‘What did I do to cause this?’
Mental filtering: the tendency to pick out a negative detail of a situation and dwell on it, to the exclusion of all positive aspects
Jumping to conclusions: arriving at an erroneous (negative) interpretation of events on the basis of little evidence
* E.g., ‘Mind Reading’: ‘she’s behaving strangely so I must have done something to upset her’
Catastrophising: exaggerating the importance of specific events (usually one’s own mistakes) – ‘I failed my first exam, so I’m going to fail the course’
Minimising: playing down your own positive qualities or achievements - ‘I got a good mark because I was lucky with the questions’
Disqualifying the positive – achievements ‘don’t count’ for some arbitrary reason
Explain The negative triad
Thoughts about themselves, future = negative
Negative views about self –> negative view about the world –> negative views about the future
This cycle causes and maintains symptoms of depression
Behavioural factors of depression include:
- Reduced activity
- Lack of exercise
- Fewer opportunities for rewarding activities
- Not living in line with values
- Isolation - more likely to have physical health and mental health problems when you are living alone / lonely.
- No sense of achievement
- Coping strategies that perpetuate problem e.g. excessive alcohol consumption (perpetuating factors)
Name a Treatment and support for mild depression
CBT
Name 4 treatments and support for moderate-severe depression
CBT
IPT
+ antidepressants
MBCT
How long does CBT last?
And what is included in it?
CBT can range from 6 to 20 sessions
Key components of CBT for depression:
Behavioural activation Increasing daily activities to reduce withdrawal and immobility Increase involvement in positively reinforcing activities Targets avoidance Cognitive restructuring Becoming aware of negative ‘automatic’ thoughts Evaluating these thoughts (particularly negative opinions about the self) and generating more helpful alternatives Testing negative beliefs against reality Relapse prevention
CBT activities include:
Diary entries:
Thought diaries
IPT in-depth treatment strategies
Exploring interpersonal problems
Increase understanding
Evaluate significance of interpersonal roles/relationships
Identify patterns
Addressing interpersonal problems
Normalise experience (grief over death, role transition)
Explore alternative responses
Develop new relationships/ways of interacting with others
Develop new social support
Resolve conflict
Develop new social skills
Relapse prevention
