What is the criteria for Major Depressive Disorder?
5 or more depressive symptoms (including sad mood or loss of pleasure)
Must occur no less than 2 weeks
What are symptoms of Major Depressive Disorder?
Hypersomnia/insomnia Weight gain/loss Psychomotor agitation/retardation Fatigue/lack of energy Sadness Anhedonia (loss of interest) Emptiness Guilt Overwhelmed Hopelessness (best predictor of suicide) Worthless Loneliness Somatization Chronic pain Suicidal preoccupation with death Inability to concentrate Indecisiveness Negative thinking Rumination Constant worrying
What is the monoamine hypothesis?
Sachar and Barron, 1979
Depression results from not enough serotonin, norepinephrine, and dopamine in the brain
How does Freud (1917) conceptualize depression?
Depressed people suffer a symbolic loss
There is a disturbance in self-regard
Anger turned inward becomes self-deprecation and low self-esteem
Cause by over or under gratification of the oral stage
What is the citation for Freud’s view of the etiology of depression?
What are the 2 types of depression? (Blatt, 1974)
Introjective - individual feels worthless, guilty, and fears loss of approvale - lots of unrelenting internal criticism
Anaclitic - individual feels helpless, weak, and fears abandonment - attachmetn concerns
What is the citation for the 2 types of depression?
Fairbairn’s view of depression? (1941)
Due to disturbed relational patterns which are internally replayed
Circumstances disturb the object relations and result in hate and aggression turned inward
Impacts ability to establish new relationships
Winnicott’s perspective on the etiology of depression? (1949)
Failures in the “good enough” mothering and holding environment
Individual takes on a false self to appease others and the external world
Anything good for the individual results in feelings of guilt and displeasure (and subsequent depression)
Furmann’s (1982) contribution to etiology of depression?
Depressive dynamics from the separation-individuation process
Occurs when mother experiences pain regarding the child’s growth and separation
Mother either clings and induces guilt or pushes the child away
Child experiences the self as bad - feels that normal wishes of aggression and independence are hurtful or learn to hate natural dependent strivings
Beck’s (1976) perspective regarding the etiology of depression?
Cognitive triad - negative thoughts of self, world, and future
Differential DX for depression? Things to rule out?
Medical problems including MS, stroke, diabetes, cancer, hypothyroidism Substance use Other mood disorders Adjustment disorder PTSD
What is the diathesis stress model? (Meehl, 1962)
Genetic predisposition for depression which then occurs as a result of environmental stressors
What is the citation for the diathesis stress model?
What brain abnormalities can be present with depression? (Elkis et al., 1996; Drevets et al., 1992)
Decreased tissue in the prefrontal cortex
Increased activity in the amygdala
What is the citation for brain abnormalities in depression?
Elkis et al., 1996
Drevets et al., 1992
What is the citation for the monoamine hypothesis?
Sachar and Barron, 1979