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Block 4 Unit 1 Depression

1. Define and describe depression.

Depression is a physical illness with many symptoms beyond just an unhappy mood. While sadness is a natural human reaction to painful circumstances, depression is a more severe and persistent state. It can include a range of psychological, emotional, and physical symptoms and is differentiated from sadness by its severity and duration.

2. Elucidate the signs and symptoms of depression in general.

General signs and symptoms of depression include:

• Persistent sadness or low mood: A pervasive and prolonged feeling of sadness.
• Loss of interest or pleasure: A diminished interest or lack of enjoyment in activities that were previously pleasurable.
• Changes in appetite or weight: Significant weight loss or gain not related to dieting.
• Sleep disturbances: Insomnia or excessive sleep.
• Fatigue or loss of energy: Feeling constantly tired and lacking energy.
• Feelings of worthlessness or inappropriate guilt: Experiencing excessive self-blame or guilt.
• Impaired concentration or indecisiveness: Difficulty in focusing, making decisions, or remembering things.
• Agitation or slowing down: Noticeable restlessness or sluggishness.
• Recurring thoughts of death or suicide: Obsessive thoughts about death or considering suicide.
• Physical symptoms of anxiety, including dry mouth, cramps, diarrhea, and sweating.

3. What are the psychological symptoms of depression?

Psychological symptoms of depression include:

• Feelings: Persistent sadness, despair, guilt, irritability, agitation, and anxiety.
• Thoughts: Negative thinking patterns, low self-esteem, feelings of hopelessness, self-blame, difficulty concentrating, and thoughts of death or suicide.
• Behaviour: Withdrawal from social activities, decreased motivation, neglecting self-care and hygiene.

4. Enlist the physical or somatic symptoms of depression.

Physical or somatic symptoms of depression include:

• Changes in appetite or weight.
• Sleep disturbances such as insomnia or excessive sleeping.
• Fatigue or loss of energy.
• Psychomotor agitation or psychomotor retardation.
• Physical symptoms of anxiety, including dry mouth, cramps, diarrhoea, and sweating.

5. Delineate the criteria for formal diagnosis of major depression.

The criteria for formal diagnosis of major depression include:

• Experiencing a major depressive episode marked by either depressed mood or loss of interest or pleasure in almost all activities, plus at least four additional symptoms from the list of general symptoms.
• Experiencing one or more major depressive episodes without ever experiencing a manic or hypomanic episode.

6. What criteria to be followed to diagnose dysthymic disorder?

The criteria for diagnosing dysthymic disorder include:

• Depressed mood for most of the day, for more days than not, as indicated either by subjective account or observation by others, for at least two years.
• Presence of at least two of the following symptoms: poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions, and feelings of hopelessness.
• The symptoms are not due to the direct physiological effects of a substance or a general medical condition.
• The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

7. What is meant by seasonal affective disorder?

Seasonal Affective Disorder (SAD) is a type of depression related to changes in seasons, often occurring during the winter months due to reduced sunlight.

8. What are the typical symptoms of SAD?

Typical symptoms of SAD include:

• Sadness, guilt, and despair.
• Irritability, agitation, and anxiety.
• Reduced motivation to participate in activities.
• Neglecting self-care.
• Thoughts of suicide.

9. Discuss the symptoms of unipolar disorder.

Unipolar disorder is another term for major depressive disorder. Symptoms include:

• Depressed mood or loss of interest/pleasure, plus at least four other symptoms.
• Possible psychotic symptoms including delusions of guilt, punishment, or poverty.

10. Delineate the causes of depression.

Causes of depression can include:

• Genetic factors: Heritability and genetic predisposition.
• Psychological factors: Including negative thinking patterns, low self-esteem, and maladaptive coping mechanisms.
• Psychoanalytic theories: Early childhood experiences and unresolved conflicts.
• Interpersonal theories: Difficulties in relationships and social interactions.
• Cognitive theories: Negative automatic thoughts and distorted thinking patterns.
• Helplessness theories: Learned helplessness and attribution styles.
• Medical conditions: Such as adrenal and thyroid dysfunction.

11. State genetic factors as causing depression.

Genetic factors can contribute to a predisposition to depression. Although the sources don't give specific details, it's understood that heredity can make an individual more vulnerable to developing depression.

12. Elucidate the psychological factors causing depression.

Psychological factors contributing to depression include:

• Negative thinking patterns: Such as black and white thinking and overgeneralisation.
• Low self-esteem: Feelings of worthlessness and inadequacy.
• Maladaptive coping mechanisms: Ineffective ways of dealing with stress and challenges.

13. What is psychoanalytical explanation for depression?

Psychoanalytic theory explains depression as stemming from:

• Early childhood experiences: Unresolved childhood conflicts and traumas.
• Loss and grief: Particularly if the losses are not properly mourned.
• Internalised anger: Feelings of anger turned inward.

14. How do interpersonal theories explain depression?

Interpersonal theories explain depression as being caused by:

• Difficulties in relationships: Problems with social interactions and relationships can contribute to depression.
• Social isolation: Lack of social support can exacerbate depressive symptoms.

15. Explain cognitive theories for depression.

Cognitive theories of depression suggest:

• Negative automatic thoughts: Recurring negative thoughts that arise habitually.
• Distorted thinking patterns: Such as overgeneralisation, magnification, minimisation, and black-and-white thinking.

16. Elucidate the helplessness theory of depression.

Helplessness theories explain depression as stemming from:

• Learned helplessness: The belief that one has little control over their life, leading to passivity.
• Negative attribution: Attributing failures to personal shortcomings and difficulties in controlling a situation.

17. Discuss the biologically based treatment for depression.

Biologically based treatments for depression may include:

• Medications: Such as antidepressants which regulate brain chemistry.
• Electroconvulsive therapy (ECT): A procedure that can help reduce symptoms in severe depression.

18. Explain behavioural therapy as treatment of depression.

Behavioural therapy addresses depression by:

• Social skills training: Teaching basic verbal and non-verbal skills, and providing practice in real life situations.
• Monitoring behaviour: Clients learn to self-monitor their experiences, noting what provides pleasure and what lowers their mood.

19. Elucidate cognitive behavioural therapy as treatment for depression.

Cognitive Behavioural Therapy (CBT) for depression:

• Self-monitoring: Clients are taught to monitor and record their negative thoughts.
• Identifying negative thoughts: Special emphasis is placed on automatic negative thoughts.
• Modifying cognitive distortions: Helping clients identify and challenge distorted thinking patterns.

20. Discuss the causes for the occurrence of depression.

Depression is caused by a combination of factors:

• Biological: Including genetics and imbalances in brain chemistry.
• Psychological: Negative thinking patterns, low self-esteem, maladaptive coping strategies, past traumas and unresolved conflicts.
• Social: Difficulties with relationships and lack of social support.
• Environmental: Such as ongoing stressful life situations.

21. Explain depressive disorders.

Depressive disorders include:

• Major depressive disorder: One or more major depressive episodes without a manic or hypomanic episode.
• Dysthymic disorder: A chronic depressed mood lasting at least two years.
• Seasonal affective disorder (SAD): Depression related to seasonal changes and reduced sunlight.

22. Explain the significance of different approaches in treating depression.

Different approaches to treating depression include:

1. Biological approaches: Medications and electroconvulsive therapy (ECT), which address the biological aspects of depression.
2. Psychodynamic approaches: Focus on past experiences, unresolved conflicts, and internalised emotions.
3. Interpersonal therapy: Emphasises relationships, communication patterns, and social support.
4. Behavioural therapy: Includes social skills training and self-monitoring to improve social interactions and promote positive behaviour.
5. Cognitive behavioural therapy (CBT): Targets negative thoughts and behaviours through identifying distorted thinking patterns and developing problem-solving skills.

23. How is normal depression different from pathological depression?

Normal sadness is a transient feeling that passes as a person comes to terms with their troubles. It's a natural reaction to painful circumstances and is a part of being human. Pathological depression, also known as clinical depression, is a physical illness with more symptoms than just an unhappy mood. Key differences include:

• Duration: Normal sadness is temporary, while pathological depression can linger for weeks, months, or even years.
• Intensity: A person experiencing sadness feels bad but continues to cope with living. A person with clinical depression may feel overwhelmed and hopeless.
• Cause: Sadness often has a logical reason or trigger, whereas clinical depression may occur without an apparent reason.
• Impact on Functioning: While sadness allows a person to continue with their day-to-day life, depression can cause people to have difficulty participating fully in their lives. Depressed people may lose contact with friends and family and have poor work performance.

24. What criteria do we use to diagnose Bipolar I Disorder?

The criteria for diagnosing Bipolar I Disorder include:

• Current or most recent criteria must be met for a Manic, a Hypomanic, a Mixed, or a Major Depressive Episode.
• There must have been at least one Manic Episode or Mixed Episode previously.
• The mood symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• The mood symptoms are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.
• The mood symptoms are not due to the direct physiological effects of a substance or a general medical condition.

25. Describe the criteria to be used for Bipolar disorder II

The criteria for diagnosing Bipolar II Disorder include:

• Presence (or history) of one or more Major Depressive Episodes.
• Presence (or history) of at least one Hypomanic Episode.
• There has never been a Manic Episode or a Mixed Episode.
• The mood symptoms are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.
• The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

26. Explain the criteria for diagnosing cyclothymic disorder.

The criteria for diagnosing cyclothymic disorder include:

• For at least two years, the presence of numerous periods with hypomanic symptoms and numerous periods with depressive symptoms that do not meet the criteria for a Major Depressive Episode.
• In children and adolescents, the duration must be at least one year.
• During the above period, the person has not been without the symptoms in the first criteria for more than two months at a time.
• No Major Depressive Episode, Manic Episode, or Mixed Episode has been present during the first two years of the disturbance.
• The symptoms are not better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified.
• The symptoms are not due to the direct physiological effects of a substance or a general medical condition.
• The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

27. What is the psychodynamic approach to treatment of depression?

The psychodynamic approach to the treatment of depression involves weekly to five times a week individual therapy. This type of therapy tries to make the unconscious motivation behind disordered behaviours into conscious motivation. The relationship between the therapist and the client is used to explore important past experiences in the patient's life. This approach aims to help the client become aware of their beliefs, which originated in past experiences, and identify their reactions, helping them to alter these reactions.

28. How does interpersonal psychotherapy function as treatment for depression?

Interpersonal psychotherapy (IPT) functions as a treatment for depression by:

• Teaching people to be more socially effective to improve their relationships with others.
• Integrating the psychodynamic perspective which emphasizes early childhood experiences with the cognitive behavioural perspective which emphasizes current stressors.
• Focusing on current psychosocial stressors such as chronic marital discord.
• Working well when paired with antidepressant medication.
• Being effective in both lessening depressive symptoms and extending periods of remission for people with recurrent depressions.