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Depression. Symptoms of a Major Depressive Disorder. Affective: guilt and sadness, lack of enjoyment or pleasure in familiar activities or company. Behavioural : passivity
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Symptoms of a Major Depressive Disorder • Affective: guilt and sadness, lack of enjoyment or pleasure in familiar activities or company. • Behavioural: passivity • Cognitive: negative thoughts, faulty attribution of blame, low self esteem, irrational hopelessness, difficulty concentrating, indecisiveness • Somatic: lack of energy, insomnia or hypersomnia, weight loss/gain, diminished libido.
Diagnosis of Depression • When someone experiences two weeks of depressed mood or loss of interest or pleasure. • Diagnosis requires at least 4 additional symptoms (such as insomnia, suicidal thoughts, passivity, or difficulty concentrating).
Facts about Depression • Depression affects 15% of people at some time in their life (Charney and Weismann 1988). • Depression tends to be a recurrent disorder with about 80% experiencing a subsequent episode. • Depression is 2-3 times more common in women than in men. • It occurs frequently among members of lower socio-economic groups. • Levav (1997) found the prevalence rate to be above average in Jewish males suggesting that some groups are more prone to depression.
Serotonin & Depression • Prozac: blocks the reuptake of serotonin thereby leaving more serotonin in the synaptic gap/cleft. • Serotonin is known to affect mood, emotions, aggression, sleep and anxiety.
Noradrenaline & Depression • Another neurotransmitter called noradrenaline is found to be correlated with depression. • Janowsky et al. (1972) • Participants were given a drug called physostigmine (which lowers noradrenaline but increases acetylcholine). • They experienced feelings of self-hate and suicidal wishes within minutes.
Cocktail of Neurotransmitters? • Rampello et al. (2000) found depressed patients to have an imbalance of noradrenaline, serotonin, dopamine (pleasure), acetylcholine (memory). • Skeptics say that pinning depression to just neurotransmitters is too simple and reductionist (reducing complex behavior to a single factor).
Stress & Depression • Cortisol: a hormone that helps us cope with stress. • Cortisol hypothesis: Too much or too little cortisol levels may predispose an individual to depression. • Cushing’s syndrome: a disease which results in excessive production of cortisol. • There is a high prevalence of depression among people with Cushing’s syndrome.
Overproduction of cortisol may decrease the density of serotonin receptors and damage noradrenaline receptors. • However, people develop depression without being stressed and people who have experienced terrible stress do not always develop depression.
Does poverty cause depression? • Fernald and Gunnar (2008) • Surveyed 639 Mexican mothers and their children. Children of depressed mothers living in extreme poverty produced less cortisol. • This indicates a “worn out” stress system that leaves children susceptible to depression.
Cognition and Depression • Ellis (1962) • Proposed that irrational thinking causes depression, not the other way around.
Beck (1976) • Observed that depressed patients’s thoughts are characterized by: • Overgeneralization based on negative events • Non-logical inference about oneself • Dichotomous thinking (black and white thinking)
Beck’s theory of Cognitive Restructuring • Identifies negative, self-critical thoughts • Notes the connection between negative thought and depression. • Examines each negative thought and decides whether it can be supported. • Replaces distorted negative thought with realistic interpretations of each situation.
Buehler & O’Brien (2011) • 1364 mothers across the US were studied and one child in the family were studied. • Interviews and observations were made during the child’s 1st, 3rd, and 5th grade years.
Findings • Full-time and part-time mothers reported fewer symptoms of depression than stay-at-moms. • Part-time moms were just as involved in their child’s schooling as stay-at-home moms and were actually more sensitive with their pre-school children than stay-at-home moms.
Diathesis-stress Model • Depression is a result of genetic predisposition and severe life events such as: • Unemployment • Having more than 3 children under 14 at home • Absence of social support • Loss of mother at a young age • Having suffered child abuse
Brown and Harris 1978 • Studied 458 women in London aged between 18 and 65 years. • Researchers used surveys and interviews on the women’s life and depressive episodes.
Findings • In the previous year, 8% of the women had been depressed. • 90% those who became depressed had recently experienced a severe life event. • Only 20% of women who had experienced severe difficulties became seriously depressed. • 23% of working class women had been depressed within the past year compared to 3% of middle class women.