Introduction
This research is aimed at investigating the causes and effects of such mental disorder as depression. In addition to that, I intend to analyze various treatment modes and ascertain their effectiveness. This particular aspect interests me, because depression is by far the most widespread mental disorder, and its causes have yet to be clearly identified. Therefore, there is a controversy regarding treatment methods. It is not clear which technique is the most efficient. Additionally, it is necessary to show whether the cause of depression and the treatment mode are closely related to each other. In my opinion, this question remains unresolved. These are the reasons why I have chosen this area of research.
Discussion
It is of crucial importance to discuss different points of view as to this issue. Moreover, the study of mental disorders requires various approaches to the psychological disease, because the concept of depression has always been a very subjective notion and even now, therapists cannot concur with each other, as to how one can define depression, its causes, symptoms, and effects. Therefore, there is no panacea for this disease.
Overall, it is worth mentioning that depression has many manifestations and many definitions are possible. However, in the most general view, it can be defined as a mental disorder, which is characterized by feelings of inadequacy, extreme gloom, and inability to concentrate. People, suffering from it, tend to experience inferiority complex, guilt, the sense of hopelessness. As a rule, they are not inclined to participate in any kind of social activity, because, they think that social activity is useless, and the society is often considered by them as a depressing factor. In the most severe cases, such people are inclined to commit suicide.
As it has already been mentioned there is no universal approach to this issue, and it can be interpreted from various standpoints, such as for instance, biological, psychological, social, and evolutionary. Moreover, treatment modes are constantly evolving and their effectiveness (or ineffectiveness) has always been a subject of heated debate. In this research, I would like to discuss the current literature, and express my views as to the authors theories and conclusions.
The difficulty that I have faced while surveying the research works dedicated to this problem is the question of relevance and credibility. The point is that the number of scientific works, analyzing the phenomenon of depression is astronomical; therefore, it is not easy find the sources, applicable to my research. Thus, I had to enter the site of American Psychological Association and view the books, considered appropriate and relevant to this investigation. Certainly, every person can be biased in his judgment, and I could overlook some landmark works. Nevertheless, I singled out the following sources.
As far as the causes of depression are concerned, I should say that there are many approaches to this issue, such as for instance, psychological, biological, sociological, and evolutionary. Patricia Ainsworth in her book “Understanding Depression” analyzes these theories and gives her own interpretation of the factors, which intensify the feeling of depression. In her view, the underlying cause of depression is the so-called distorted information processing, which means that our memory sifts the information that we perceive, and some people usually focus their attention only on some negative events. Therefore, their world perception and self-esteem are distorted. As a rule, these people suffer from inferiority complex. Negative thoughts only intensify each other and the person falls into depression. Another psychological cause, that Patricia Ainsworth focuses on is the discrepancy between the persons expectations (“ideal ego” as the author puts it) and the reality. This inability to transform imaginary world into the real one also makes a person feel inferior to other people. It should be mentioned that, very often such people are prone to commit suicide.
While analyzing the biological approach to the problem of depression, the researcher does not quite approve the extensive use various antidepressants. Overall, the essence of the biological theory boils down to the belief that the deficiency or serotonin is the main cause of depression. It is also known as Monoamine Theory. According to this approach, increasing the level of serotonin can be efficient in treating depression. However, many researchers object to this Monoamine Theory, saying that there is no interrelationship between the deficiency of this substance and depression. The main reason for such controversy is that it is difficult to identify the connection between these two phenomena. For instance, many people, who have low level of serotonin or dopamine, do not suffer from depression. Nevertheless, Patricia Ainsworth believes that this theory cannot be altogether rejected mainly due to the complexity of such connection. In her view, the interrelationships between mental disorders and biological processes still require thorough research and analysis (Patricia Ainsworth, pp. 49- 56).
As regards social causes of depression, Patricia Ainsworth refers to behavioral theory. She believes that the loss of social support contributes to the overall feeling of despondency. In addition to that, the researcher stresses the idea that people often “overrespond” to this loss. To some extent, it is a vicious circle. The point is that people, usually withdraw from social activities, thus, they do not receive social support. It only intensifies the disease.
There is also evolutionary approach to depression; according to it, every mental disorder is genetically determined. Naturally, many recent researches substantiate this theory; every gene is charged with a certain function, and some genes shape out emotional behavior, for instance the propensity to depression. If this gene of depression is a dominant one, the person is very likely to suffer from this mental disorder.
This book is relevant to my research, because it provides a thorough and concise analysis of the factors that cause depression. The author presents up-to-date views as to this problem, which is of the utmost importance, because psychological science is constantly evolving. Furthermore, Patricia Ainsworth argues, that in the overwhelming majority of cases, the causes of depression should not be discussed separately, because they are often closely intertwined and create a complex. Consequently, it is necessary to combine treatment modes, because otherwise the therapy can be useless.
Now when the causes of depression are briefly discussed, it is necessary to analyze the use of various therapy methods, it is necessary to show the relationships between the cause and the method. It should be mentioned that, sometimes therapists can diminish or the effect of the disease, however, they are not able to eradicate its cause, which makes the therapy less efficient to say the least.
For example, it is quite possible to mention such book as “Reinventing Depression. A History of the Treatment of Depression in Primary Care, 1940-2000” by Christopher Callahan and German Berrios. The authors trace the genesis of various treatment modes. In particular, they focus attention on the effectiveness or ineffectiveness of these methods. Furthermore, this book provides a thorough analysis of such phenomenon as depression, and its manifestations.
For instance, the authors subject to heavy criticism the use of various drugs in treating depression (such approach was very widespread in the middle of the twentieth century in the USA and many other countries). It is necessary to take into account that the focus of this book is primary care, and at times, drugs can be the only possible solution. However, the researchers prove that such method can only have detrimental effects on the patient, because it disregards “human capacity”, in other words, the ability of our consciousness to cope with depression or any other mental disorder. In their opinion, it is necessary to find equilibrium between “human capacity and capacity of technology”. To some extent, it is the golden mean between drugs and the strength of will (Christopher M. Callahan, pp. 105-108).
It is also necessary to present their views and ideas as to the modern treatment modes of depression. The scholars believe that there are no objective diagnostic criteria for mental or emotional disorders in general and namely depression. In other words, what can be called depression and why? How does it declare itself physiologically and psychologically? The authors argue that therapists can be easily mistaken in their judgment, while diagnosing. In order to substantiate their statement, they draw an example of three therapists, setting different diagnoses to the same patient, who, in fact did not suffer from any mental disease. Christopher Callahan and German Berrios also stress the necessity for new measures of severity, because very often a mistake of a psychotherapist may prove to be catastrophic to the patient. This book is of great relevance to the research that I intend to carry out because, it presents a thorough analysis of various treatment modes, in particular their advantages and disadvantages. Moreover, the authors touch upon a very important issue as criteria for diagnosing. It seems to me that that psychological still cannot give a concise answer to this question.
It stands to reason there is a vast variety of treatment modes and their modifications. In this research, I would like to discuss only the major ones, as for instance, as for instance cognitive behavioral therapy, medication (or the use of antidepressants) , interpersonal therapy, and psychoanalysis.
As far as the cognitive therapy is concerned, I would like to refer to the works of such scholar as Aaron Beck, and particularly to his book “Cognitive Therapy of Personality Disorders”. Overall, this kind of therapy is based on the belief, that people usually distort the information about themselves and the surrounding world. Those people, who suffer from depression disregard the positive aspects and see only negative ones. Additionally, even if they admit positive aspects, they usually downgrade them. In fact, cognitive therapy views depression as a “negativistic personality disorder”. The therapist has to perform several important tasks; first, he must to prevent the patient from maximalist thinking, such motto as “all or nothing” is usually a token of impending depression. Secondly, the therapist should pay extra attention to the results that the patient has already achieved, proving that they cannot be ignored or disregarded (Aaron T. Beck, pp 77). As every method or technique, CBT may have its drawbacks, and Aaron Beck warns therapists of the dangers, that they should expect. First, the therapists can also distort the patients perception of the world, and especially the patient can ignore the reality and turn into a Narcissus, the person with overrated self-esteem. Recent researches prove that CBT is more efficient if it is combined with other therapy methods, for instance, interpersonal therapy (Reinecke, p.33).
Interpersonal therapy mostly deals with the social causes of depression, in particularly the loss of social support and the persons overreaction to this fact. It was described and analyzed in Mark Reineckes book “Comparative Treatments of Depression” The therapist must teach the patient to “elicit positive responses” from other people(Mark A. Reinecke, pp. 82-86).
This kind of therapy also focuses on developing social skills and especially ability to hold a conversation, because very often reticence may produce an impression that a person is disinterested or even haughty. Therefore, we usually tend to ignore him or her. In turn, this individual feels abandoned or alienated. This type of relationships creates a closed circle, which is very difficult to break. The therapist should identify the aspects of clients behavior, which contribute to his alienation and modify them. As the author states, interpersonal therapy can be more effective if it is used together with CBT. In fact, interpersonal therapy employs some principles of cognitive approach, but it looks at them from a social standpoint.
Regarding the use of psychoanalysis while treating such mental disorder as depression it should be mentioned that for the first time this technique was employed by Karl Abraham, who believed that depression as any mental disorder can be ascribed to a persons inability to control his destructive or sexual instincts or impulses. It the destructive instincts are predominant, the patient is not confident in his libidinal abilities. The main task of the therapist is to resolve the conflict between Eros and Tanatos (love and death instincts). However, some scholars believe that psychoanalysis cannot be always applicable to depression, mostly, because it does not take into account the causes of depression. They argue that depression is not always determined by the instincts of self-preservation and the sexual desire. Therefore, such approach should be used only as a part of complex (Maser, pp. 22-30).
As for the use of pharmacological therapy, I can single out such book as “Depression Disorders”, written by Mario Maj. As it has been mentioned almost every antidepressant increases the level of serotonin in the human body, and that is supposed to prevent the patient from falling into depression. The author argues that such treatment mode reduces only effects of depression, but it does not eradicate the cause. Mario Maj believes that deficiency of serotonin is only the consequence of despondence. Moreover, he stresses the idea that frequent use of antidepressants eventually leads to addiction, which subsequently only intensifies depression(Mario Maj, pp. 92-100).
In my opinion, none of the above-mentioned methods can be disregarded or rejected. However, one must always bear in mind the degree of severity, because various cases require various types of medical intervention. However, it seems to me that combined use of CBT and interpersonal therapy will be the most prudent way to cope with depression.
Conclusion
This research can be easily continued; in particular, I would like to focus on the relationships between cognitive and interpersonal therapy, and the way these two approaches to depression can be incorporated.
Bibliography
- Aaron T. Beck. Denise D. Davis (2004). Cognitive Therapy of Personality Disorders. Guilford Press.
- Christopher M. Callahan. German E. Berrios (2004).Reinventing Depression: A History of the Treatment of Depression in Primary Care. Oxford University Press
- Jack D. Maser. (1987) Depression and Expressive Behavior. Lawrence Erlbaum Associates.
- Mario Maj. (2002) Depressive Disorders. Wiley.
- Mark A. Reinecke. (2002). Comparative Treatments of Depression. Springer.
- Patricia Ainsworth (2000). Understanding Depression. Univ. Press of Mississippi.