Which explanation for depression is the most effective?

1 Dec

Depression is a complex affective disorder which causes a variety of symptoms such as cognitive (impaired concentration), emotional (feelings of guilty), behavioural (social withdrawal) and biological (insomnia).

Finding an suitable treatment for depression depends on using the appropriate explanation.. The Biological approach assumes that depression is caused by a physiological malfunction in the body and can be cured by rectifying the malfunction. Specifically the approach looks at the levels of serotonin in the brains synapses and how these can be disrupted if too many enzymes (MAOase) are produced so more serotonin is broken down than is necessary or if serotonin is not taken in by the reuptake protein. Wender et al (1976) compared the psychiatric evaluations of 71 adult adoptees with depression, to their biological relatives and found that relatives of the adoptees were eight times more likely to have that same disorder. This suggests that biology is a major contributing factor to the development of depression because the disorder was inherited without any noticeable influences within the environment.

An advantage of this explanation is drug treatments can be used, independently of therapy. This alone should be able to cure the patients depression, in a relatively quick and less time consuming method.  However, a disadvantage is that drug treatments can have considerable side effects which may discourage the patient from adhering to their medical regime. For example Monoamine Oxidise Inhibitors (MAOIs) can react with specific common foods, such as cheese, to cause an increase in blood pressure and heart failure.

The Behavioural approach assumes that depression is caused by individuals reaction to a specific environmental factor.  Lewinnsohn (1974) thought that depression was a result of operant conditioning, where a person experiences a loss (of a loved one) and means they get less positive reinforcement because they used to make the person feel good, leading to depressive symptoms. Others may become initially concerned about the depressed person and this creates positive reinforcement and a reason for the person to continue with their depressed behaves.

The same researcher tested this theory by comparing the amount of positive reinforcement received by depressed and non-depressed patients. The participants completed two questionnaires, twice a day for thirty days. The first was a list of words and the participant had to select which represented their mood (for example “blue”) and this indicated how many symptoms of depression they were experiencing. The second questionnaire recorded how many pleasant activities (such as yoga) the participants took part in. A significant correlation was found between the mood rating of participants and taking part in pleasant activities. This shows that reinforcement from pleasant activities is linked to a lesser likelihood of developing depression. Depression can then be treated by reinforcing non-depressive behaviour with a “coping with depression course”.  Lewisohn (1990) found that after taking the course only 57% of participants still met the DSM criteria of depression compared with the control group, of which 95% of the participants were still depressed.

An advantage of the behavioural approach to explain depression is it reduces the causes of depression down to environmental stimuli, so once the trigger for depression is found it can be treated effectively. However, further research is needed to identify the individual differences between participants, other than positive reinforcement, which could be the cause of depression. As yet, the behaviourist explanation is not extensive enough to be trusted as valid.

Overall, I think that both approaches to explaining depression are too reductionist to be used alone, because the biological approach does not take into account how the depression affects the patients emotions. The behavioural approach fails to recognise that drugs can be effective, because it only considers the environments influence on an individual, when empirical evidence has shown that drugs can be effective. A combination of explanations is needed in order to produce an effective treatment for each patient.

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8 Responses to “Which explanation for depression is the most effective?”

  1. psychdout December 4, 2011 at 4:29 pm #

    Depression is an individual diagnosis and each case should be treated on an individual basis, therefore effectiveness of treatment cannot necessarily be generalised. Although I do agree to a certain extent that the biological explanation is important,as to identify the bioloigcal resasoning behind depression is making it one step closer to early treatment, as researchers are able to know what to look for. However, drug treatment is not for everybody and should be seriously thought about before administrating. I agree that both approaches are reductionist in explaining depression, but I think many researchers need to be reductionst when researching this topic, in order to gain a whole picture, therefore all appproaches would gain an effective treatment fro depression in their area and then all treatments, can be integrated and can be used in combination to effectively treat individual cases.

  2. bpmjb December 5, 2011 at 4:11 pm #

    There is considerable evidence to support the biological explanation of depression. Particularly as you have stated a reduction in the neurotransmitter serotonin is thought to be apparent in individuals diagnosed with depression. Major depression and suicide have come to be associated with fluctuations in serotonin in the brain. Arango et al. (2003) found that a reduced serotonin input in the brain in suicide victims could predispose the individuals to act on their suicidal thoughts. In addition Mann et al. (1991) fond impaired serotonin functioning in depressed patients. Mayeux (2004) corroborated this evidence indicating that depressed participants in their investigation had significantly lower levels of the neurotransmitter serotonin than the control group of non-depressed participants. One of the main problems with the biological account in relation to the neurotransmitter serotonin is aetiology fallacy, in that it is unknown whether low levels of serotonin are the cause of depression or the result of depression. Drug therapy which complements the biological explanation of depression has been criticised with regard to drugs only tackling the symptoms and not the root cause of the issue. Furthermore drugs can in some ways act as chemical strait jackets in that they control the persons behaviour making it more manageable and socially acceptable. I agree with you that the just using the biological explanation is both insufficient and reductionist in accounting for depression. Considering behavioural theorists such as Beck (1979) have found that depressed people often engage in negative thought processes were they exaggerate their weaknesses and minimise their strengths.

  3. codyporter December 7, 2011 at 2:59 pm #

    Kenneth & Prescott (1999) found that major depression is equally heritable in men and women. They reach this conclusion by carrying out research for MZ and DZ twins. I noticed in your blog that you did not have a lot of supporting research for the biological explanation for depression.

    Family history studies are also a good method for looking at depression and how it can effect people. Another disadvantage of using drug therapy is that often when the drugs stop, the depression returns. This is because drugs only target and stop the symptoms of depression, they do not deal with what is causing it.

    The biological approach is reductionist as it fails to take other factors into consideration such as the environmental issues concerning the person. However, when looking at the behavioral explanation for depression, it also fails to take other factors into consideration so is also reductionist. I agree with you that both approaches have supporting evidence as well as limitations. I would personally be in the middle of these two explanations of depression.

    Reference;

    Kenneth.S.K., Prescott.A.C 1999. A Population-Based Twin Study of Lifetime Major Depression in Men and Women. Arch Gen Psychiatry. 56:39-44.

  4. bngpsych December 8, 2011 at 3:55 pm #

    I agree with you that a unified approach is needed in psychology to help those who suffer from depression. However, psychology has six conflicting perspectives in the field so a unified approach and understanding is unlikely. The biological, cognitive, behavioural and social approaches theorise about the origins of depression. Depression is a common psychological disorder. Those who suffer from it experience loss of self-esteem and lack motivation, the degree of the depression can also vary. Some argue that there is a cultural difference in the amount of people who suffer from depression, arguing that western based societies suffer more. However, Rack (1982) argued that Asians are also depressed but just do not go to the doctor to report emotional stress, but rather physiological problems.

    Modern technology helps explore the brain through the use of EEGs and fMRIs and is it argued that it can therefore pinpoint depression. However, Lacasse and Leo (2005) argue that modern neuroscientific research is lacking in empirical evidence to suggest that depression is a result of simple neurotransmitter deficiency.

    Without a unifying approach in psychology each individual approach is reductionist as it is reducing depression down to one specific factor (genetics or environment). Drug treatment has come a long way in helping those who have low serotonin and who suffer from depression, as has therapy. Beck’s therapy aims to help those who suffer from depression by expressing their thoughts of themselves, the environment and their future. With therapy and drug treatment, the effectiveness of each treatment would increase.

  5. psue85 December 8, 2011 at 4:59 pm #

    Nature vs Nurture? I think that both biological and behavioral can both equally explain depression, as long as they are used together. A balance of the use of drugs and the consideration of different emotions. The behavioral approach can help find the source of the individuals depression and the biological approach can help treat the individuals depression. There may however be problems as these are obviously two different approaches based upon different perspectives. Putting the two approaches together is a good idea in theory but it could possibly mean holes are left. Aspects of the two different perspectives could be used to create a unified theory but still retain the individuality of two perspectives.

  6. psuf0f December 9, 2011 at 5:04 pm #

    I don’t think the cause of depression can be pinned down to either one of these approaches. Firstly, it is common knowledge that some people are genetically predisposed to develop depression, maybe someone in their family had it, or maybe they just are because their genes are that way. Then again, even though someone is predisposed to it doesn’t mean they’re going to get it, however, if something, such as the loss of a loved one, happens to kick start it then it is safe to say that you kind of need both of these explanations to get an accurate view on how depression develops. However, depression is an individual disorder and no individual’s circumstances are the same, everyone is unique, it would have been good of you to consider the humanistic approach to depression as well as the biological and behavioural one as it can never be truly determined what caused it unless the person who is afflicted with it tells us.

  7. rlrom December 9, 2011 at 11:08 pm #

    Individual differences should always be taken into account as there may be more than one valid explanation for depression and I agree that a holistic approach taking both explanations and finding a middle ground would be best. However there are more explanations to consider than even these two. For example, Beck and Clarke (1988) provide a cognitive explanation of depressive schemas which are a strong negative state. They argued that there are three elements to consider: negative views of self, negative views of the world and negative views of the future. Nolen et al (1992) found supporting evidence as a negative attributional style on older children predicted development of depressive symptoms in response to stressful life events, therefore a predisposition to negative cognitive processing can leave people vulnerable to depression. However there is also much evidence for genetic links which may or may not support the above theroy. In summary holism is the best bet, to cover all the bases of a complex illness is the best way to begin unravelling the explanations to find the true cause.

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