Case Study of Major Depression
Muhammad Zafar Iqbal1* and Sadaf un Nisa Awan2
1Hypnotherapist and Psychotherapist, Islamabad, Pakistan
2M.Phil Psychology, Gujarat, Pakistan
- *Corresponding Author:
- Muhammad Zafar Iqbal
Hypnotherapist and Psychotherapist
Therapist, Private Psychology
House 39, Street 3, Park Avenue
Park Road, Islamabad 44000, Pakistan
Received date: May 07, 2016; Accepted date: Jun 04, 2016; Published date: Jun 11, 2016
Citation: Iqbal MZ, un Awan SN (2016) Case Study of Major Depression. J Med Diagn Meth 5:214. doi:10.4172/2168-9784.1000214
Copyright: © 2016 Iqbal MZ, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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This document pertains to the case study of Major Depression. The subject of the disorder was Mrs. RJ (Initial instead of real name), 43 years old housewife and mother of four children. She visited my clinic along with her husband who informed that she feels burden on shoulder and at the back of her head most of time, feel weakness, facing lack of concentration on her daily work, disturbance with loud voices of anyone specially loud voice of males, shivering of body without any reason. He also informed about her weak memory, negative dreaming which disturb her sleep, fidgety and restless most of the time, aggressive behaviour and sometime weeping and shouting without any reason. Before visiting my clinic she visited some psychiatrists for treatment because she had become very aggressive and started to throw things and whatever was in her physical approach. One of those psychiatrists recommended ECT for treatment but ECT only affected her memory badly. Assessment made after taking semi-structured interviews from Mrs. RJ and her husband. In light of assessment and DSM-IV, Mrs. RJ was diagnosed by Major Depression Disorder.
Major depression; Fear stimuli identification therapy (FSIT); Assessment; Treatment
Major purpose of this particular case study was to reaffirm and prove the efficacy of Fear-Stimuli Identification Therapy (FSIT) on empirical grounds. It was also intended to use FSIT in order to eliminate the symptoms of Major Depression Disorder in which Mrs. RJ was suffering from as the therapy was already successfully used to remove the symptoms of various disorders in different cases [1,2].
Hypotheses: "It is expected that the FSIT method would effectively cure the Major Depression Disorder from which the above referred person Mrs. RJ is suffering."
Fear Stimuli Identification Therapy (FSIT): Fear-Stimuli Identification Therapy (FSIT) is based upon the perception that some of the incidents (mostly the sudden incidents) in the early age of a child become stimuli for fear instinct which cast negative effects over the personality of a child and become reason for one or the other type of disorder. FSIT investigates and digs out such events from a person’s unconscious which play as stimuli for fear instinct. Whenever effected person encounters the events in his/her life resembling to the stimulus/ stimuli the specific incident which has stimulated the fear instinct previously is recalled.
Participants: Mrs. RJ (client)
Materials: No any specific material used in this case study.
Procedure: In the first two sessions semi-structured interviews were conducted with Mrs. RJ and her husband. Assessment was made in the light of these interviews and reasons/causes for disorder were dig out. DSM-IV was consulted to decide the nature or type of disorder.
In the subsequent of fifty sessions Mrs. RJ was asked to write on specific topics. Cross-questioning was carried out over the ideas mentioned in the writings.
Results and Discussions
Results: After diagnosis of Major Depression Disorder, treatment was started in the light of FSIT method. Five sessions per week were taken, total of fifty sessions were conducted. In the course of treatment, her husband reported about Positive behavioural change in different spheres of Mrs. RJ’s life. Clinical observations during treatment also indicated a gradual positive change in his personality. The difference between pre-assessment and post- assessment confirmed precision of hypotheses and efficacy of FSIT. Feedback was obtained on weekly basis for a period of one month from Mrs. RJ’s husband about any possible reappearance of symptoms of Mrs. RJ Disorder and this was confirmed that there was no reoccurrence of disorder’s symptoms anymore.
Discussions: Before visited to the clinic, Mrs. RJ had already consulted a psychiatrist and was mostly treated by means of antidepressants and ECT. This had no significant effects upon client’s disorder. Anyhow this medication helped Mrs. M RJ to sleep little well, as she was not able to sleep before .
Prior to write about intervention/treatment, a brief description of patient’s social and family environment is necessary in order to understand the main causes of Mrs. RJ’s disorder.
Family history: Her father was employed in Pakistan Army in lower staff with low income level. Their family always faced financial problems but despite of their low level of income, her father spend most of his income on himself and his own entertainments and ignored the necessities and basic needs of his family. Her grandfather and an uncle usually supported her family but as they were also not financially well off so her family has been remained in financially crisis throughout her life till she had to depend on her father’s income. This scenario was somehow changed after her marriage because his husband was a teacher and she also started to teach in a school and income of both life partners helped them to fulfil their basic requirements of life. Her father always behaved badly, strict and harsh to client like traditional behaviour of most of the males to females in that backward area. Even her mother had also been facing her father’s behaviour since her marriage with his father. Mrs. RJ remembers that she saw her mother mostly weeping and unhappy with her life and due to her own problems she also never tried to give due attention, love and care to her daughter (Client) and she also behaved badly to Mrs. RJ. Whenever her father visits his home after a month or more from his job, he never tried to spend his time with his family (client and her mother) and never tried to understand their basic needs and always like to spend his time outside the home as well as spend his money outside the home without considering the basic need of his family. On his visit to home, how much time he spend his home was a tough time for both of these females i.e., client and her mother because he behaved badly, strict and always looked in a mood to taunt them, yelling at them, scolding them loudly and insulting them. This behaviour of her father and even her mother towards her made her deprived personality. And feelings of being deprived and ignorance effected badly in her personality and sense of deprivation was developing in her mind. This sense of deprivation was increasing in her mind when she started to make comparison between her own father’s behaviour with them and other families that how their father deal with their family. She thought that her father had worst behaviour as compared to others. Mrs. RJ has a younger brother who was also effected person of this atmosphere but as he was a male so he could go out and managed to have catharsis for his depression little bit although he has also a submissive behaviour.
Although after her marriage she had a happy life with a loving husband. She have not financially problems after her marriage as both, her husband and she, doing jobs and have enough income for their basic needs. Her husband is a loving person and both have been happy with each other. Her husband cares for her and tries to make her happy. When they got their first baby girl, her husband was also very happy to have a female child despite of traditional approach to have baby boy. He loves her daughter and very much caring for both of them. He usually spends time with them, plays with her daughter. Although her husband is a loving, caring and nice person but he has a bad habit that he also speaks loudly as this is the traditional habit of most of the males of their area so he also do the same. And his habit of speaking loudly again reminds her past life, before marriage in her own home, specifically pertaining to her father that how he speaks loudly. So, this was miserable position for her unconscious level of mind and her psychological problem kept increasing instead of being removed as to her husband behaves with her and their kids very nicely and in loving and caring manners.
Social History: Mrs. RJ belonged to a small village which was a backward area with low population and mostly people have very traditional and low mentality. They have strong religious believes. Most of the females of that village spend their time in their home without any entertainment and refreshing activities. Their males were very strict about going out alone and without covers for females. Most of the people were against the education of their females. So as the trend of her village she was also compel to act like that. She was never allowed to go out to meet her friends alone so her feelings from her childhood were lonely. But her uncle fully supported her so she was sent to school for education. She had just two friends in school but this relation were also limited to school and after school she had to spend her time in her home only. Due to low population of the village, there were lesser gatherings or social events. Whenever there was any social gathering like marriage or any funerals, she went there with her parents or any elder family member. She never participated in any social activities.
Medical / Past psychiatric history: She has been using antidepressant medicines since 10 years from different physiatrists and one of those physiatrists recommended E.C.T which effected very badly to her memory even she lost her some memory for a specific period of one months.
Assessment: Since her childhood she was facing lots of psychological problem with behaviour of her father who used to behave badly, strict and harsh to client. Even her mother had also been facing her father’s behaviour since her marriage with his father. Mrs. RJ remembers that she saw her mother mostly weeping and unhappy with her life and due to her own problems she also never tried to give due attention, love and care to her daughter (Client) and she also behaved badly to Mrs. RJ. On his visit to home from job as he was an army person, how much time he spend his home was a tough time for both of these females i.e., client and her mother because he behaved badly, strict and always looked in a mood to taunt them, yelling at them, scolding them loudly and insulting them. This behaviour of her father and even her mother towards her made her deprived personality. And feelings of being deprived and ignorance effected badly in her personality and sense of deprivation was developing in her mind. She was scared of loud voices and feels fidgety and uncomfortable whenever she hear loud voice and by some time her this problem started occurring to hear any loud voice of any male even except her father. An association of loud voice with cruelty was developed in her unconscious level of mind and loud voice became stimulus for fear instinct. She thought that her father had worst behaviour as compare to others.
Treatment: In first 7 sessions, I made cross questioning with her about her past history of her childhood and I focused behaviour of her father specially in her childhood (1 year to 7 years) and it was clearly known that her father had much insulting and harsh behaviour with her mother and even with my patient also which affected my patient’s personality and she started to face some psychological problem since her early childhood. It was also explored that whenever her father used to come back from his duty, patient was much conscious (careful) till her father remained present in home. During the period of her father’s presence in home, my patient was extra conscious and careful, definitely, this consciousness increased pressure on her nervous system and she felt burden on her shoulder although she felt much relax after her father again go to his duty. So the problem just occur only when her father remain present at home.
In next 7 session I analyzed her behaviour during presence of her father in home and emotional effects during her father’s presence in routine as well as due to scolding, snubbing (in loud voice) or harsh behaviour of her father with her or her mother. I also analyzed that how her unconscious level of mind perceives her father’s behaviour and how it affected her unconscious level of mind. After cross questioning and analyzing it was found that her father’s harsh, insulting behaviour and scolding them in loud voice was become a stimulus for her fear instinct. Although this has become a stimulus for her fear instinct but as well as it created the sense of deprivation, humiliation and indignity for which her unconscious level of mind reacted due to her feelings of anger and being humiliated but her these feelings was suppressed by her conscious level of mind due to same stimulus so she could never be able to express her anger and used to sob and weep in low voice when she was alone.
In next 7 sessions I asked her to write about two topics specifically, one is her father and loud voice of males. So initially I asked her to write about her father and while she was writing, she felt very difficult to write about her father because her all symptoms were appeared like burden on her shoulder which showing resistance of her unconscious level of mind. Next day when I made cross questioning after analyzing her writing and her behaviour, during this session of cross questioning, her all symptoms were again strongly appeared although consciously she tried to avoid any negative remarks about her father (this because of traditions, customs and religiously most people can’t be able to say anything negatively about their parents). In next session, I continued cross questioning with her about her father and at last she admitted that she did not like her father at all since her childhood. She also admitted that she disliked her father since her childhood and she has been keeping negative feelings and hate about her father since childhood even sometimes she had in her mind some abuses in very bad wording but she never expressed these sought of feeling to anyone else tried to get rid of these negative feelings consciously. After this I asked her to write about loud voice of males specifically. During writing the about loud voice of males, same symptoms were appeared as appeared during writing about her father. After analyzing her writing, I made cross questioning to her in next session and it was known that the loud voice of males has been associated with her father being a stimulus by her unconscious level of mind because her father used to scold and humiliate her in loud voice so whenever she hear any male speaking anything in loud voice her symptoms were appeared. Her husband is very loving and caring husband for her and father for their kids but unfortunately her husband also use to speak in loud voice in routine not to show any anger but even he speaks in loud during normal and routine conversation. So loud voice of males has become a reference for her stimulus and her unconscious level of mind always used to associate every loud voice of any male with her stimulus. The loud voice of any other male, except her father, at any place even on road has become a reference for her stimulus. This reference also brings all symptoms which are associated with stimulus.
Whatever has been happening with my patient since her childhood lead her defence mechanism of unconscious level of mind to make a shelter against fear instinct and this shelter is over consciousness about cleanness. She always remain over conscious about cleanness for example if she has cleaned her kitchen and after some time when she visits kitchen next time she was usually of the view that may be there is some incest in kitchen so she again started to clean everything in kitchen unnecessarily and if she has cleaned her home but she sees any little piece of litter/dust or garbage on anywhere in floor she must clean whole house anyway although her mother was not much conscious about cleanliness so she never try to instruct her about cleanliness and never ask her to clean her house or anything else since her childhood. When I asked her to write about cleanliness and make cross questioning, she feel all problems and appears all symptoms as appeared during writing about references. During last 9 session of first stage, I made cross questioning in broad view repeatedly about stimulus, references and shelter to strike her fear instinct again and again. Her behaviour was getting rude and harsh and aggression level was much increased even in a session her unconscious level of mint resisted as much that her some senses like sense to hear and talk was suspended for almost 1 minute. She was not been able to listen and talk anything during this minute and this was a clear sign that when I tried to repeat it during cross questioning that her all problem/ symptoms caused by her stimulus, references and shelter and when I insisted to make her realize the fact, her unconscious level of mind resisted much forcefully and halted her senses for a while.
In next twenty sessions, I asked her to write about her stimulus, references and shelter again but this time I asked her to write only positive possibilities about her stimulus and references as there are many other reasons why a person can speak in loud voices so I tried to make her understand and write that what can be other possibilities of her stimulus and references and on the other side I asked her to write some negative aspects about her shelter that why she was so conscious about cleanliness and what happened if she does not repeat this practice again and again and why she felt so uncomfortable with a little bit dust on floor and what if she just clean that part of floor not the whole floor or when she sees an incest on any item in kitchen so what happens if she only clean that item not the whole kitchen. Basically these negative associations with stimulus and reference, associated with the stimulus, are the main cause which suppressed her real personality and when with the help of writing and cross questioning, she explored the all other positive possibilities and her conscious level of mind have griped the positive aspects of stimulus and reference, the negative associations of stimulus and reference were removed from unconscious level of mind and when her unconscious level of mind became realistic about stimulus and references then automatically her unconscious level of mind don’t need any shelter anymore which it has made against those stimulus and reference and this scenario made her personality at normal.
There was no extra factor occur or create problem during the assessment or treatment process it was only resistance of unconscious level of mind.
Follow up was made during the time of treatment and after treatment for feedback and about progress of the client from her and her husband. It was good during the entire course of treatment and after treatment.
Mrs. RJ was a patient of Major Depression Disorder.
Basic reason was behaviour of her father (Specially speaking in loud voice which became stimulus for her fear instinct).
Loud voice of any male became reference for her stimulus.
Unconscious level of mind (defence mechanism) made a shelter against stimulus and reference that is “over conscious about cleanliness”.
Treatment could not be possible without deep analysis of her unconscious level of mind that what was the stimulus and references for fear instinct.
It was necessary to explore all positive possibilities about her stimulus and references (loud voice) to make her personality unsuppressed and make it at normal.
When all other positive possibilities were realized by her unconscious level of mind and negative association with stimulus and reference removed so there was no need of any shelter so the role of shelter was also wiped out.
Minimum 5 sessions per week required for treatment because if there was gap between each session and next session may not be conducted on consecutive day, the fear which was explored in one session may again suppressed and resistance level of the client may also again suppressed. So continuity in sessions without having gap is very important in treatment for proper cure.
Access and Barriers to Care
Only resistance of unconscious level of mind was a barrier but when it was sought out by free writing and cross questioning that barrier was also removed successfully.
• It is recommended that study should be done on Fear instinct.
• FSIT should be used for the treatment when the patients problem led to the fear instinct.
• Therapist should focus on the reason of the problem for the treatment.
- (2000) American Psychiatric Association. Diagnostic and statistical manual of mentaldisorders (5thEdn.).
- Ejaz M, Iqbal MZ (2016) Case Study of Major Depressive Disorder. J ClinCase Rep 6:698
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Psychological Theories of Depression
Saul McLeod published 2015
Depression is a mood disorder which prevents individuals from leading a normal life, at work socially or within their family. Seligman (1973) referred to depression as the ‘common cold’ of psychiatry because of its frequency of diagnosis. It is usually quite easy to see when someone is depressed.
Behaviorism emphasizes the importance of the environment in shaping behavior. The focus is on observable behavior and the conditions through which individuals' learn behavior, namely classical conditioning, operant conditioning and social learning theory. Therefore depression is the result of a person's interaction with their environment.
For example, classical conditioning proposes depression is learned through associating certain stimuli with negative emotional states. Social learning theory states behavior is learned through observation, imitation and reinforcement.
Operant conditioning states that depression is caused by the removal of positive reinforcement from the environment (Lewinsohn, 1974). Certain events, such as losing your job, induce depression because they reduce positive reinforcement from others (e.g. being around people who like you).
Depressed people usually become much less socially active. In addition depression can also be caused through inadvertent reinforcement of depressed behavior by others.
For example, when a loved one is lost, an important source of positive reinforcement has lost as well. This leads to inactivity. The main source of reinforcement is now the sympathy and attention of friends and relatives.
However this tends to reinforce maladaptive behavior i.e. weeping, complaining, talking of suicide. This eventually alienates even close friends leading to even less reinforcement, increasing social isolation and unhappiness. In other words depression is a vicious cycle in which the person is driven further and further down.
Also if the person lacks social skills or has a very rigid personality structure they may find it difficult to make the adjustments needed to look for new and alternative sources of reinforcement (Lewinsohn, 1974). So they get locked into a negative downward spiral.
Behavioral/learning theories makes sense in terms of reactive depression, where there is a clearly identifiable cause of depression. However, one of the biggest problems for the theory is that of endogenous depression. This is depression that has no apparent cause (i.e. nothing bad has happened to the person).
An additional problem of the behaviorist approach is that it fails to take into account cognitions (thoughts) influence on mood.
During the 1960's psychodynamic theories dominated psychology and psychiatry. Depression was understood in terms of:
- inwardly directed anger (Freud, 1917),
- introjection of love object loss,
- severe super-ego demands (Freud, 1917),
- excessive narcissistic, oral and/or anal personality need (Chodoff, 1972),
- loss of self-esteem (Bibring, 1953; Fenichel, 1968), and
- deprivation in the mother child relationship during the first year (Kleine, 1934).
Freud’s psychoanalytic theory is an example of the psychodynamic approach. Freud (1917) prosed that many cases of depression were due to biological factors. However, Freud also argued that some cases of depression could be linked to loss or rejection by a parent. Depression is like grief, in that it often occurs as a reaction to the loss of an important relationship.
However, there is an important difference, because depressed people regard themselves as worthless. What happens is that the individual identifies with the lost person, so that repressed anger towards the lost person is directed inwards towards the self. The inner directed anger reduces the individual’s self-esteem, and makes him/her vulnerable to experiencing depression in the future.
Freud distinguished between actual losses (e.g. death of a loved one) and symbolic losses (e.g. loss of a job). Both kinds of losses can produce depression by causing the individual to re-experience childhood episodes when they experienced loss of affection from some significant person (e.g. a parent).
Later, Freud modified his theory stating that the tendency to internalize loss objects is normal, and that depression is simply due to an excessively severe super-ego. Thus, the depressive phase occurs when the individual’s super-ego or conscience is dominant. In contrast, the manic phase occurs when the individual’s ego or rational mind asserts itself, and s/he feels control.
In order to avoid loss turning into depression, the individual needs to engage in a period of mourning work, during which s/he recalls memories of the lost one. This allows the individual to separate him/herself from the lost person, and so reduce the inner-directed anger. However, individuals very dependent on others for their sense of self-esteem may be unable to do this, and so remain extremely depressed.
Psychoanalytic theories of depression have had a profound impact on contemporary theories of depressions. For example, Beck's (1983) model of depression was influenced by psychoanalytic ideas such as the loss of self-esteem (re: Beck's negative view of self), object loss (re: the importance of loss events), external narcissistic deprivation (re: hypersensitivity to loss of social resources) and oral personality (re: sociotropic personality).
However, although being highly influential, psychoanalytic theories are difficult to test scientifically. For example, many of its central features cannot be operationally defined with sufficient precision to allow empirical investigation. Mendelson (1990) concluded his review of psychoanalytic theories of depression by stating:
'A striking feature of the impressionistic pictures of depression painted by many writers is that they have the flavor of art rather than of science and may well represent profound personal intuitions as much as they depict they raw clinical data' (p. 31).
Another criticism concerns the psychanalytic emphasis on unconscious, intrapsychic processes and early childhood experience as being limiting in that they cause clinicians to overlook additional aspects of depression. For example, conscious negative self-verbalisation (Beck, 1967), or ongoing distressing life events (Brown & Harris, 1978).
This approach focuses on people’s beliefs rather than their behavior. Depression results from systematic negative bias in thinking processes.
Emotional, behavioral (and possibly physical) symptoms result from cognitive abnormality. This means that depressed patients think differently to clinically normal people. The cognitive approach also assumes changes in thinking precede (i.e. come before) the onset of depressed mood.
Beck's (1967) Theory
One major cognitive theorist is Aaron Beck. He studied people suffering from depression and found that they appraised events in a negative way.
Beck (1967) identified three mechanisms that he thought were responsible for depression:
- The cognitive triad (of negative automatic thinking)
- Negative self schemas
- Errors in Logic (i.e. faulty information processing)
The cognitive triad are three forms of negative (i.e. helpless and critical) thinking that are typical of individuals with depression: namely negative thoughts about the self, the world and the future. These thoughts tended to be automatic in depressed people as they occurred spontaneously.
For example, depressed individuals tend to view themselves as helpless, worthless, and inadequate. They interpret events in the world in a unrealistically negative and defeatist way, and they see the world as posing obstacles that can’t be handled. Finally, they see the future as totally hopeless because their worthlessness will prevent their situation improving.
As these three components interact, they interfere with normal cognitive processing, leading to impairments in perception, memory and problem solving with the person becoming obsessed with negative thoughts.
Beck believed that depression prone individuals develop a negative self-schema. They possess a set of beliefs and expectations about themselves that are essentially negative and pessimistic. Beck claimed that negative schemas may be acquired in childhood as a result of a traumatic event. Experiences that might contribute to negative schemas include:
- Death of a parent or sibling.
- Parental rejection, criticism, overprotection, neglect or abuse.
- Bullying at school or exclusion from peer group.
However, a negative self-schema predisposes the individual to depression, and therefore someone who has acquired a cognitive triad will not necessarily develop depression. Some kind of stressful life event is required to activate this negative schema later in life. Once the negative schema are activated a number of illogical thoughts or cognitive biases seem to dominate thinking.
People with negative self schemas become prone to making logical errors in their thinking and they tend to focus selectively on certain aspects of a situation while ignoring equally relevant information.
Beck (1967) identified a number of systematic negative bias' in information processing known as logical errors or faulty thinking. These illogical thought patterns are self-defeating, and can cause great anxiety or depression for the individual. For example:
- Arbitrary Inference. Drawing a negative conclusion in the absence of supporting data.
- Selective Abstraction. Focusing on the worst aspects of any situation.
- Magnification and Minimisation. If they have a problem they make it appear bigger than it is. If they have a solution they make it smaller.
- Personalization. Negative events are interpreted as their fault.
- Dichotomous Thinking. Everything is seen as black and white. There is no in between.
Such thoughts exacerbate, and are exacerbated by the cognitive triad. Beck believed these thoughts or this way of thinking become automatic. When a person’s stream of automatic thoughts is very negative you would expect a person to become depressed. Quite often these negative thoughts will persist even in the face of contrary evidence.
Alloy et al. (1999) followed the thinking styles of young Americans in their early 20’s for 6 years. Their thinking style was tested and they were placed in either the ‘positive thinking group’ or ‘negative thinking group’. After 6 years the researchers found that only 1% of the positive group developed depression compared to 17% of the ‘negative’ group. These results indicate there may be a link between cognitive style and development of depression.
However such a study may suffer from demand characteristics. The results are also correlational. It is important to remember that the precise role of cognitive processes is yet to be determined. The maladaptive cognitions seen in depressed people may be a consequence rather than a cause of depression.
Martin Seligman (1974) proposed a cognitive explanation of depression called learned helplessness. According to Seligman’s learned helplessness theory, depression occurs when a person learns that their attempts to escape negative situations make no difference.
As a consequence they become passive and will endure aversive stimuli or environments even when escape is possible.
Seligman based his theory on research using dogs.
A dog put into a partitioned cage learns to escape when the floor is electrified. If the dog is restrained whilst being shocked it eventually stops trying to escape.
Dogs subjected to inescapable electric shocks later failed to escape from shocks even when it was possible to do so. Moreover, they exhibited some of the symptoms of depression found in humans (lethargy, sluggishness, passive in the face of stress and appetite loss).
This led Seligman (1974) to explain depression in humans in terms of learned helplessness, whereby the individual gives up trying to influence their environment because they have learned that they are helpless as a consequence of having no control over what happens to them.
Although Seligman’s account may explain depression to a certain extent, it fails to take into account cognitions (thoughts). Abramson, Seligman, and Teasdale (1978) consequently introduced a cognitive version of the theory by reformulating learned helplessness in term of attributional processes (i.e. how people explain the cause of an event).
The depression attributional style is based on three dimensions, namely locus (whether the cause is internal - to do with a person themselves, or external - to do with some aspect of the situation), stability (whether the cause is stable and permanent or unstable and transient) and global or specific (whether the cause relates to the 'whole' person or just some particular feature characteristic).
In this new version of the theory, the mere presence of a negative event was not considered sufficient to produce a helpless or depressive state. Instead, Abramson et al. argued that people who attribute failure to internal, stable, and global causes are more likely to become depressed than those who attribute failure to external, unstable and specific causes. This is because the former attributional style leads people to the conclusion that they are unable to change things for the better.
Gotlib and Colby (1987) found that people who were formerly depressed are actually no different from people who have never been depressed in terms of their tendencies to view negative events with an attitude of helpless resignation.
This suggests that helplessness could be a symptom rather than a cause of depression. Moreover, it may be that negative thinking generally is also an effect rather than a cause of depression.
Humanists believe that there are needs that are unique to the human species. According to Maslow (1962) the most important of these is the need for self-actualization (achieving out potential). The self actualizing human being has a meaningful life. Anything that blocks our striving to fulfil this need can be a cause of depression. What could cause this?
- Parents imposing conditions of worth on their children. I.e. rather than accepting the child for who s/he is and giving unconditional love, parents make love conditional on good behavior. E.g. a child may be blamed for not doing well at school, develop a negative self-image and feel depressed because of a failure to live up to parentally imposed standards.
- Some children may seek to avoid this by denying their true self and projecting an image of the kind of person they want to be. This façade or false self is an effort to please others. However the splitting off of the real self from the person you are pretending to be causes hatred of the self. The person then comes to despise themselves for living a lie.
- As adults self actualization can be undermined by unhappy relationships and unfulfilling jobs. An empty shell marriage means the person is unable to give and receive love from their partner. An alienating job means the person is denied the opportunity to be creative at work.
Abramson, L. Y., Seligman, M. E., & Teasdale, J. D. (1978). Learned helplessness in humans: critique and reformulation. Journal of abnormal psychology, 87(1), 49.
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Klein, M. (1934). Psychogenesis of manic-depressive states: contributions to psychoanalysis. London: Hogarth.
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How to reference this article:
McLeod, S. A. (2015). Psychological theories of depression. Retrieved from www.simplypsychology.org/depression.html