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11. Some psychological theories of depression - Psychoanalytical theory

Sigmund Freud noted how similar mourning and grieving and depression are. Depression could be a response to loss.

The loss may be bereavement, a separation, redundancy, bankruptcy, loss of a home. Depression can also be caused by a threatened loss – perhaps loss of health and independence, the threat of job loss, the threat of a broken marriage. You do not need to be trained in psychoanalysis to see how very persuasive this theory is.

11.1 Learning theory

This was put forward by the psychologist Seligman. He found that, if he reared rats that had little or no control over their environment, they are poor at getting out of bad situations – even when given an opportunity to escape, they do not take it. They have learnt that their behaviours, and what happens to them, are not linked. Failure leads to a feeling of helplessness and a belief that whatever you do will not change anything – this can become a starting point for depressive thinking.

11.2 Cognitive theory

This puts forward the idea that if you are repeatedly negative, you can unknowingly build up a depressive way of dealing with life, which can go on to make you ill. The negativity becomes a selffulfilling prophecy. This view can be challenged with cognitive behaviour therapy.

11.3 Social factors

There are certain social factors that seem to make people more vulnerable to depression. They make up an unfavourable background in which illness is more easily provoked.

Studies were done by Brown, a sociologist, looking at a group of inner city young women who became depressed. Those who became ill tended to be unemployed outside the home; had no intimate, confiding relationship; had three or more children under the age of 14 at home, and had lost their mother before they were aged 11. Low self-esteem was later found to make the women more vulnerable. Having a low income was also a valid factor. To this list was added the occurrence of threatening life-events, or serious difficulties.

11.4 Life-events

These are not the small day-by-day happenings but bigger events that require us to adapt and change to cope with them. A new baby may be a total joy, and much wanted, but will require both parents to make huge changes in their lives to accommodate the event. Changes cause stress, and stress can go on to cause mood shifts. Promotion may be exciting, but it also can be stressful. Other life-events are more clearly stress-provoking, such as the loss of a job or marital breakdown. You are more likely to become depressed if there has been a cluster of life-events in the preceding 6–12 months than if your life has been settled.

11.5 Physical illness and depression

Depression can occur as part of a wide range of illnesses and physical factors. The following box is long but is not in any way inclusive. It just shows some of the causes. Do not be alarmed. It is relatively unusual for there to be a physical underlying cause for depression – it is much more often psychological factors, stresses and genetics that are responsible for depressive illness.

11.6 Illnesses and other factors causing depression:

 Endocrine (gland) - over- or underactive thyroid gland dysfunction - or underactive adrenal gland

Kidney - disease kidney failure and renal dialysis

Infections - ’flu, glandular fever, hepatitis or shingles

Anaemia - folate deficiency, iron deficiency (the most common), pernicious anaemia (vitamin B12 deficiency) - (both pernicious anaemia and folate deficiency occur in alcoholism)

Neurological, dementia - brain disease epilepsy, multiple sclerosis, Parkinson’s disease stroke

Stopping drugs - alcohol (withdrawal or use of), amphetamines or benzodiazepines (Valium family)

Malignant disease - brain tumour, cancer of the pancreas or lung cancer

Side-effect of drug treatment - anti-epileptic drugs, barbiturates (phenobarbitone), beta-blockers, chemotherapy (anticancer treatment), interferon, L-dopa (used for the treatment of Parkinson’s disease), methyldopa (Aldomet), most tranquillisers and sleeping tablets, Roaccutane (for severe acne) and steroids (prednisolone).




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