Depression: The Psychological Perspective
So last week we spoke about the biological causes of depression. We explained that depression is caused by a genetic vulnerability of having a chemical imbalance and this imbalance can be activated by over secretion of stress hormones to create what we understand as depression. Therefore, the role of the psychologist is to help depressed people reduce their level of stress. We have no control over how we have been genetically created but we do have control over our stress levels. This is achieved by changing how we think about stressful situations. For example, when someone has a really difficult interview coming up, people can think ‘this is going to be so difficult. I don’t have enough time to prepare. I’m not going to be good enough and they are going to know” and this will cause a greater secretion of the stress hormone. On the other hand, if someone thinks “Ok I’ll make a plan to manage my time so I can be as best prepared as possible and if I don’t get it, it’s not the end of the world", stress hormone secretion is reduced and this makes us less susceptible to developing depression. Therefore, how we think influences ho we we feel and this is the cognitive psychological explanation to depression.
This approach has the belief that people become depressed when they develop irrational, disturbed or unhelpful thought patterns.
According to Beck, the founder of cognitive behavioural therapy, people who are depressed are more likely to focus on negatives about themselves, the future and the world (the cognitive triad). For the self, an irrational thought pattern would be focusing on two questions you did incorrectly even though you got 90% in a test. For the future, the irrational thought pattern would be ‘good things will never happen for me’ and for the world, the irrational thought pattern is that ‘society is falling apart and the world is a terrible place’. These thought patterns are developed in childhood. For example, if a child is continuously told they are not good enough and they need to do better, they will never be proud when they succeed. Because we don’t always stop and show awareness of our thoughts, we develop thought patterns. When these are negative, they are known as negative automatic thoughts or NATs. There are about ten of these and they can be found on our other blog posts. There is strong evidence fo this cognitive psychological role in psychology. For example, depressed people recall more negative pictures than positive pictures on a test and they interpret ambiguous information as more negative than positive (memory and focus directed towards negatives). Furthermore, a study by Grazioli and Terry (2000) found that pregnant women with irrational thought patterns before birth were more likely to suffer from post-natal depression.
An incredibly important trait of depression is our perception of our level of control over a situation. When a situation happens, we make a judgment on how much control we had over the situation, or if the situation would be likely to happen again in time or if similar situations could happen again. For example, if you failed a test, you could say it is internal (I should be smarter or should have studied harder) or external (the test was very difficult), stable (I will always fail this test) or unstable (If I did the test again, I would pass), and global (I failed at this test so I am stupid) or specific (I am just not good at this subject). These attributions develop in childhood and people who have internal, stable and global attributions are more likely to develop depression.
So what cognitive therapy involves is a therapist helping you restructure your thought patterns. They help you break down situations to identify your emotions, thoughts and behaviours in a situation. For example, John breaks up with his girlfriend. The emotions he would feel are anger, sadness and shame. If John has the unhelpful or irrational thoughts patterns of ‘my life is terrible’, ‘nobody will ever like me’ and ‘I’ll never get a girlfriend again’, then this will lead to the unhelpful behaviour of isolating himself, and this can then lead to a long term sadness that could develop into sadness. However, the therapist would correct his thinking and get him moving towards the helpful thoughts of ‘there are plenty of other fish in the sea’, ‘sometimes negative stuff happens’ and ‘I’m sad now but I will get over it’, then this will lead to the helpful behaviour of accepting support around him and focusing on his own development, which will lead to the sadness going away. The therapist then continues to work on this through thought journals and homework tasks until John is able to independently restructure his thoughts. Therefore, the therapist teaches John how to become his own therapist.
All of this depression talk is, well a bit, depressing. Some readers might be thinking that they have a tendency to focus on the negatives, like to complain and believe they have no control. Well research actually shows that rather than depression, maybe people who think like that are just more realistic. Enter researchers Alloy and Abramson in 1979. They had students high and low in depressive symptoms judge how much control they had over a light turning on when they pressed a switch. In some cases, the participants did have control but in most cases they did not. However, there was a clear difference between the two groups. The participants who scored higher in depressive symptoms had better judgement over when they were in control or not in control. This created the term of depressive realism, whereby it appears that while depressed people are more likely to be sad, they are wiser. This research ties in with the hundreds of famous intellectuals who suffered from depression, such as Abraham Lincoln, JK Rowling and Sir Isaac Newton.
So how we think plays a huge role in depression and this is why therapy is a remedy. However, what if being depressed is actually just being realistic? Are we better off being sad and wise, or stupid and optimistic? I’ll let you choose what to think.
Yours sincerely, The Motus Movement.