.::Unipolar Depression Essay::.

Describe and evaluate possible contributions of social/psychological factors to depression

There is much debate over the cause of depression - largely over whether it is caused by genetic/neurological factors or social/psychological factors or a combination of the two. In this essay I will consider the social psychological factors thought to contribute to unipolar depression, focusing on the causes of low self worth which is associated with unipolar depression.

In the late 19th and early 20th century Freud arrived at a theory whereby depression occurs when one loses an ambivalently loved person, for example the mother, because they have died or withdrawn love. He claimed that guilt redirected anger felt towards the lost one to being against oneself. Later in life this could reemerge as depressive symptoms.

A more popular set of theories are cognitive theories, particularly those of Aaron Beck. Beck (1967, 1976) proposed a ‘cognitive triad’ - that depressed people think negatively about themselves, their future and their world. He also suggested an idea of ‘depressive schemas where reality is distorted to fit these negative views.

In 1983, Beck noted that depression is particularly evident when a person experiences a negative event in an area which they associate with their self-worth. Research by Hammen, Marks, De Mayo & Mayol (1985); Hammen, Elliot, Gitlin & Samison (1989) and later by Robins (1990) support this hypothesis. They all found that depression seems to occur when a negative event occurs in the area participants had previously connected with their self-worth. For some people this may be academic achievement and for others social relationships.

This was a particularly useful development of the cognitive theory of depression as it explain how some people experience depression at times where others may not.

Gotlib & Hammen (1992) agree with Beck, finding depression to be shown by pessimism, self-criticism and hopelessness, and this often to be connected with cognitive patterns.

Evidence supporting Beck’s theory is its success in treatment. Addressing irrational cognitive beliefs have been highly effective in treating depression.

However, Haaga et al (1991) note that there is little evidence to support claims that negative thoughts outside of depression give vulnerability to depression. This leads to an argument over the direction of a causal relationship between depression and negative thoughts. Methodological problems in isolating underlying negative thoughts from current mood state make it hard to test Beck’s idea.

Seligman et al (1975) observed animal behaviour to propose the ‘learned helplessness theory’. Here he believed that one learns from past experience that there is no way out of negative situations, and that one has no control over negative events. One then gives up and does not even try to escape even when it may be possible. Seligman’s experiments with animals certainly back this theory up, but some believe it to be reductionism to interpret human behaviour from that of animals.

Abramson, Seligman & Teasdale (1975) have combined cognitive and behavioural models to suggest that it is one’s interpretations of these negative events which determines vulnerability to depression. This is supported by research by Peterson & Seligman (1984) where it was found that depression was more likely to occur when the person blames themselves for negative events. However, other research has found different results (as reviewed by Gotlib & Hammen).

Alloy, Lipman & Abramson (1992) suggested a ‘hopelessness theory’ applying to a subgroup of depressed people who’s thoughts were characterised by thoughts of hopelessness. This concerned their interpretations of events and negative beliefs about themselves.

Others believe that the most important indicator of depression is stressful life events. Hammen (1991) studied clinical populations of depression to note that the participants had mostly experienced high stressors.

Again, the strength of the stressors to induce or trigger depression may depend on cognitive appraisals of the event, the domain of self-worth vulnerability and support systems in place. Depressed people often believe themselves to be unsupported, but there is no conclusive evidence of whether depression causes these negative beliefs or vice-versa.

More women than men are diagnosed with depression which is a fact which may come in useful when investigating its causes. Some people believe that women are simply more likely to seek professional help for depression while others feel that more women than men actually are depressed.

Some psychologists suggest that women have more stressors and inescapable situations (as would support Seligman’s theory above). For example, women may experience more childcare and low income problems. Nolen-Hoeksema (1987) suggested that women dwell on problems, so inviting depression, while men use avoidance tactic such as physical activity. Men may also be more prone to alcohol or drug abuse. Others have suggested that women direct feelings inward, against themselves, while men act outwards, for example, behaving aggressively.

Cognitivists believe a vulnerability to depression to a arise from [often unjustified] feelings of worthlessness and incompetence, and cognitive behaviourists believe that it results from interpretations of negative events which are seemingly inescapable. However, neither suggest where there are feelings of low self-worth originate.

Brown & Harris (1993) recognised that a poor parent-child bond and/or sexual/physical abuse may lead to low self-worth which could then give vulnerability to depression. However, such childhood problems as these may link to poor social support systems which could then lead to, or exacerbate, depression rather than the childhood experiences themselves.

Bowlby (1980) proposed a theory of attachment where if children do not form adequate attachments, particularly with the mother, this could lead to problems of depression.

Indeed, Suomi has looked at monkeys to note that failure of monkeys to form attachments can result in depression in later life. Again however, this reductionism may mean that this is not evident in humans.

As noted by Hammen (1991), depression appears to run in families. This could be a result of genetic/neurological factors (such as levels or serotonin or dopamine) or of environmental factors.

Large scale research by Weissen (1987) and smaller scale research by Gotlib & Lee (1990), Hammen (1991) and Klein, Taylor, Dickstein & Harding (1988) has shown that between 50 and 80 per cent of children of a depressed parent have a diagnosable mental disorder, mostly including depression.

Environmental factors which could forge this link could be that the child receives negative responses from a depressed parent - this may be disinterested or critical - and this may make them feel unloved and may contribute to low self-worth.

So, interactions between a depressed parent and a child who may have problems may exacerbate each other’s depressive symptoms. In a vicious circle the parent(s) may not respond fully to a ‘depressed’ or disordered infant, who in turn would not give them the natural rewards of parenthood.

Diasthesis stress models suggest that there is a predisposition to depression which is then triggered by life events or
psychological stress. This predisposition could be a result of genetic/neurological factors or of childhood experiences,
or a combination of both ideas. These both could explain the genesis of vulnerability to depression such as low
self-worth.

So, in conclusion, while there is evidence of an environmental impact of unipolar depression, there is much debate over the nature of these psychological factors. Most likely is probably a complex interplay between all the discussed factors, although the lifetime prevalence of depression being as high as 20% may not lend support to such a combination of factors. Perhaps each risk factor can causes depression in people for different reasons and with different degrees of severity.