Biological Theory on Depression

This is probably the best place to start as those of you who have been to the Doctor to get help with depression or low mood, may understand depression from the view point of the National Health Service (NHS). The NHS diagnose depression based on a set of symptoms you have, including, but not limited too, fatigue, anhedonia (disinterest in doing things that were once pleasurable), insomnia and changes in your appetite. The Biological model of depression defines it as an imbalance of neurotransmitters, affecting brain function.

The NHS follow NICE guidelines, which is a policy that outlines how depression needs to be treated. They believe in a stepped-care approach, where the therapy, medication or interventions are changed as the depression progresses. This is also dependant on how severe the depression is in the individual and whether this is a first experience of it, or something that has been around for a long time.

The NHS feel that Cognitive Behavioural Therapy, Interpersonal Therapy and Medication are the best forms of treatement for depression. The treatment offered by the GP is dependant on the outcome of a thorough assessment.

Humanistic Theory of Depression

Humanistic therapies such as Person-Centred and Gestalt, approach depression by focussing on the individuals subjective experience of it and potential for growth. A humanisitc therapist will see depression as a barrier to self-actualisaton (the process of realising ones full potential) and they will aim to help the individual understand their personal obstacles that get in the way. This is a holisitc approach, and the therapist will help the client explore their thoughts, feelings and experiences that may be causing their depression.

These therapies will focus on how the depression is impacting the clients life in the here and now. Whether that is with relationships, health or work. Overall a Humanistic therapist will aim to empower the individual to understand and address their depression through self-exploration and self-acceptance.

Cognitive Behavioural Theory of Depression

Cognitive Behavioural Theory see’s Depression as a state that is created and reinforced by ones negative thought patterns and behaviours. They believe by identifying and changing these negative patterns, symptoms can be alleviated, resulting in improved overall well-being.

According to CBT, depressed individuals typically exhibit a negative view of themsleves (e.g., “I am worthless”), a negative view of the world (e.g.,”The world is a harsh place”) and the future (e.g, “Things will never get better”).

CBT therapists will aim to treat the depression by setting a goal with the client, engaging in cognitive restructuring (this involves identifying and challenging negative automatic thoughts and cognitive distortions), reframing thoughts, behavioural activation (engaging in activites to improve mood) and skills training. They may also issue “homework” where the client practices skills and behaviours learned in therapy.

Psychodynamic Theory of Depression

Psychodynamic Therapy believes Depression is caused by unresolved, unconcious conflicts that often stem from childhood experiences. This could be trauma, loss or attachment issues. They believe that these internl conflicts can lead to negative thinking patterns and behaviour, and create feelings of guilt, worthlessness and helplessness, contributing to depressive symptoms.

They also believe that depression can be caused by harsh inner critical thoughts and dialouge that was internalised from a young age. This can be words said by a critical parent, teacher, care giver or sibling. This may cause the person to use defence mechanisms such as denial, repression or displacement to avoid painful feelings or memories. These defense mechanisms can cause the individual to isolate themselves, resulting in more feelings of loneliness and helplessness.

A Psychodynamic therapist will help the individual explore their unconcious thoughts and feelings and bring them into the concious. They may do this by exploring dreams, memories and fantasies to uncover hidden conflicts. They will help identify cyclical behaviour patterns and increase their self-awareness to influence change. They will also help the client to process any emotions that are yet to be acknowledged, so that the conflicts within can lessen.

Integrative Therapy’s view on Depression

An Intergrative Therapist (like myself) views depression from a holisitc perspective, combining elements from all the theories above, and maybe some more, to create a tailored approach that meets the needs of the individual.

Integrative therapists recognise that depression can have multiple causes, including biological, social, psychological and environmental factors. After all, bad housing and abusive relationships can absolutely make someone depressed.

Integrative therapists that these factors interact in complex ways, contributing to the development and the maintenance of depression. They recognise that each persons experience of depression is unique to them, and getting to know and understand that is key.

The key part here is the relationship with the counsellor/therapist and ensuring this is a collaborative piece of work.

Conclusion

As you can see , these therapies all view depression differently. Depending on who you are, your view on life and whether or not you’re a homework kinda’ person, will determine what therapy will fit you best. This absolutely matters, so I hope this page has helped you make an informed decision, or at least know the right questions to ask your future therapist.