Depression - Psychological theories

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Various aspects of personality and its development are integral in the occurrence and persistence of depression. Although episodes are strongly correlated with adverse events, how a person copes with stress also plays a role. Low self-esteem, learned helplessness, and self-defeating or distorted thinking are related to depression. Depression may also be connected to feelings of religious alienation; conversely, depression is less likely to occur among those with high levels of religious involvement. It is not always clear which factors are causes or effects of depression, but in any case depressed persons who are able to make corrections in their thinking patterns often show improved mood and self-esteem.

Cognitive theories

Cognitive psychologists and cognitive behavioral therapists have theorized that depression arises from cognitive biases and distortions stemming from deficits in memory and information processing. According to American psychologist Martin Seligman, depression in humans is similar to learned helplessness in laboratory animals, who remain in unpleasant situations when they are able to escape, but do not because they initially learned they had no control. Learned helplessness and depression may be related to what American psychologist Julian Rotter, a social learning theorist, called an external locus of control, a tendency to attribute outcomes to events outside of personal control. American psychiatrist, Aaron T. Beck, proposed that a triad of negative thoughts, Beck's cognitive triad, are present in depression entailing cognitive errors about oneself, one's world, and one's future.

On the other hand, depressed individuals often blame themselves for negative events. According to one study, depressed adolescents, while feeling responsible for negative events, do not take credit for positive outcomes. This tendency is characteristic of a depressive attributional, or pessimistic explanatory style. According to Canadian social psychologist, Albert Bandura, who is associated with Social cognitive theory, depressed individuals have negative perceptions of themselves, including a negative self-concept and perceived lack a sense of self-efficacy; in other words they do not believe they can influence events or achieve personal goals. Milder depression has been associated with what has been called depressive realism, or the "sadder-but-wiser" effect, a view of the world that is relatively undistorted by positive biases.

Psychoanalytic theory

Sigmund Freud argued that depression, or melancholia, could result from loss and is more severe than mourning.

A large body of research has documented the importance of interpersonal factors, including strained or critical personal relationships, in the onset of depressive symptoms and depression in young and middle-aged adults. Vulnerability factors—such as early maternal loss, lack of a confiding relationship, responsibility for the care of several young children at home, and unemployment—can interact with life stressors to increase the risk of depression in women. However, the validity of risk factors has been widely debated. For older adults, the factors are often health problems, changes in relationships with a spouse or adult children due to the transition to a care-giving or care-needing role, the death of a significant other, or a change in the availability or quality of social relationships with older friends because of their own health-related life changes.

Austrian psychiatrist Sigmund Freud, the father of psychoanalysis, likened the state of melancholia to mourning in his 1917 paper Mourning and Melancholia. He theorized that objective loss, such as the loss of a valued relationship through death or a romantic break-up, results in subjective loss as well; the depressed individual has identified with the object of affection through an unconscious, narcissistic process called the libidinal cathexis of the ego. Such loss results in severe melancholic symptoms more profound than mourning; not only is the outside world viewed negatively, but the ego itself is compromised. The patient's decline of self-regard is revealed in his belief of his own blame, inferiority, and unworthiness.

Humanistic theories

Generally grouped together, existential and humanistic approaches represent a forceful affirmation of individualism. Austrian existential psychiatrist Viktor Frankl connected depression to feelings of futility and meaninglessness. American existential psychologist Rollo May stated that "depression is the inability to construct a future". In general, May wrote, "depression...occur[s] more in the dimension of time than in space," and the depressed individual fails to look ahead in time properly. Thus the "focusing upon some point in time outside the depression...gives the patient a perspective, a view on high so to speak; and this may well break the chains of the...depression." Humanistic psychologists argue that depression can result from an incongruity between society and the individual's innate drive to self-actualize, or to realize one's full potential. American humanistic psychologist Abraham Maslow theorized that depression is especially likely to arise when the world precludes a sense of "richness" or "totality" for the self-actualizer.

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