Case Study Margaret

In the American Psychiatric Association’s Diagnostic & Statistical Manual (APA, 2000) the symptoms of depression are: loss of interest or enjoyment in activities; changing in weight and appetite; changes to sleep pattern; loss of energy; feeling worthless or guilty; suicidal thoughts; poor concentration and being either agitated or slowed up.

     One type of therapy used is psychotherapy, which “should focus on helping the individual understand the nature and consequences of his disorder so he can be helped to control his behavior” (Black, 2000). Another type of therapy used is cognitive therapy,

Like anything else Behavior Therapy does have its strengths and weakness. One of it strength is the ownership the client is given, at the onset of therapy goals are established and clients are encourage to be active in the therapeutic process, by developing a plan of action. This allows the clients to have a vested interest in deciding with the goals of their therapy will be. (Corey, 2013, p. 278). Behavioral therapy is also one of the few therapies that place an emphasis on research, this has made the behavior therapy method one of the most effective in the treatment of a number of behavioral illness. Because research is consider to be a basic aspect of this approach and therapeutic techniques are continually refined (Corey, 2013, p. 277) cognitive behavioral procedures are currently the best treatment strategies available for depression, obsessive-compulsive disorder, panic disorder, social phobia and eating disorders (Corey, 2013, pp. 278-279).

Antidepressant medication is the most popular treatment for depression. Studies have suggested that cognitive therapy of depression might have a significant advantage over medication in preventing relapses or recurrences (Robinson, 2005). Despite the alarming prevalence of depression in society, there is yet no completely adequate explanation as to how or why it occurs (Robinson, 2005). The three major etiological models for understanding depression are cognitive models (based on the work of Beck & Ellis), biological models that link depression to variance in biochemistry (Robinson, 2005), and diathesis-stress models that view depression as the result of a complex interaction of contextual factors and intra-individual factors (Robinson, 2005). There is some evidence to suggest that once treatment-to-remission-from-depression is terminated that pharmacologically treated patients were twice as likely to relapse than patients treated with cognitive therapy (Miller, 1989). Many studies have reported evidence of negative cognitive patterns among depressed individuals. A self-deprecating style, negative attitudes toward the future and negative automatic thoughts frequently are associated with depression (Miller, 1989).

The negative triad consists of negative views of the self, the individual’s world and the future. If the individual constantly has negative thoughts about themselves, their world and the future, they will develop a sense of hopelessness because they might begin to think that nothing they do will ever be right. Thus, major depressive disorder can occur. Furthermore, if the individual can remember only negative feedback, no matter how small, they will fail to remember the positive things that have occurred. Thus, their schema will continue to be a negative one—again leading to MDD.

Unipolar depression is a treatable illness involvingan imbalance of brain chemicals called neurotransmitters. It is not a character flaw or a sign of personal weakness. You can?t make yourself well by trying to "snap out of it." Although it can run in families, you can?t catch it from someone else. The direct causes of the illness are unclear, however it is known that body chemistry can bring on a depressive disorder, due to experiencing a traumatic event, hormonal changes, altered health habits, the presence of another illness or substance abuse.

How a person perceives depression or depressed symptoms may be influenced by their family history and their observations of family members who were depressed. The depressed personality can be described as a pessimistic person. This can also play a role in how people will

It also shows that this effect is not dependent on whether or not a person is, or has been, depressed. It also negates the idea that the effects could also be found in reflective rumination, supporting the distinction between the two. The results highlight a potential method for assessing a person risk for depressive thoughts, and attentional biases. Further research into this topic could provide a better understanding of depression and its related symptoms, thus helping us develop better method for treatment and for

The key concepts of a cognitive behavioral approach have been broken down into a four-stage process. According to Corey (2016), “the specific unique characteristics of behavior therapy include conducting a behavioral assessment, precisely spelling out collaborative treatment goals, formulating a specific treatment procedure appropriate to a particular problem, and objectively evaluating the outcomes of therapy” (p. 349). The behavioral assessment is aimed at gathering as much detailed information about the client’s problem. This part of the process will also focus on the client’s current functioning and life conditions and taking samples of his or her behaviors to provide information about how the client typically functions in various situations. Lastly, the behavioral assessment is narrowly focused and integrated with therapy.

Therefore, treatment approaches that are the most effective are still being developed and refined based on emerging research. The various methods utilized in the past include: medication, psychodynamic therapy, behavior therapy, cognitive therapy, cognitive-behavioral therapy, and a combination of methods (Cororve & Gleaves, 2001). In the current literature, leading research on treatment focuses on pharmacology and cognitive-behavioral therapy.

Sarah presents with more than enough relevant symptoms and signs often associated with Criterion A, for a diagnosis of Major Depressive Disorder with a recurrent episode. Based on the duration of her symptoms and the fact that she mentions having previous episodes of depression in the past, further reinforced this diagnosis. It is important to note that none of her symptoms are attributed to any medical conditions or etiology. With no current or past history of alcohol or substance abuse/use, it is clear that these symptoms and signs have caused a change of previous functioning as noticed by her sister Gloria. Sarah reported having a depressed mood with crying spells lasting all day, for more than several weeks. Her recurrent (Criterion A1) suicidal ideation without a specific plan are explained as she reported being close to taking all the pills in her medicine cabinet. In this depressed mood, she also reports having chronic feelings of profound emptiness. This essential feature of MDD, along with her self reporting of (Criterion A2) loss of appetite as evidenced by her not going out to buy groceries to eat, could have also contributed to her rapid weight loss. Sarah reported having no energy to do anything and only watching television in bed, which can also be seen as a sign that meets (Criterion A3) of extreme fatigue. Her reporting of not bathing for a week can also meets (Criterion A4) of markedly diminished interest

The stereotype ‘Depression only happens due to life circumstances’ is bad because if someone has a depression people

Cognitive Behavioural Therapy has various techniques that are used and combined such as relaxation, problem solving, stress inoculation and several more (Beck and Fernandez, 64).

To do this, the learning principles that underlie the learning of human behavior are used so that the depressed person progressively begins to perform activities that are pleasurable and provide a sense of control over their own lives. When we are depressed, we often think in a way that does not correspond to reality. Is referring to thoughts like "No one will ever love me" "Everything goes wrong" "I'm sure I'll have a bad time" "I do not like people" "This has no way out" "I'm ugly, useless, silly, clumsy, etc. "These thoughts trigger a torrent of very intense negative emotions, and that in most cases are far from reality. The way someone think is a habit that develops in the same way as any other and that therefore can be changed. So, in the same way that an individual has made it a habit to think in a negative way, he or she can replace it by thinking in a more rational way and that therefore makes them feel

Hopelessness Theory of Depression. The hopelessness theory of depression (Abramson et al., 1989), which is a based on the reformulated theory of helplessness and depression (Abramson, Seligman, & Teasdale, 1978), provides a conceptualization for the underlying vulnerability in the proposed integrative biopsychosocial etiological model discussed in this review. The hopelessness theory of depression is a cognitive diathesis-stress model that outlines a series of three cognitive inference tendencies that interact with each other and negative life events to contribute to the etiology of MDD (Abramson et al., 1989). These three cognitive inference tendencies include: (1) inferring stable and global causes for the event, (2) inferring negative consequences of the event, and (3) inferring negative self-characteristics as a result of the event (Abramson et al., 1989). The hopelessness theory of depression hypothesized that the depressogenic inferential style was one that included all three of the cognitive inference tendencies (Abramson et al., 1989). Furthermore, the theory posited that the objective severity of the negative event required to result in an episode of MDD was inversely proportional to level of the depressogenic inferential style, such that the higher the cognitive vulnerability, the lower the objective severity of the triggering life event, and vice-versa (Abramson et al., 1989).