Tuesday, February 14 , 2012
*Material today not on the midterm*
The Physiognomy of Mental Disease…
The further you are removed from an event that causes an emotion, the less intense the
emotion will be. Depression happens a lot. About 4% of a population meets the diagnostic
criteria for major depression. Faced with the same negative event, not everyone would
become depressed, however. Morison believed that there was something about the
appearance of the patient that could tell you something about what they had. He was a
psychiatrist and an artist.
Thinking about the causes of mental health conditions. This skull dates to several thousand
years ago. It was believed that if you were suffering significantly for a long period of time,
they thought that there were evil spirits trapped inside the head. So the most logical
solution would be to provide an exit route for evil spirit.
Determinants of Depression
From a psychological standpoint, we know that we do NOT know a lot about what causes
depression. We know that people who are depressed have usually gone through elements
like the ones listed on the slides (life situations). But this does not mean that these things
cause the depression. We could expose many people to these things, but it does not mean
that every one of them will become depressed.
Symptoms of Depression
When we talk about someone with a diagnosis of a mental condition, it is not just about
feeling bad. They must present some symptoms; 5 of the 9 listen on the slide.
How we try to understand the contributions to depression. Freud said you became
depressed when you turned your anger inwards. Sullivan came to realize that whenever
people would seek help for depression, it was always around some interpersonal
disturbance (someone died, they ended a relationship, etc). Seligman (experiment with the
shocked dogs); any situation where you learned you were helpless would usually make you
depressed. Lewinsohn (cookies and punishment in life). Beck is one of the fathers of
cognitive behaviour therapy. Here, there is something about your beliefs or cognitions that
heightens the possibility that you will be depressed (eg: parents put pressure on you to do
well in school; your belief that you have to be perfect will be ever present in your life, and if
you do not do well always, it is a belief-relevant situation, it will make sure you think about
your beliefs in consciousness, you will feel worthless and become depressed). This last
thought is most used now.
There is no evidence that biochemical anything causes depression, but there is evidence
that biochemical interventions does help reduce the symptoms of depression. All
antidepressants generally work in the same way. New antidepressants seem to have better/fewer side effects than the older ones (eg: older ones like tricyclines). Often people
would not take them because of the side effects.
Almost everyone who takes antidepressants experience at least some of these within the
first 10 days, and then afterwards they will subside. But if they continue after 10 days,
people will not want to take them.
Treatment Response (multiple slides)
There is no cure for depression. Interventions reduce the severity of symptoms, but do not
cure it. Depression is a lifelong condition (likely). If you are diagnosed with an episode, you
can get better, but it is very likely that you will have 6-9 more episodes in their lives. This is
important to make patients understand so that they do not get discouraged if they do.
People who do not respond to the treatment are classified as having treatment resistant
depression. Antidepressants do not work right away- they take maybe 4-6 weeks to make
you feel better. After this period, if they do not work, you will be put on different ones.
You cannot think of antidepressants as a cure for depression.
In the Jaws of Black Dogs
Important for psychoanalysts is to try to understand what their patients are experiencing.
What makes some people more vulnerable and others resilient to distressing situations? If
we can identify enough risk factors, we will be able to determine which people will become
depressed before they do, and give them tools to deal with this and to prevent depression.
Depression is basically an emotion tied to an initial emotion like sadness, but it persists
beyond the initial eve