PSYCHOPATHOLOGY OF DEPRESSION

1- Psychodynamic

• The psychodynamic understanding of depression defined by Sigmund Freud and expanded by Karl Abraham is known as the classic view of depression

• Loss of love object>projective identification and introjection>ambivalence>anger and turning against self>depression

• That theory involves four key points: • (1) disturbances in the infant mother relationship during the

early oral – late anal predispose to subsequent vulnerability to depression

• (2) depression can be linked to real or imagined object loss• (3) introjection of the departed objects is a defense

mechanism invoked to deal with the distress connected with the object's loss

• (4) because the lost object is regarded with a mixture of love and hate, feelings of anger are directed inward at the self.

• Melanie Klein understood depression as involving the expression of aggression toward loved ones, much as Freud did

• Bibring regarded depression sets in when a person becomes aware of the discrepancy between high ideals and the inability to meet those goals

• Jacobson saw the state of depression as similar to a powerless, helpless child victimized by a punishing parent.

• Silvano Arieti observed that many depressed people have lived their lives for someone else rather than for themselves.

• Depression sets in when patients realize that the person or ideal for which they have been living is never going to respond in a manner that will meet their expectations.

• Heinz Kohut's • Self psychology• the developing self has specific needs that

must be met by parents to give the child a positive sense of self-esteem . When others do not meet these needs, there is a massive loss of self-esteem that presents as depression

• Bowlby • believed that damaged early attachments and

traumatic separation in childhood predispose to depression.

• Adult losses are said to revive the traumatic childhood loss and so precipitate adult depressive episodes.

2- Cognitive Theory• According to cognitive theory, depression results from

specific cognitive distortions present in persons susceptible to depression.

• Those distortions, referred to as depressogenic schemata, are cognitive templates that perceive both internal and external data in ways that are altered by early experiences.

• Aaron Beck postulated a cognitive triad of depression that consists of negative views of self, world and future.

• Therapy consists of modifying these distortions.

3- Learned Helplessness(Seligman)

• connects depressive phenomena to the experience of uncontrollable events.

• internal causal explanations are thought to produce a loss of self-esteem after adverse external events.

• Behaviorists who subscribe to the theory stress that improvement of depression is contingent on the patient's learning a sense of control and mastery of the environment.

4-Social model ( brown and harris)