Psychology Factsheets

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Depression
This Factsheet describes the symptoms of unipolar
and bipolar depression. It also looks at the causes of,
and treatments for, depression.
1. Introduction
DSM-IVR (see glossary) classifies depression as a
mood disorder. A mood disorder affects a person’s
emotional state. There are two types of depression. These are
unipolar disorder (depression) and bipolar disorder (depression).
We will look at each of these in turn.
A. Unipolar depression
This is also known as major or clinical depression. It occurs five
times more frequently than bipolar depression. Its symptoms (clinical
characteristics) include:
• Depressed mood (e.g., sadness, loss of pleasure, tearfulness).
• Emotional symptoms (e.g., intense guilt, lack of enjoyment).
• Motivational symptoms (e.g., difficulty initiating action).
• Cognitive symptoms (e.g., frequent negative thoughts, problems
concentrating).
• Somatic symptoms (e.g., loss of energy, sleep disturbances such
as insomnia or hypersomnia).
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B. Bipolar depression
This is also known as manic depression. This disorder
involves cycles of depression (see above) and mania.
Periods of mania or hypomania follow periods of
depression. The clinical characteristics of mania
include:
• Emotional symptoms (e.g., abnormally euphoric or irritated
mood, greatly increased enjoyment in activities).
• Cognitive symptoms (e.g., increased self-esteem, many racing
ideas/thoughts).
• Motivational symptoms (e.g., increase in activity directed to a
goal).
• Somatic symptoms (e.g., less need for sleep, physical agitation,
more talkative).
Exam Hint: You must understand the difference between the
two types of depression. Be careful in the exam – do not write
about bipolar disorder if asked about unipolar disorder, and
vice versa!

Exam Hint: You will need to know the clinical characteristics

(symptoms) of unipolar and bipolar depression.

2. Explanations (causes/aetiology) of depression:

There is not a single explanation for depression – there are several explanations that each may contribute to depression. Table 1 outlines
the explanations of depression. Note that the varying theories that explain depression fall into several categories.

Table 1(a): Explanations of depression - Biological (medical)

Category of theories Theories Description

Biological (medical) 1. Genetic • Depression seems to run in families. Close relatives of someone with
depression (e.g., parent, sibling) have a higher risk of developing it themselves.
• Unipolar depression – moderate evidence for role of genes.
• Bipolar depression – stronger evidence for role of genes.
• However, depression can occur in people with no family risk, so other factors
must also be important.

2. Neurochemical • Lack of neurotransmitters noradrenaline (norepinephrine) and serotonin

related to depression. Evidence for this comes from research into how
antidepressant drugs work (drugs increase activity of neurotransmitters).

• Lithium carbonate is a very effective drug for bipolar disorder, which indicates
a strong biological cause.

• Hormones may play a role in unipolar depression (e.g., increased level of the
stress hormone, cortisol).

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Table 1(b): Explanations of depression - Psychological & Environmental (social)

Category of theories Theories Description

Psychological 1. Learning theory (behaviourism) • Reinforcement and punishment may be involved in depression. For
example, a lack of positive reinforcement may lead to ‘sad behaviour’,
which reinforced by attention the sad behaviour gets.
• Depressives show learned helplessness (Seligman) where the person
has been unable to control unpleasant experiences in past, so views
new traumatic experiences in a passive way.

2.Psychodynamic (psychoanalytic) • Unconscious conflicts lead to regression and anger towards self. Freud
proposed that depressives turn aggression and anger for others
inwards and therefore punish themselves.

3. Cognitive theory • Negative thinking or distorted attribution of failure (blaming self when
things go wrong).
• People become depressed when they believe that nothing they do
will help their situation.

Environmental (social) 1. Socioeconomics • Depression is more common in women.

• It is especially common in ‘working class’ women who stay at home
and who have three/more children under the age of 14 years (Brown
and Harris, 1978).

2. Life events • Depression can occur after major stressful life events (e.g., death of
mother when young).
• It is linked to levels of stress and ‘hassles’.
• Life events may trigger depression in individuals who have a genetic
vulnerability (predisposition) to it.

3. Interpersonal • Depressed individuals tend to report having sparse social networks

which means that they are less able to deal with negative events.
They are more vulnerable to depression continuing.
• Joiner et al. (1992) found that depressed people have poorer social
skills (e.g., lack of eye contact) which lead to rejection from other
people.

Interaction • Rats which show learned helplessness also show large decreases in the production of the neurotransmitter
explanations norepinephrine (Weiss and Simon, 1985).
• Stress causes the release of hormones (e.g., cortisol) which play a role in regulating genetic influences on
behaviour (Checkley, 1992).

Evaluating the explanations of depression

• It is not entirely clear to what extent neurochemicals are involved in depression. The role of neurotransmitters is very complex. Also,
antidepressants can affect many other chemicals, not just serotonin and norepinephrine.
• Antidepressants that involve serotonin do not help everyone who suffers from depression.
• Learning theory cannot account for the fact that individuals in similar environments do not all become equally depressed.
• Seligman’s ideas were based on studying animals, so it is not clear if they can be generalised to humans.
• Psychoanalytic theory lacks support from scientific research.
• Environmental factors may be triggers, rather than causes, for depression in people who are predisposed.
• It is not established whether social skill deficits cause depression or are the result of depression.
• Individuals differ in their susceptibility to develop depression. This may be partly due to genes and partly due to life experiences. The
interaction between the individual and environment is called the ‘diathesis-stress model’.

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3. Treatments for depression Exam Hint: If the exam question asks you about
explanations or treatments of depression, do not spend
There are many types of treatment available. These are explained in table 2.
a lot of time describing the symptoms. This will just
waste time and lose marks.
Table 2: Description and evaluation of treatments for depression.

Type of treatment Description Strengths Weaknesses

Biological 1. Drug therapy • Relatively cheap. • Around half of people using

This is the most common • Easy for doctors to antidepressants will have
treatment. Antidepressants prescribe. another episode of depression
relieve the symptoms of • Effective for many people. within two years.
depression. The drugs supply • Drugs can have unpleasant
neurotransmitters that are side effects (e.g., nausea,
lacking. For example, SSRIs deal drowsiness).
with imbalance of serotonin, • Withdrawal symptoms when
Lithium carbonate used for stop.
bipolar depression. • Drugs alleviate symptoms but
do not cure.
• Can take up to four weeks to
have an effect
2. ECT Rapid effect so useful for • Controversial treatment which
ECT is used when patients do suicidal patients. raises ethical issues.
not respond to drugs or • High relapse rate within a year
psychotherapy. It is used for suggests that it is a temporary
very severe depression. solution.
• It can cause memory loss,
headaches, etc.
Psychological 1. Behavioural therapy A moderately effective It helps with behavioural symptoms
The aim is for the depressive to treatment (it is more effective but not the underlying cause.
change ‘maladaptive behaviours’ than psychodynamic
by learning new, more appropriate therapy).
ones. It is based on conditioning.
This therapy focuses on current
problems and behaviour.

2. Cognitive therapy It is moderately effective (it is • It helps with behavioural

This focuses on the person’s more effective than symptoms but not the
thoughts and beliefs. It aims to psychodynamic therapy). underlying cause.
remove irrational thoughts and • It can be challenging as it
replace them with more positive questions the person’s beliefs
ones. It views negative thinking as and thought processes.
the cause of depression, not just
the symptom.
3. Cognitive-behavioural therapy • It is cost effective and It is more effective for anxiety
(CBT) This combines the more relatively short-term. disorders (e.g., phobias) than for
successful features of • It treats the causes rather mood disorders.
behavioural and cognitive than the symptoms.
therapies. It changes beliefs and • It is very popular in the
behaviours. UK and USA.

Psychodynamic Psychodynamic therapy Moderately effective for • There is some evidence that
This involves psychoanalysis (Freud). depression. people recover just as well
It views mental illness as being due to without psychoanalysis.
unresolved issues from the person’s • It is not relevant for people with
past. It uses various techniques (e.g., happy childhoods.
dream analysis).

Exam Hint: If the exam question asks you to ‘compare and

Acknowledgements: This Psychology Factsheet was researched and written by Amanda Albon.
The Curriculum Press, Bank House, 105 King Street, Wellington, Shropshire, TF1 1NU.
contrast’, make sure that you can describe the similarities and
Psychology Factsheets may be copied free of charge by teaching staff or students, provided differences between, for example, explanations or treatments
that their school is a registered subscriber. No part of these Factsheets may be reproduced, of depression. Do not answer a ‘compare and contrast’ question
stored in a retrieval system, or transmitted, in any other form or by any other means, without in the same way that you would answer a ‘discuss’ question.
the prior permission of the publisher. ISSN 1351-5136

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Worksheet: Depression
Name
1. Depression is what type of disorder?

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2. What are the two types of depression? How do they differ?

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3. Describe the clinical characteristics of one type of depression.

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4. Describe one biological and one psychological explanation for depression.

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5. What are the similarities and differences between social explanations and biological explanations of depression?

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6. Evaluate the biological explanation of depression.

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7. By drawing arrows, match the description in column A Match to its correct name in column B.
Column A - description Column B - explanation
Depression seems to run in families Life events explanation
Depression is caused by negative thinking Interpersonal explanation
People reject those with poor social skills Neurochemical explanation
Death of a spouse causes depression Cognitive theory
Hormones have a role in depression Genetic explanation
8. Explain the similarities and differences between biological and psychological treatments for depression.

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9. How does the psychodynamic approach explain depression and how does it treat it?

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Glossary
DSM-IVR: This stands for ‘Diagnostic and Statistical Manual of Mental Disorders, 4th edition, revised’. Clinical psychologists use this manual as a
reference book for all types of mental disorder.
ECT: This stands for ‘electroconvulsive therapy’. During ECT, an electric current is passed between two scalp electrodes to cause a seizure. It is done
while the person is under general anaesthetic.
Euphoric: The state of well-being and happiness. It can be exaggerated in mania.
Hypersomnia: Tendency to sleep excessively.
Hypomania: Shorter, less severe mania.
Insomnia: Inability to fall asleep or stay asleep.
Neurotransmitters: Brain chemicals that transmit signals between neurons.
SSRI: This stands for ‘selective serotonin reuptake inhibitors’. These drugs increase the amount of serotonin in the brain by stopping it being
reabsorbed. Prozac is one example of a SSRI.
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