Chapter 6: Clinical Psychology

Causesand
treatmentofMood
Disorders
Biological and Psychological
Biological causes of Mood Disorders
Dopamine Neurotransmitter

Dopamine carries signals in parts of the brain responsible for, among

other things, feelings of motivation and pleasure. So, it makes sense that
if levels of dopamine are reduced, feelings of motivation and pleasure
would be affected. As we know, core symptoms of depressive disorder are
low mood, lack of interest or enjoyment in usual activities and lack of
motivation.

Research shows that low levels of dopamine are often found in those
suffering from depressive disorder. Furthermore, anti-depressants reduce
symptoms of depressive disorder by increasing dopamine levels, which
supports the theory that low dopamine levels were the cause of the
depressive symptoms.
 Serotonin Neurotransmitter
Serotonin is a neurotransmitter that regulates sleep and appetite as well as mood and anxiety. When
serotonin levels are normal, mood and anxiety levels are balanced.
However, when serotonin levels reduce, this can lead to low mood, anxiety and disruption to sleeping
and eating patterns, which are all symptoms of depressive disorder.

Genetic

First-degree relatives such as parents and siblings share 50% of

their DNA.
Just like physical illnesses, some mental disorders are thought to
have a genetic basis, meaning they can be transmitted from one
generation to the next.
Current evidence for bipolar and depressive disorder suggests that
there is at least some genetic explanation for why some individuals
are more at risk of developing such disorders.
Psychological causes of
Mood Disorders
Beck’s cognitive theory of depression
Cognitive theorists such as Beck (1979) believe that the negative views held by someone with
depression form a reality for that person, even if they seem far-fetched to others. The reason for the
individual’s low mood and physiological symptoms is an underlying process of incorrect information
processing.

Another term for this irrational thinking is ‘cognitive distortion’. According to Beck, cognitive distortion
is when a person tends to see things in a negative way (a negative bias). This develops as a result of
negative experiences during childhood, leading to negative schemas. When faced with events or
experiences throughout their life, the person’s negative schema is ‘activated’ (their bias affects their
processing) and they expect things to turn out badly. The result of cognitive distortion is the emotional,
cognitive and behavioral symptoms typical of depressive disorder.
Beck’s cognitive theory of depression
 Components of triad model

The first component of this

Second, the individual The third component is a
model relates to the
perceives the world as negative view of the future;
individual’s view of
presenting them with when considering
themselves. Unpleasant
insurmountable obstacles undertaking a specific task
experiences are attributed
to happiness and well- in future, the person
internally, meaning that the
being. They misinterpret anticipates failure or
individual thinks that they
external forces as being rejection
are worthless and not
against them.
capable of being happy
Psychological causes of
Mood Disorders
Learned helplessness and attribution style
Learned helplessness was developed by Seligman and his colleagues in the 1960s. Learned
helplessness is a state that occurs as a result of a person having to endure an unpleasant situation
when they perceive the unpleasantness to be inescapable. In theory, the individual learns that they are
unable to control the situation and prevent suffering, so they eventually stop trying to resist it

Seligman believed that learned helplessness could explain depressive disorder. His view was that
depression was a direct result of a real or perceived lack of control over the outcome of your situation.
 Learned helplessness and attribution style

Learned helplessness is the basis of ‘attributional style’ or ‘explanatory style’. As life experiences
teach us to develop trust or distrust in our environments, so we develop particular patterns of thinking
towards the world and ourselves. A person who has had a difficult upbringing, or experienced parental
loss, for example, might be more likely to perceive a lack of control over the negative events in their
lives (learned helplessness), and subsequently be more inclined towards a negative attributional style

This means they will consistently view things that happen in the future as internal, stable and global. If
something bad happens they might think it is their fault (internal), or that it will stay this bad forever
(stable) and that it means more things are likely to go wrong now (global).
Psychological causes of
Mood Disorders
Beck’s cognitive theory of depression
Cognitive theorists such as Beck (1979) believe that the negative views held by someone with
depression form a reality for that person, even if they seem far-fetched to others. The reason for the
individual’s low mood and physiological symptoms is an underlying process of incorrect information
processing.

Another term for this irrational thinking is ‘cognitive distortion’. According to Beck, cognitive distortion
is when a person tends to see things in a negative way (a negative bias). This develops as a result of
negative experiences during childhood, leading to negative schemas. When faced with events or
experiences throughout their life, the person’s negative schema is ‘activated’ (their bias affects their
processing) and they expect things to turn out badly. The result of cognitive distortion is the emotional,
cognitive and behavioral symptoms typical of depressive disorder.
Chapter 6: Clinical Psychology

Treatmentof
Mooddisorders
Biological and Psychological
 Biological Treatment of Mood
Disorders
Medication
Tricyclics were first introduced in the 1950s and are still used today, although usually
only when other treatments have failed. Tricyclics increase levels of serotonin and
norepinephrine in the brain by stopping them from being reabsorbed.
The increase in levels of these neurotransmitters reduces symptoms of depressive
disorder. Side effects of tricyclics include drowsiness, nausea and vomiting, blurred
vision and weight gain.

Monoamine oxidase inhibitors (MAOIs) inhibit the work of an enzyme known as monoamine oxidase. This enzyme is responsible for breaking down and
removing the neurotransmitters norepinephrine, serotonin and dopamine. Thus, MAOIs prevent these neurotransmitters from being broken down, and
allow them to remain at higher levels in the brain
they have numerous side effects such as headaches, drowsiness/insomnia, nausea, diarrhoea and constipation
 Biological Treatment of Mood
Disorders
Medication
More recently developed anti-depressants include the group known as selective
serotonin reuptake inhibitors (SSRIs). SSRIs act on the neurotransmitter serotonin to
stop it being reabsorbed and broken down once it has crossed a synapse in the brain.
This means that serotonin levels in the brain are increased, which reduces the symptoms
of depressive disorder
 Psychological treatment
of Mood Disorders
Beck’s cognitive restructuring

The cognitive restructuring aims to gain ‘entry into the patient’s cognitive organisation’ (Beck, 1979). It is essentially a talking
therapy, based on one-to-one interactions between the patient with depressive disorder and their therapist. It involves
techniques, such as questioning, to identify illogical thinking, and talking through ways of changing the patient’s way of
thinking.

Once the individual can recognise their own cognitions, the therapist helps them to understand the link between their thoughts,
affect and behaviour, and how each influences the others.

Cognitive therapy is now a well-established way to manage depressive disorder, particularly in cases where drug treatment is
unsuitable. Wiles et al. (2013) showed that it can reduce symptoms of depression in people who fail to respond to anti-
depressants.
 Psychological treatment
of Mood Disorders
Ellis’s rational emotive behaviour therapy (REBT)
Rational emotive behavioural therapy (REBT) is a psychological
approach to treatment based on the principles of stoicism. Stoicism is
a philosophy, and one of the principles is that in most cases, an
individual is not directly affected by external things but by their own
perception of external things

Albert Ellis (1962) placed this belief at the core of his theory on how
depressive disorder should be recognised and treated. He argued that
a person becomes depressed because of internal constructions;
because of their perceptions and attitudes towards things that happen
to them in their lives

Cognitive therapy is now a well-established way to manage depressive

disorder, particularly in cases where drug treatment is unsuitable.
Wiles et al. (2013) showed that it can reduce symptoms of depression
in people who fail to respond to anti-depressants.
 REBT, the therapist helps individuals to
Goal of the Therapy
understand the process known as the ABC model
The goal of therapy therefore is to help
(see Table 6.2). The most important element of
individuals create and maintain constructive,
the model is ‘B’, one’s beliefs about the event.
rational patterns of thinking about their lives.
This is because, while we all experience adversity
This means identifying and changing thoughts
and setbacks to some degree, Ellis argues that it
which lead to guilt, self-defeat and self-pity, or
is how we think about those experiences that
negative behaviour such as avoidance,
have greatest impact on our emotional well-
withdrawal and addiction
being and behavioural outcomes