Depression by Wender et al (1986) to

Depression
is common in majority of people. According to mind.org.uk (2013) depression is medical
illness that shows symptoms of low mood that lasts for a long time, and affects
your everyday life including the way you think, feel and react. Seligman (1973)
stated that “depression is like the ‘common cold’ of psychiatry because of its
frequency of diagnosis”. Psychiatry.org (2017) states that depression affects
about 6.7% of adults in each year. The biological and the psychodynamic
approach both attempt to explain depression in very different ways. There are
different treatments arising from both approaches. This essay will look
thoroughly at the views of what depression is and treatments of depression on
the biological approach and psychodynamic approach.

The
biological approach believes that mental disorders such as depression are
related to the functioning and physical structure of the brain. This approach
focuses on genetics, neuroanatomy, neurotransmitters and neurophysiology and it
also believes that disorders have an organic or physical cause.  According to Nemade et al (2007) in twin
studies, scientists have found that there is a powerful genetic influence in
depression. Identical twins are three times as possible to have depression than
fraternal twins raised in the same environment. This is because fraternal twins
only have fifty percent of the same genes in common. This suggests that
depression can be inherited. Even if twins are adopted they still have the
vulnerability to become depressed. Thus, there is evidence that there is a
genetic link to depression and it suggest that people may carry genes that
predispose them to depression. This shows that depression could be because of
genetic predispositions.

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In a
study by Wender et al (1986) to investigate whether genetics or the environment
seemed to be more associated with depression in adopted adults. In this study
all participants were removed from their mothers at a young age. The results
showed that adoptive parents were eight times more likely to have depression
and the biological parents having depression correlated more significantly with
depression in the adopted children than the adopted parents having depression (Wender
et al, 1986). This shows that depression can be as a result of the biological
approach.

On the
other hand, in Monoamine Oxidase Hypothesis (MAOH) depression is said to be
cause by a reduction of serotonin, noradrenaline and dopamine (psychologywizard.net, 2017). These factors all causes
melancholic symptoms of depression. The high levels of these factors cause
mania and serotonin (5-HT), norepinephrine (noradrenaline) and dopamine are
known as monoamine oxidase (MAO) transmitter (psychologywizard.net, 2017). The
MAOH is working backwards by understanding the mechanisms of the drugs that induces
or reduces depressive symptoms (psychologywizard.net, 2017). Davison and Neale
(2001) supports MAOH, by saying that they are effective in treating depression
and there is a strong link is established between low levels of serotonin and
depression.

However,
according to Claridge and Davis (2003) the MAOH is the longest standing
biological explanation for depression but it may take about seven-fourteen days
or more to work. As a result, by that time the neurotransmitters have already
returned to their previous levels and hence, a little increase in the
neurotransmitters is not enough to explain the reason that the drugs ease
depression. Hence, there is no evidence that depression is caused by serotonin
or whether depression causes low serotonin or is there another factor that
causes the both. This shows that the MAOH may not always be a reliable source
in explaining depression.

There
are two treatments according to the biological approach that will help in
treating depression. These two treatments are known as the tricyclics
antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs). The
tricyclics antidepressants are one of the oldest classifications of
antidepressants and they are still widely used such as amitriptyline. They stop
the reuptake of noradrenaline and serotonin. However, patients may experience
severe side effects such as shaking, dry mouth and weight gain. The SSRIs are
the newest and they were developed in order to present a positive response to
the need for better tolerated such as fluoxetine. They are safer than TCAs,
however, the are no less effective for the symptoms of depression. The levels
of serotonin that are raised are achieved by SSRIs and they produce a great
antidepressant effect, an example of this is Prozac. Therefore, these
treatments can be proven to treat depression. However, according to Hatzinger
(2010) the SSRIs were developed to reduce side effects, but it has been proven
that about 25 to 50% of people do not respond to the treatments.

Furthermore,
other biological alternatives were introduced because some patients were not
responding to the treatments. Two of the biological alternatives are as
follows: electroconvulsive therapy and partial sleep deprivation are very
effective in the treatment of critical depression. Light therapy is established
treatment alternative, in cases such as seasonal affective disorders. The other
treatment is rapid transcranial magnetic stimulation (rTMS) this is a new
biological treatment approach and it has shown inconsistent results. Biological
treatments are not seen as effective enough on its own to use on patients and
therefore, patients are offered a combination of biological and psychological
treatments and are often used in combination. These are the treatments to treat
depression according to the biological approach.

According
to McLeod (2014), the psychodynamic approach believes that problems are formed
in the unconscious mind. These symptoms are seen as caused by hidden
disturbances and these causes includes unresolved issues during childhood
development (McLeod, 2014).  McLeod
(2014), states that the “treatment focuses on bringing the repressed conflict
to consciousness, where the patient can deal with it”. Psychoanalysts believes
that depression is related back to the loss every child may experience when
they are realizing the separateness from their parents early in childhood. This
approach assumes that the reduction of symptoms alone is unimportant, if the basic
conflict is not resolved. It is believed that the neurotic symptoms will simply
be substituted. Failure to resolve this, the person may be predisposed to
depression in later life.

According
to Freud (1917), every stage of the psychosexual stage is linked with a
conflict, that must be resolved before the individual can successfully progress
to the next stage. In order to resolve these conflicts, it requires the
expenditure of the sexual energy and the more energy that is expended at a
specific stage, the more the important characteristics of that stage remain
with the individual as he/she matures psychologically. Depression is caused by
a combination of unconscious forces in early childhood experiences. Freud
(1917) believed that depression begins from the oral stage of the psychosexual
development which occurs during the first year of a child’s life. Within this
stage the child relies on their caregiver to satisfy their needs by oral
feeding. The individuals whose needs are unsatisfied or over satisfied during
this stage may become fixated and are dependent on other people to maintain
self-esteem.  This personality allows
them to be vulnerable to depression and they spend their time in seeking the
love and approval of others.

Freud
(1917) also assumed that deep in human’s unconsciousness, unknown to them are
feelings of hatred and negativity towards people they love, and this is turned
in on oneself. This is known as the unconscious process, this states that the
individuals do not connect their feelings with their parents. For example; if
an individual experience a loss, later in their life, they may stir up the
unresolved conflicts in their unconscious mind. 
However, this approach may be effective in various ways such as many of
the different observations of psychodynamic therapists appear to be borne out
in everyday life, for example defence mechanisms. Many people with
psychological disturbances do recollect childhood traumas and Freud’s theory
provides a comprehensive framework to describe human personality. Freud (1917)
rehumanised the distressed, thereby allowing their suffering to be
comprehensible to the rest of society. Freud (1917) developed a method for the
treatments and thereby encouraging a more optimistic view regarding
psychological distress. Hence, mental illness could be treated in some cases.
On the other hand, Freud (1917) used a biased sample to relate to his study.

According
to the psychodynamic approach the treatments involves in treating depression
(psychoanalysis), are by encouraging the client to recall that experience and
to unravel the fixations that have built up around it. Care is taken with transference
when working with depressed clients because of their overwhelming need to be
dependent on others.  The goal for the
clients is for them to become less dependent and to develop a more useful way
of understanding and accepting the negative factors in their lives.
Psychoanalysis is a long process which involves 2 to 5 sessions per week for
several years. There is a blank screen whereas the client will disclose very
little information about themselves to ensure that the client will be able to
use the space in the relationship to work on their unconscious without
interference. The therapist may use one or more of the following techniques
such as free association, interpretation, therapist neutrality, transference
and working through. These are the treatments of the psychodynamic approach.

However,
Shapiro and Emde (1991) states that psychodynamic therapies have been
successful only sometimes. Some depressed people may be uninterested to
participate in the session and a more directive approach may be useful such as
CBT. Other people may want a quick response and this treatment take some time.
The psychoanalysis is very subjective as it depends on the therapist
interpretation. Overall, this treatment is time consuming and people must be
prepared to invest a lot of time into it. 
Some painful memories may be relived, and they might cause some more
distress. Psychoanalysis does not provide a proper balance of power between the
therapist and client. This therapy does not work for everyone and all types of
disorders.

In
conclusion, the biological and psychodynamic approach have aimed to explain
depression according to their approach and the treatments that may arise.
However, there are strengths and weakness for both approaches.