“I am extremely depressed!”.

Depression is one of the most common psychological disturbances and is

characterised by an extremely low mood state. Statistics show that about 15% of the people will suffer
from depression at some point in their life (National Health Association).. According to DSM IV TR formal
diagnosis of major depression requires either two weeks of depressed mood or loss of interest and
pleasure. In addition it requires the presence of other symptoms such as sleep and appetite
disturbances, feelings of worthlessness and excessive guilt, fatigue, diminished ability to concentrate
and suicidal thoughts. This mental state can be caused by a variety of reasons and the different models
of abnormal psychology namely medical, psychodynamic, cognitive and behavioural trace the onset of
depression to various distinct causes.

Firstly, the medical model of abnormal psychology traces the onset of depression to low level of
serotonin, over activity of hypothalamic- pituitary adrenocortical(HPA) axis and genetic causes. Research
conducted by Goodwin and Murphy 1962 supports the relation between low serotonin levels and
depression(Goodwin and Murphy 1972). Hence, research shows that individuals who have a low level of
the neurotransmitter are more prone to depression. Furthermore, the HPA axis may also play a role in
the onset of depression. The HPA axis controls various endocrine glands and the hormones they secrete
and is a major factor identified by the medical model. In addition, a genetic influence has also been
found in the origin of the disorder. Family study evidence has shown that a person has a 10% greater
risk of suffering from depression if one of his first degree relatives suffers from the same disorder
(Weissman et al 1987). Thus based on the causes identified, the medical model suggests therapies such
as tricyclic antidepressants like Trofanil and Elavil, MAO inhibitors and SSRI’s like Prozac. These adjust
the neurotransmitter level of the individual and can help cure the disease.

In contrast, the psychodynamic model provides a completely different explanation. In his celebrated
paper “Mourning and Melancholia” Freud theorized that we unconsciously harbour negative feelings
towards those who we love. Upon losing the loved one these negative feelings of anger are turned
against oneself and one suffers from depression. Thus the disorder is caused by repressed unconscious
conflicts (Mourning and Melancholia). Treatments based on psychodynamic model include
psychoanalysis and dream association. Such treatments help one resolve the unconscious conflicts and
is brought to face the reality.

Cognitive model, on the other hand, traces depression to errors in thinking, irrational assumptions and
negative views. Aaron Beck said that negative schemata together with cognitive biases or distortions
called the negative triad lead to depression (Psychology in Focus). This theory is supported by the
Temple Winsconsin study of cognitive vulnerability to depression. A group of university students was
studied for a period of 2 years to examine the onset of depression. The study showed that 17% of the
high risk students who had negative thinking developed depression compared to only 1% of those who
thought positively. (Barlow and Durand 1999). Therapies provided by the cognitive model include
cognitive therapy and rational emotive therapy. As cognitive model believes that this disorder is caused
by errors in thinking, all these therapies suggested aim to replace negative thoughts with optimism and
hence cure the disorder.
Lastly, the behavioural model explains depression in terms of reinforcement and lack of social support.
Research conducted by Lewinsohn et al 1979 showed that depressed people received fewer positive
reinforcements and are likely to have more unpleasant experiences than non-depressed people.
Similarly, the study by G Brown and Haris 1979 showed that out of a large number of women who had
experienced a serious life stress, only 10% of those who had a friend in which they could confide in
became depressed compared to 37% of those who did not have a friend. Thus, substantial amount of
research supports the findings of the behavioural model which explains the onset of this disease in
terms of lack of social support and positive reinforcement. Therefore, therapies suggested by this model
include interpersonal psychotherapy and family therapy which target an increased social support for the
depressed individual.

Thus, each model of abnormal psychology provides its own set of assumptions and suggests suitable
treatment for depression. Considerable debate exists in psychology as to which model identifies the
aetiology of depression correctly. The actual cause may vary from one person to the other. Correct
identification of the cause can guide us as to which treatment is to be followed and how should one cure
one of the most common abnormalities known as depression.