Topic: Major depression

I. History

A. Goes back at least to Hippocrates, who included melancholia in his first nosology (Davison and Neale, 1998)

B. Aretaeus of Cappadocia (second century B.C.) showed that depression was sometimes the polar opposite of mania

C. Kraepelin and Freud both worked with depression. Depression seems to have been with us throughout recorded history, and appears in every culture and socioeconomic class studied.

D. Modern theorists of depression include Seligman (1974) and Beck (1967).

II. Diagnosis

A. Major depression is diagnosed if a major depressive episode lasts for at least two weeks (DSM-IV)

B. A major depressive episode occurs when five or more of the following symptoms, including at least one of the first two, occur most of the day nearly every day:

1. depressed or irritable mood
2. loss of interest or pleasure in formerly enjoyed activities
3. appetite and weight change
4. sleep disturbance
5. changes in movement patterns, like restlessness or inertia
6. fatigue
7. feelings of worthlessness or inappropriate guilt
8. cognitive changes: lack of concentration, loss of willpower
9. recurrent thoughts of death or suicide

C. May also be rated or coded as mild, moderate, or severe.

D. May have psychotic, catatonic, melancholic, or atypical features

E. May be postpartum onset, chronic, in remission, or follow a seasonal pattern

III. Etiology

Due to its pervasive nature in both individuals and societies, major depression has attracted many etiological theories.

A. One old theory blames depression on evil spirits.

B. Hippocrates offered a somatogenic model, developed by Galen into a humoral theory: melancholia is caused by an excess of black bile.

C. Freud (1917/1950) and Abraham (1911/1927) maintained that depression was caused by the loss of a loved one, either actual or symbolic, followed by the turning inward (introjection) of negative feelings and the failure of mourning work.

D. Beck (1967) suggested that depression goes along with logical errors of thinking, which support negative schemas of self-deprecation and self-blame.

E. Seligman (1974) supports a learned-helplessness model of depression, while Metalsky Halberstadt, and Abramson (1987) connect depressed mood to attributional style a la social psychology.

F. Physiological problems, including nutrition or imbalances of neurotransmitters, may also cause depression (McNeal and Cimbolic, 1986).

IV. Treatment

A. Drug therapies are commonly used in conjunction with psychological treatments. Tricyclics, MAOIs, and SSRIs all have antidepressant action.

B. Electroconvulsive therapy (ECT or shock treatment) has been successful with some patients, but it has risks.

C. Psychoanalysis may be beneficial in ideal patients: wealthy, bright, and Western.

D. Frankl's logotherapy tries to restore a sense of meaning to replace feelings of worthlessness and alienation common in people with depression.

V. Prognosis

A. About 80% of patients correctly diagnosed with depression will respond well to a combination of drugs and psychotherapy.

B. Chronic depression does not respond well to most medications, but may respond to some newer drugs.

C. The poor prognosis for many people with major depression is underlined by the observation that depression is a major cause of suicide.

Abraham, K. (1927). Notes on the psychoanalytical investigation and treatment of manic-depressive insanity and allied conditions. In E. Jones (Ed.), Selected papers of Karl Abraham, M.D. London: Hogarth Press. (Original work published 1911)

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, D.C.: Author.

Beck, A.T. (1967). Depression: clinical, experimental and theoretical aspects. New York: Harper and Row.

Davison, G.C. & Neale, J.M. (1998). Abnormal psychology, fifth edition. New York: Wiley.

Freud, S. (1950). Mourning and melancholia. In Collected Papers (vol.4). London: Hogarth and the Institute of Psychoanalysis. (Original work published 1917)

McNeal, E.T. & Cimbolic, P. (1986). Antidepressants and biochemical theories of depression. Psychological Bulletin, 99, 361-374.

Metalsky, G.I., Halberstadt, L.J., & Abramson, L.Y. (1987). Vulnerability and invulnerability to depressive mood reactions: toward a more powerful test of the diathesis-stress and causal mediation components of the reformulated theory of depression. Journal of Personality and Social Psychology, 52, 386-393.

Seligman, M.E.P. (1974). Depression and learned helplessness. In R.J. Friedman & M.M. Katz (Eds.), The psychology of depression: Contemporary theory and research. Washington, D.C.: Winston-Wiley.

Here you are to list, in alphabetical order and APA format, fifteen additional sources pertinent to your topic. At least ten of them must be journal articles; up to five may be books.