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Depression
A person with depression must have at least five of nine symptoms in the DSM-IV-TR for two weeks. There are many theories of the causes of depression:
(1.) Psychoanalytic theories - internal conflicts and a low self-image leading to anger turned inward.
(2.) Behavioral theories - disruptions of normal reinforcement patterns brought on by stressors.
(3.) Cognitive theories - cognitive distortions and/or cognitive errors and a person's mistaken underlying assumptions.
(4.) Humanistic theories - a slavish concern with expectations and values from others leads away from genuineness and wholeness in the person.
(5.) Biopsychosocial models - psychological, biological, and social factors play a role in depression. An outgrowth is the diathesis -- stress model that asserts that depression occurs as a result of a preexisting vulnerability (diathesis) triggered by stressful life events. The diathesis can be biological, psychological, or both.
(6.) Biological models - an imbalance of neurotransmitters (serotonin, norepinephrine, and dopamine).
Research on depression has favored cognitive and biological theories although this does not substantiate them as the only valid explanations (Lauber, Falcato, Nordt, & Rossler, 2003). The outgrowth of biological models of depression has led to the development of numerous drugs for treatment. These drugs generally fall into three classes:
(1.) MAO inhibitors work by reducing monoamine oxidase which breaks down the neurotransmitters believed to be lacking in the brains of depressed people. Potentially fatal side effects can occur from eating foods with the amino acid tyrosine such as liver, fermented drinks and aged cheese. Rarely used today.
(2.) Tricyclic antidepressants work by inhibiting the reuptake of serotonin and norepinephrine. Side effects include dry mouth, blurry vision, constipation, cognitive impairment, drowsiness, anxiety, emotional blunting, and sexual dysfunction.
(3.) SRRI's selectively block the reuptake of serotonin and are the most commonly used medications for depression today. Potential side effects...
In addition, although many people think that SSRIs like Paxil work better than the other groups, research has indicated that all the classes of drugs are equally effective and SSRIs produce fewer side effects. The drugs work best on people that have more vegetative or biologically-based symptoms of depression such as fatigue, insomnia, etc. Different drugs of the same class seem to work better for different people, but about 10-20% of patients are not helped.
Mania
Mania is a state of prolonged elevated mood, arousal level, and energy level. It is often thought of as the opposite of depression and is the upside on bipolar disorder. Psychological theories regarding mania are not as well-developed as those for depression. Mania can also be the result of taking medications or illicit drugs and this should always be ruled out. Relevant theories of mania include:
(1.) Psychoanalytic theories are similar to those of depression, internal conflicts regarding a low self-concept and mania is a reaction-formation to this.
(2.) Biopsychosocial models such as the diathesis-stress models probably better account for mania than purely psychological models and are most popular as a large number of manic episodes appear to be triggered by stress (Barrios, Chaudhry, & Goodnick, 2001).
(3) Biological models of mania assert that an overabundance of neurotransmitters in the brain produces mania. Several different neurotransmitters have been implicated including dopamine, serotonin, glutamate, and norepinephrine.
While biologically-based theories are favored, no one has yet determined the exact cause of mania. Medications to treat mania include Lithium (often the first choice), anticonvulsants (e.g., Depakote and Tegratol), antipsychotic medications (Risperdal), and some antihypertensive drugs such as Verapamil. These drugs seem to work by reducing the manic symptoms but have a myriad of side-effects…
References
Barlow, DH (2000). Unraveling the mysteries of anxiety and its disorders from the perspective of emotion theory. American Psychologist, 55, 1247 -- 1263.
Barrios, C., Chaudhry, T.A., & Goodnick, P.J. (2001). Rapid cycling bipolar disorder. Expert Opinions on Pharmacotherapy, 2 (12), 1963 -- 1973.
Lauber, C., Falcato, L., Nordt, C., & Rossler, W. (2003). Lay beliefs about causes of depression. Acta Psychiatrica Scandinavica, 108 (418), 96 -- 99.
O'Rourke, J.A., Scharf, J.M., Yu, D., & Pauls, D.L. (2009). The genetics of Tourette Syndrome: A review. Journal of Psychosomatic Research, 67(6), 533-545.
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