Major Depression and Depression

Depression in the Lifespan

Depression is a multifaceted and complex phenomenon affecting multiple age cohorts. It is therefore important to understand what differential age-related risk factors account for the manifestation of depressive symptoms, whether precipitating factors are genetic or environmental, also how specific treatment interventions might change depending on age-related needs or age-appropriate interventions. A developmental approach to depression can provide some insight into how clinicians can improve treatment interventions and promote a more nuanced and realistic understanding of the disorder. The symptoms of depression are also likely to be different for different age cohorts, in part due to developmental differences, but also to biological differences in brain structure and chemistry, life experiences and socialization. This topic is important to both clinical and counseling psychology because reframing depression from a developmental perspective can shed light on etiology and best practices.

Review of Literature

Literature has generally not focused on a developmental theoretical perspective, even though early research showed that "socioemotional, cognitive, linguistic, social-cognitive, neurobiological, and neurochemical" domains all need to be "taken into account" when investigating depression (Cicchetti, Nurcombe & Garber, 1992, p. 1). Moreover, researchers have yet to devise reliable methods of measuring depression in early childhood, instead reverting to the misapplication of adult surveys and instruments that might be irrelevant for younger age groups. Simmons, Wilkinson & Dubicka (2015) note that, "since the recognition of youth depression, numerous instruments have been developed, but there is little consensus regarding their use," (p. 230). Increased consensus and more finely tuned instrumentation for measuring and diagnosing depression in young people would tremendously help evolve more efficacious interventions.

More recent research on the application of Interpersonal Therapy (IPT) to depression reveals potential areas where developmental psychology can converge with other frameworks for understanding mood disorders in childhood and adolescence. IPT in particular might be indicated for young cohorts to the proven efficaciousness of the modality in general: deMello, Mari, Bacaltchuk & Neugebauer (2005) performed a meta-analysis and found that IPT leads to results comparable to medical interventions for depression, and in fact the results "did not increase when combined with medication," (deMello, et al., 2005, p. 75). This would suggest methods of intervention that avoid the use of pharmacological treatments. IPT also offers a "time limited" method of helping young people, who may benefit from a targeted and brief approach. deMello, et al. (2005) also found that IPT proved more efficacious when treating depression versus cognitive-behavioral therapies (CBT). Because IPT has proven results with depression specifically, and because IPT also avoids the pathology model that has become the standard in clinical psychology, it may be especially potent for understanding depression in ways that provide positive and solution-oriented interventions for persons of all age cohorts. In fact, the results of the deMello, Mari, Bacaltchuk & Neugebauer (2005) meta-analysis also show how IPT can be adapted to suit a developmental framework, providing interventions for a single client throughout the life span.

Whereas the bulk of literature encompasses issues related to depression in adolescence, early adulthood, and adulthood, a relative paucity of research investigates issues specific to depression in seniors. However, Hyde, Hanson, Chungkham, Leineweber,& Westerlund (2015) conducted a nationally representative longitudinal cohort survey of persons employed in Sweden between 2003 and 2005, restricting the sample to respondents who had involuntarily left the labor market. Total sample size was well over 1000 seniors, making the study generalizable and reliable. Major depression was measured using the Symptom Checklist Core Depression Scale (SCL-CD6), which is useful for the age cohort (Hyde, Hanson, Chungkham, Leineweber,& Westerlund, 2015). Even after controlling for "socio-demographic variables, health, health behaviors, and baseline depression" the researchers found that, "involuntary employment exit was associated with an increased risk of reporting major depression," as well as seeking pharmacological interventions (p. 381). The results suggest that age-specific factors such as having a meaning or purpose in older life through engagement in the workplace might be uniquely impacting seniors, precipitating depressive incidents. These are not factors that would impact young people, showing why a developmental approach to depression is important.