Depression is one of the most commonly known and diagnosed disorders, the feeling of depression is a reflex that individuals may encounter when an undesired event has taken place, or a discontented emotion is felt as a result of an experience. Analysing mental health is something that has been studied by Psychologists for hundreds of years, many people are surprised to realise that it is not just doctors and surgeons that restore people back to health. Psychologists research and try to understand the cause of disorders such as depression and conclusively treat individuals suffering from such illnesses. The main approaches in Psychology that will be discussed in connection with depression are humanistic and psychodynamic.
Many individuals that have been diagnosed with depression in the first instance are prescribed medication but this can rarely be used as a complete solution as mood disorders are not physical in origin. Both the humanistic and psychodynamic approaches treat the illness with different types of therapy. This is because both follow the theory that depression in most cases is as a result of an emotion or event in the past that once treated can be overcome.
The humanistic approach lays emphasis on the uniqueness of humans and their freedom to choose their own destiny; it believes that scientific methods are inappropriate to study human behaviour. The view is very optimistic and positive, Maslow a key psychologist in the field of humanism believed we strive to achieve our own potential within out own limitations. Carl Rogers (1902-1987) believed that we are all born with an actualising tendency; this drives us to grow and develop into mature, healthy individuals.
Central to this he developed the theory of ‘The Self’ how a person views themselves as a result of life experiences, more commonly known in humanism as ‘The Perceived Self’ who you are in reality, and ‘The Ideal Self’ who you want or wish to be. Ideally these should be relatively compatible to be psychologically healthy, if not then can lead to problems and this is how it can relate to illnesses such as depression.
In comparison to what is said by humanism, psychodynamic approaches to illnesses such as depression are believed to have stemmed from a stage in childhood or an imbalance of personality. Freud (1865-1939) most famously known for his work in the psychodynamic field of psychology, likened the mind to an iceberg, only the tip of which can be seen above the surface, and the remainder is hidden.The conscious, the part of the mind that individuals are aware of and the unconscious mind which holds our fears, yearnings and deepest thoughts. He believed the unconscious mind had a significantly larger influence over behaviour than the conscious. The way in which Freud’s theory analyses psychological illnesses such as depression, lays emphasis on the structure and development of personality.
Freud believed there were three parts to human personality; The ID which is the child like part which functions according to the pleasure principal, wanting to avoid pain and obtain pleasure, be that emotionally or physically. The SUPEREGO, which Freud believed the rational part of the personality that controls the conscience and stands judgement on the thoughts and activities of the ID. Lastly the EGO “which ultimately keeps individuals in a state of reality and represents reason and good sense” (Freud 1923).
An imbalance in this structure can lead to psychological illnesses such as depression. If the Superego, which controls feelings of being socially accepted is stronger than the rest, judging actions or events from the past can become upsetting. If having higher than average standards of what is socially acceptable can lead to anxious behaviour. This part of the personality judges the actions controlled by the ID and Ego, making us feel guilt or shame so that we know right from wrong. Main symptoms of depression are the feeling of helplessness, anxiety and guilt.
Freud’s theory can be applied to depression when looking at his understanding of defence mechanisms. As the three parts of the personality are often in conflict the mind uses defence mechanisms that distort or deny reality. These affect our mood in away we have no control over because they are unconscious, and for conditions such as depression play a key part in understanding why individuals suffer with the illness. There are seven defence mechanisms in total but only three can be applied to suffers of depression; Repression, Reaction Formation and Denial.
Repression pushes feelings that individuals have that they do not want to feel into their unconscious mind. For instance, rape victims often suffer from depression and may have repressed feelings of guilt or blame after the event. They can believe that they could have avoided the event if they had done something different i.e. not taken the route home that led to the incident. Because they do not want to feel this emotion it becomes repressed, meaning they are not even aware of it in their conscious mind, and the feeling remains unconscious. This causes emotional difficulty and influences behaviour in a way that they are not aware and it is not a long term solution. Outbursts of anger and loneliness are some side affects of repression and also symptoms of depression.
Reaction Formation is a defence mechanism individuals suffering from depression use unconsciously to reduce anxiety and keep undesirable characteristics repressed. If an individual with depression due to the break down of a marriage/family often have feelings of loneliness, anxiety and detachment. Reaction formation would come into place when the individual would act dramatically extrovert, seeking attention in social groups by being loud or criticizing quiet introvert behaviour.
Psychoanalysts would view those characteristics they portray are only a defence mechanism, to show social groups and family that they are not suffering as a result of a loss or grievance. The last defence mechanism that can be applied to depression is denial. People sometimes refuse to believe events or admit they are experiencing certain emotions that provoke anxiety. In the most obvious explain for a depressant, they may not believed that that they are depressed, the same as an alcoholic would not believe they were dependant on alcohol.
Humanism approaches mental health in a similar way to psychoanalysis when it comes to treating the issue, but they differ most in diagnosis and finding a route that cause the depressive behaviour. Depression is a form a neuroses, although in many cases it is medicated before counselling is given that which is similar to psychoses. Many symptoms of depression such as extreme levels of anxiety and severe mood swings could be seen as psychoses conditions that which need the individual to be hospitalised and medicated. In the past the psychodynamic approach has been referred to as the most unethical of all of psychological approaches, and there is very little evidence to support some of Freud’s fundamental theories.
Anna O was a patent at Bellevue Sanatorium, admitted by Josef Breuer and Sigmund Freud. She suffered symptoms of; paralysis, disturbed vision, cough, high anxiety and hallucinations. Both Freud and Breuer came to the conclusion and diagnosed Anna O with Hysteria, a condition also known as somatisation disorder. Anna O was treated by Breuer, techniques used included; free association, dream analysis and hypnotherapy all of which designed to uncover emotions, fears, feelings and events that lie deep within what Freud believed as the unconscious mind. They concluded that the symptoms were a result of hysteria, due to the death of Anna O’s father which she experienced as a child and that her symptoms were not physical but psychological.
After the treatment given by both Freud and Breuer, Anna O was discharged from Bellevue Sanatorium although her symptoms had become increasingly worse at the time of her release. (Shultz & Schultz, 2004) Over time the symptoms lessened many believe they were heightened due to institutionalisation. According to current research, “examination of the neurological details suggests that Anna suffered from complex partial seizures exacerbated by drug dependence.” (Macmillan, 1991) Freud had suggested Anna O’s condition psychological but many psychologists today believe it was but neurological. Many believe that Freud misdiagnosed her, and she in fact suffered from temporal lobe epilepsy, and many of her symptoms are common in epilepsy.
Abraham Maslow a humanistic psychologist formed his theory of psychology and how individuals behave by studying human growth and created his well known ‘Hierarchy of Needs’. Above is an example of what Maslow believed to be the route of all individuals’ growth in life, and any components not achieved or lacking can lead to problems. The way in which Maslow approached Psychology was that of an optimist. When creating his hierarchy of needs, he focused on individuals he knew to have reached self actualization, for example Albert Einstein (Hoffman, 1988). Maslow wrote “It is as if Freud supplied us the sick half of psychology and we must now fill it out with the healthy half.” (Toward a psychology of being, 1968)
Freud believed that humans were a product of their environment and become who they are physically and psychologically as a result of experiences and reacting to situations, in contrast to Maslow and Rogers who supported that individuals have an internal ability to achieve desires and reach self actualisation.
In contrast to Freud who studied mentally unhealthy individuals, Maslow studies those who he believed exceptionally psychologically healthy, Maslow wrote that “the study of crippled, stunted, immature, and unhealthy specimens can yield only a cripple psychology and a cripple philosophy” (Maslow, 1954) Therefore, when looking at individuals with depression the humanistic view would not be that their abnormal behaviour be focused on, but how client centred therapy can restore back to normal mental health. Client centred therapy also known as person centred therapy was originally developed by humanistic psychologist Carl Rogers (1902).
A therapy whereby patients would be provided with an opportunity to develop a sense of self wherein they can realize how their attitudes, feelings and behaviour are being negatively affected and make an effort to find their true positive potential (Cepeda & Devenport, 2006). Individuals suffering from depression would be taught how to focus on positive experiences, and show how to centre there attention on how to enjoy life, how to work their way up Maslow’s hierarchy of needs, and how by starting with the basic needs their self esteem, confidence and mental health will grow.
Both the psychodynamic and humanistic approaches faced criticism and still do today. Both approaches have very little scientific evidence to prove each of the theories. But as humans we are able to understand and recognise key factors in both which we can see in ourselves, which make the theories of Freud and Maslow hard to disprove. Psychology overall is a very subjective topic and is hard to prove any theory through cause and effect, but as we are all individual and unique not every cause will have the same effect. How we developed illnesses such as depression is individual to our experiences, personality and view of reality.
The DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders) state that when diagnosing and treating individuals with mental illnesses, appropriate use of the diagnostic criteria require extensive clinical training, and its contents “cannot simply be applied in a cookbook fashion” (Maser, JD. ; Patterson, T, 2002)
The way in which depression is treated and diagnosed is simply down the to health professional who is dealing with the individual and the techniques used in restoring the patient back to ideal mental health is also dependant on this. Whether CCT, Psychotherapy or Dream Analysis used health professionals today are able to amalgamate the theories of all approaches to psychology to best suite the individual they are treating.
