Depression Cognitive Approach
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The cognitive explanation of depression basically rests the idea that disorders happen because of faulty thinking. There are other explanations for depression, and other treatments.
The cognitive approach assumes that behaviours are controlled by thoughts and beliefs. Therefore irrational thoughts and beliefs cause abnormal behaviours. There are many different models that help to explain how irrational thoughts can lead to depression. Examples are:
- Ellis's ABC model - This ABC three stage model was proposed by Ellis in 1962. This model claims that disorders start off with an activating event (A) for example failing an exam, which then leads to a belief (B) about why this happened. The belief can either be rational or irrational. A rational belief would be like for example "I didn't prepare well enough" whereas an irrational belief would be "I'm too stupid to pass exams". These beliefs then lead to consequences (C). According to Ellis, rational beliefs lead to healthy emotional outcomes and produce adaptive consequences like for example more revision needs to be done, whereas on the other hand irrational beliefs lead to unhealthy emotional outcomes and produce maladaptive consequences, including depression.
Here is the flow chart of Ellis's ABC model:
Beck's negative triad - Beck (1963) developed a cognitive explanation for mental disorders, but focussed it on depression. He believed that individuals who are depressed feel as they do due to their thinking being biased towards negative interpretations of the world and lacking a perceived sense of control. Beck then identified a 'negative triad' which was a cognitive approach of understanding depression, focusing on how negative expectations (schema) about themselves (e.g. I can't succeed at anything), the world (e.g. I must be successful to be a good person) and the future (e.g. nothing will ever change) lead to depression. Beck then claimed that negative schemas may be acquired in an individual's childhood due to a traumatic event. Experiences that might contribute to negative schemas include parental rejection, bullying at school, and the death of a sibling. People with negative schemas become prone to making logical errors in their thinking and they usually focus selectively on certain points within a situation going on while ignoring the relevant information.
Cognitive behaviour therapy (CBT) is an effective treatment for all mental health problems including depression. CBT is based on the idea that how we think (cognition), how we feel (emotion) and how we act (behavior) all interact together. Basically, our thoughts determine our feelings and our behavior.
It is the idea that patients learn how to notice negative thoughts when they have them, and then test how accurate they are. During CBT, what generally happens is:
- The therapist and patient identify the patient's faulty cognitions.
- The therapist then tries to help the patient see that these faulty cognitions are not true, for example that the patient does not always fail on anything they do.
- Both the therapist and patient then set goals to think in a more positive perspective or adaptive ways, for example focusing on things the patient has succeeded in and trying to build on them.
- Even though the patient may sometimes need to glance back to past experiences, the CBT mainly focuses on the current situation.
- Therapists sometimes encourage their patient to keep track of a diary so that they are able to accurately record their feelings, actions and patterns.
CBT differs from other depressions treatments because it focuses on specific problems for a patient and is goal orientated. Along with this cognitive behaviour treatment is educational too because therapists use structured learning experiences that teach the patient to monitor and write down their mental images and negative thoughts. Furthermore, cognitive therapy helps individuals develop alternative ways of behaving and thinking, which tries to reduce their psychological stress.
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