Research Plan

Quantitated research is information collected and the production of data via statistics and numbers. The data is collected through questionnaires, surveys or by manipulating pre-existing statistical data. For example, calculating the number of people who suffer with depression, this research can provide a number of manifestations but cannot provide an explanation to why people are depressed (Skills you need, 2018). Primary research (field research) is inspected first hand by individuals via surveys, interviews and observations. Variables of such research should be considered when addressing the results in particular age groups, sex and number of participants within a survey. Secondary research (desk research) involves collection on existing research using primary research sources as a source of data to analyse. (Research Optimus, 2018)

In order to complete the project brief a secondary research technique has been applied opposed to primary research due to the absence of ethics committee within the college. The research will include looking at journal articles, statistics, legitimate websites and newspaper articles with further reading. This will then allow analysis and evaluation of material in attempt to answer the essays question with an unprejudiced perspective.

Table 1 – Project timeline and Key activities

The research will focus on six key areas:

1. What is depression?
2. Who’s more likely to suffer from depression?
3. What is the genetic explanation for depression?
4. What is the biochemical explanation for depression?
5. What are the psychological explanations of depression?
6. What are the sociological explanation of depression?

Information contained within this essay will not be open to debate as statistics collected are the result of a worldwide research being high in validity and reliability. Moral judgement, assumptions and personal opinions is not suitable or necessary for the purpose of this essay.  This essay will include conflicting perspectives with the intention to enable the reader to form their own conclusion. Throughout this essay efforts will be made to assess the validity and reliability of the information available such as government statistics highlighted in reputable studies. Health and safety protocol will be followed during the process of researching and assembling the essay such as regular breaks to reduce eye strain and upper limb problems. Information will be referenced accurately ensuring plagiarism is avoided, whilst observing all ethical and legal obligations at all times.

Introduction

Depression is one of the most common and serious illness with devastating consequences in its most server form, it is estimated that more than 300 million people suffer with depression worldwide (WHO, 2017) Depression is the most common mental disorders within the UK and reports suggests that it’s hit a record high, increasing by nearly a third in the last four years. The total estimated number of people living with depression worldwide increased by 18.4% between 2005 and 2015 to 32 million according to the World Health Organisation (Families for depression Awareness, 2017). This has prompted urgent calls for the government to ensure better health provisions are put in place, with the need to look deeper into this phenomenon to enable an understanding of the disorder enabling them to overcome it. Research has shown that depression does run in families, which could potentially mean that depression is genetic (inherited condition) NHS (2013). However, families don’t just share genes – they also experience similar environments.

Depression is a common and serious mental disorder that negatively effects how we feel, how we act and how we think (American Psychiatric Association, 2018). Depression is classified as a mood disorder that has an impact on both physical and mental health, affecting a large portion of the UK population with around 3 in 100 adults suffering every year (Mind Org, 2013). An episode of depression serious enough to require treatments occurs more commonly in 1 in 4 women and 1 in 10 men at some stage in their lives (Kalat, 2001). This could just be due to the fact women are more open to express their concerns and feeling then men are or that women are more willing/ likely to seek treatment. To meet the criteria for having depression the sufferer needs to display at least 5 symptoms that are laid out by the DSM-IV (Diagnostic and statistical Manual of mental health disorders, 2013). World Health Organisation WHO (2001), marks depression as when “capacity for enjoyment, interest, reduced concentration and marked tiredness after even minimum effort is common. The core symptoms of depression would entail persistent sadness or low moods, loss of interest or pleasure in activities, disturbed sleep or tiredness, change in appetite, feeling worthless or in server cases recurrent thoughts of death, excessive feelings of guilt and hopelessness (NHS, 2016). It’s also common for people with depression to develop physical symptoms such as headaches, palpitations, chest pains and hallucinations these are called psychotic symptoms.

Depression is generally divided as follows; major depressive disorder, dysthymia, Bipolar disorder, Seasonal affective disorder, premenstrual dysphonic disorder and atypical depression affecting anyone at any time (Very well mind, 2018). There are many contributing factors that seem to increase the risk of developing or triggering depression. These include certain personality traits, traumatic or stressful events, a history of mental health disorders, history of depression in blood relatives, abuse of recreational drugs or alcohol, chronic illness and medication(Kalat, 2001) However, this does not factor in the environmental factors such as poverty with the affects it has on an individual’s well-being.

Genetic assessment

There are strong biological links with those who sufferer with depression, in terms of genes family research- especially twin and adoption studies shows a genetic link were Individuals may inherit pre-dispositions to depression or other mood disorders( kalat, 2001). Wender et al (1986) conducted family correlational research into depression through adoption study which observed whether genetics or the environment appeared to be more associated with depression in adopted adults would suffered depression. Psychiatric evaluations were conducted and the study produced results showing that the biological parents of the adopted adults were eight times more likely to have the disorder than the adopted parents. Twin studies are an additional way of studying if genetic factors are the cause of the pre-dispositioned disorder. Monozygotic twins (MZ) share 100% of their genes whereas dizygotic twins (DZ) only share 50%, of the  rate is the process for assessing the likelihood of one twin having the disorder in which the other also has to have the same. A significant note that need to be considered, is in previous research it wasn’t possible to differentiate between the MZ and DZ twins so statistics may also be incorrect.  Diverse studies have produced fluctuating statistics but the overall trend pattern was usually the same concluding MZ twins indicated increased rates in depression in contrast to DZ twins. From these studies environmental factors cannot be ruled out, MZ twins share comparable environment’s than DZ twins so influences such as friends and education are more likely to be similar on both. Even in MZ twins being raised apart their environments may not be that diverse. Despite the thousands of studies carried out to locate the gene, studies have failed to identify locus of any significant gene specific to depression (http://www.psychology4a.com/depression.html, no date). It is however possible for people with no family history to also develop depression.

A British team of scientists has recently located a gene that seems to be predominant in multiple family members suffering with depression, chromosome 3p25-26 was situated in more than 800 families with recurring depression. This study looked at DNA from over 800 families including 971 sibling pairs who had European origin and who were affected by recurring depression. It also included 118 pairs of siblings with one affected by depression and the other not.  Other studies were conducted at the same time as the British researchers which matched the link between the same chromosome and depression. (Heath line, 2016) However the results could not be applied to those suffering with less serve depression. This evidence also lacks ecological validity as it cannot be generalised to the whole population and only represents the European. Research has also shown that individuals with parents suffering with depression are 3 time more likely to have the disorder.

 Scientists now have confidence in that as many as 40% of individuals suffering with depression can be linked back to genetics.  (Health line, 2016)

Biomedical Assessment

The biological aspect of depression looks for indications that relate to diagnostic categories of mental disorders with an outlook that a sick body can be restored to health (McLeod, 2014). This theory links depression to imbalances or problems in the brain regarding the neurotransmitters, serotonin, norepinephrine and dopamine. Evidence of the imbalances is very difficult to monitor and measure in a person brain. The neurotransmitter serotonin involves the regulation of important physiological (body orientated) functions such as sleep, aggression, mood and sexual behaviours. Research suggests that the decrease in the production of serotonin by the neurons can cause depression in some people but not all. Catecholamine hypothesis was a popular explanation in the 1960s to why people developed depression, suggesting that a deficiency of norepinephrine in certain areas of the brain was responsible for creating depressed moods. (Mental help net, 2007) Autopsy studies support this theory as it shows that individuals who experienced multiple depressive episodes had less norepinephrine neuron than individuals with no history of depression. Conversely, the research outcomes also revealed that not all people who experienced mood change was the reaction to the norepinephrine levels being lower. Modern studies also suggest that decreased levels of serotonin triggers a drop in norepinephrine levels leading to depression.(Harvard medical school,2009)With this explanation or approach anti psychotics have long been established as a fairly cheap, effective and speedy treatment at reducing symptoms for the individual. However, it could be argued that the side effects and addiction caused by these types of medication is a weakness of this approach. Although this approach created psychological treatments for many mental disorders it has neglected the treatment process. Scientists have been testing the chemical imbalance theory validity for over 40 years (approximately) and regardless of thousands of studies been conducted there’s still not one direct supporting evidence proving the theory accurate (Psychology Today, 2017).

Psychological assessment

The psychological perspective on depression explores unconscious thinking, possible past traumas and focuses on aiding the individual to realise their potential and emphasis on social support and psychological interventions. Freud was the first to offer an explanation on depression. This theory delivers evidence based explanations for how people think, behave and feel the way they do (http://www.psychology4a.com/depression.html, no date).

 The psychodynamic approach regards the source of mental disorder being the cause of loss or rejection by a parent (McLeod 2015). Although, this does not take in to account current experiences/problems that the individual may be going through. Supporting evidence of this was Bifulco et al (1992) studies found that children who lose their mother are more likely to suffer with depression (http://www.psychology4a.com/depression.html, no date).

The cognitive- behavioural model has a strong emphasis on reinforcements (positive or negative) as an explanation for depression. Beck’s (1976) hypothesised that individuals with negative thoughts towards themselves or those who have low self-esteem are far more susceptible to suffer from depression, suggesting that the negative perception that they held towards themselves was built up through negative experiences. Beck anticipated that experiences in childhood could lead to a cognitive traid resulting in the individual suffering with depression. This traid is built up in three parts in which people hold negative thoughts; the self, the world and the future. In addition those who suffer with depression or are susceptible to it magnify the bad experiences and minimise the good (Eysenck, 2012). Weissman and Beck (1978) as cited in Dobson (2010) supported this theory by using self-schemas to discover out how people perceived themselves and the world around them. The results showed that those people with negative self-schemas were far more likely to suffer with depression. Although, White (1985) agrees that there was enough evidence to suggest that Beck’s theory was correct although, he suggests it does not show the true connection of depression and failed to identify that logical errors might be triggered by biological factors such as chemical imbalance in the brain. Becks theory was based upon questionnaires, although there are limitations to this form of information gathering. This questions the reliability of the research as the participants of the questionnaire can be effected by social desirability (McLeod, 2015)

Ferster (1973) behavioural theory suggests that it’s a lack of positive reinforcements is the cause of depression. For instance a loss of a loved one may cause depression due to the loss of a positive reinforcement. Lewinsohn (1976) suggested that when others give the depressed individual attention this reinforces the depressive behaviour and symptoms. This can also have the reverse effect when there’s a lack of attention given by family or friends and thus lack of reinforcements, this can equally exacerbate depressive symptoms. This raises the debate to whether depression causes negative thinking and perceptions or that the negative perceptions were the cause of depression. Abreu and Santos (2008, p.131)

Sociological explanation

The sociological explanation for mental health such as depression regards social forces as the most important determinants of mental disorders, taking a broader view of a psychiatric disorder than any other model. Regarding an individual’s environment and behaviour as being fundamentally linked. In some perspective it’s similar to the psychodynamic model which also sees individuals moulded by external events. However, whereas the psychodynamic model views depression as highly personalised and determinants are not immediately recognisable. This model views depression based on general theories of groups and caused by observable environmental factors such as poverty, poor neighbour hoods, low education, ethnicity, divorce and the loss of a loved one WHO (2014). Although short term sadness is a normal response to these triggers and should not be confused for depression. People who live in poverty struggle causing them to be in a continuous stressful state, feeling overwhelmed and inadequate of taking control over their own lives. Health Ross (2000) as cited in Cockerham, (2008) linked better quality neighbourhoods with those of a poor disadvantaged neighbourhoods, the  findings were higher levels of depression occur in the latter with individuals suffering psychologically due to their environment (although there were also links to their individualism). The daily stressors of living in these deprived areas with low income, unemployment etc. are linked to the symptoms of depression (Haralambos and Holborn, 2008). Individual’s living in clean and safe environments displayed lower levels of depression further supporting that social factors contribute. Individuals living in poverty become the strongest predictor of depression WHO (2004)

Consideration must also be given to the possibility that individuals living in communities  with increased employment opportunities are still being diagnosed with depression as a result of losing their jobs through suffering with depression rather than not having a job and becoming depressed. This raises to the question is depression the cause of the environmental factors or is the environmental factors the cause of depression.

In conclusion, there doesn’t seem substantial evidence in any one area to state that there is a single source of depression. Evidence points towards genetics playing 40% role in cause of depression, especially in cases of family studies. However, it is suggested that instead of being a direct cause of it makes a person more prone to getting depression than others.  The behavioural and cognitive theories have reputable aspects of validity to such that you can apply findings to real life situations and cases of depression. However it does have a weakness with both approaches being that either do not consider or recognise the biological or genetic effects of depression. The research has established that mental illness is complex and depression is no exclusion, therefore it cannot have a singular, unpretentious explanation and is a result of a combination of biological, psychological and social factors. Evaluation of the available research would suggest that although genetics may have an impact on depression there is more sound evidence to suggest other factors heavily contribute.

Evaluation  

The introduction of this essay specified clear figures regarding those suffering with depression within the UK and women being more susceptible as pose to men. However it could have given more insight to that particular causes of this issue such as evidence based studies to suggest why.

The research throughout this essay was gathered by a wide variety of reliable sources and used the most up-to-date information as possible. As this essay was limited to secondary research this restricted access to research on a more personal level such a questionnaires within the community on families who suffer or have recurring depressive disorder. Due to the word count set on this essay it restricted more divulge information on other cause/ explanations for depression. For example Personality, Gender, Disabilities etc.

The Researched statistics that was presented in this essay was analysed and evaluated were possible. Links to genetic theories supported the findings of certain studies which in turn strengthened the statistics enabling the essay question to be answered.  However there could have been additional analysis of genetic studies not relating to the MZ twins and DZ twin siblings.

From the supporting evidence and statistics gathered within this essay the conclusion was able to answer the essay question giving a figure of 40% of depression is caused through genetics. It also acknowledges the serious mental health disorder and its complex problems and cause. Yet it was unable to single out one defining cause of depression. A more enhanced insight and knowledge was obtained by carrying out this project in the wider field of depression and its root causes.

References

Abreu, R.B. and Santos, E.C (2008) Behavioural Models of Depression:A critique of the emphasis on positive reinforcements.4 (2) pp130-145 International Journal of behavioural consultation and therapy [online] Avaliable at:https://files.eric.ed.gov/fulltext/EJ800945.pdf (Accessed 25April 2018)

American Psychiatric Association (2018) what is depression? Available at: https://www.psychiatry.org/patients-families/depression/what-is-depression. (Accessed 20 March 2018)

Beck, A.T.(1976). Cognitive therapy of emotional disorders. New York: New American Library

Cockerham, W. (2008). The social causes of health and disease. Oxford: Polity.

Diagnostic and statistical manual of mental disorders. (2013) 5^th Ed. Arlington, VA: American Psychiatric Association.

 Dobson, K. (2010). Handbook of cognitive-behavioral therapies. 3rd ed. New York, N.Y.: The Guildford Press, p.150.

Eysenck, M. (2012). AS level psychology. 5th ed. Hove: Psychology, pp.278-280.

Families for Depression Awareness (2017) Depression on the rise worldwide, says WHO. Avaliable at:http://www.familyaware.org/who-2017-depression-report/ (Accessed 13 March 2018)

Haralambos, M. and Holborn, M. (2008). Sociology. 7th ed. London: Collins.

Harvard Medical school (2009) What causes depression? Available at:https://www.health.harvard.edu/mind-and-mood/what-causes-depression (Accessed 19 April 2018)

Health Line (2016) Is depression Genetic?. Available at: http//www.heathline.com/health/depression/genetic (Accessed 15 March 2018)

Kalat, J. (2001). Biological psychology. 7^th Ed. Belmon,CA: Wadsworth Thomson Learning, p428-429

McLeod, S. A. (2014). The Medical Model. Retrieved from www.simplypsychology.org/medical-model.html (Accessed 19 April 2018)

McLeod, S.A. (2015). Psychological theories of depression. Retrieved from www.simplypsychology.org/depression.html (Accessed on 20 April 2018)

McLeod, S.A. (2015). Unconscious mind. Retrieved from www.simpplypsychology.org/unconscious-min.html (Accessed 23 March 20180

 Mental help net (2007) Biology of depression. Available at:https://www.mentalhelp.net/articles/biology-of-depression-neurotransmitters/ (Accessed 10 April 2018)

Mind Org (2013) Mental health facts and statistics. Available at: https://www.mindorg.uk/information-support/types-of-mental-health-problems/statistics-and-facts-about-mental -health/how-common-are-mental-health-problems/#Wv1x9BbTXYU. (Accessed 21 March 2018)

NHS (2011) Genetic link. Available at:http://www.NHS.uk/news/genetics-and-stem-cells/genetics-link-for-depression-found/ (Accessed 20 March 2018)

NHS (2016) Symptoms of depression. Available at: https://www.nhs.uk/conditions/clinical-depression/symptoms/ (Accessed 24 March 2018)

NIH (2013) Common genetic factors found in 5 disorders. Available at: https://www.nih.gov/news-events/nih-research-matters/common-genetic-factors-found-5-mental-disorders (Accessed 25 March 2018)

Organisation, W (2001) World health report 2001. Geneva: World Health Organisation

 Psychology Today (2017) On myth of the chemical imbalance. Avaliable at:https://www.psychologytoday.com/gb/blog/mental-illness-metaphor/201709/the-myth-the-chemical-imbalance (Accessed 20 April 2018)

Psychology4A.com http://psychology 4a.com/depression.html/(no date) (Accessed 20 April 2018)

Research Optimus (2018) Primary research methods. Available at: https://www.researchoptimus.com/article/primary-research-methods.php. (Accessed 10 March)

Skills You Need (2018) Quantitative and Qualitative Research methods. Available at:https://www.skillsyouneed.com/learn/quantitative-and-qualitative.html (Accessed 10 March 2018)

Very Well Mind (2018) Common Types of Depression.  Available at:http://www.verywellmind.com/common-types-of-depression-1067313 (Accessed 10 April 2018)

WHO (2004) Promoting mental Health. Available at:http://www.who.int/mental_health/evidence/en/promoting_mhh.pdf (Accessed 05 May 2018)

WHO (2014) Social determinants of mental health. Available at:http://apps.who.int/iris/bitstream/handle/10665/112828/9789241506809_eng.pdf;jsessionid=AB96531936427A020E8E24B7E0F0C8F2?sequence= (Accessed 05 may 2018)

WHO (2017) Depression: let’s talk says WHO, as depression top llist of causes of ill health. Available at: http://www.who.int/news-room/details/30-03-2017–depression-let-s-talk-says-who-as-depression-tops-list-of-causes-ill-health. (Accessed 20 March 2018)