Aaron Beck is very big. Aaron Beck
is a name that is worth knowing.
In a cognitive perspective of depression and the idea here is that,
and we've talked about these things before, way back. We talked about
structuralism, functionalism, psychodynamic perspectives, behavioral
perspectives, humanistic perspectives and
cognitive perspectives. This perspective is that the way
people who are depressed think, predisposes them to becoming more depressed
because they then focus on negativity to the exclusion
of positivity or evidence of at least neutrality.
So errors in interpreting self,
errors in interpreting the world and errors in interpreting the future,
become problematic, such that you have
a triad.
Internal - life is
bad because of me
because I'm worthless or not good enough or won't
achieve success or am incapable, whatever negative thoughts about one's
self, right.
Coupled with, it's probably always going to be like that.
So therefore there's not a lot of hope for the future.
And it's global. It's all areas of life. It's not just work
were I'm having problems but work, home life. You know,
what I want to be as a person kind of existential issues
as well as kind of daily life issues. It's kind of like everything
is negative. And with that depressive triad
you would expect that people just are going to be very happy.
If that's the way you think about the world and you get stuck in what
Albert Ellis will call automatic negative thinking
without putting it in check or testing it, it makes sense that you would be depressed.
And that's another way of looking at depression because there's a lot of ways
to look at depression as it turns
out. It's not just one thing. A lot of people go, that's a, that's a
chemical imbalance isn't it? But we'll see that that's not necessarily
what it is. There's
certainly chemicals involved but there's chemicals involved in everything.
There's nothing that you think, feel or do
that neurotransmitters aren't involved in. And if you are
like me not good at sports, you don't say well that's a chemical imbalance isn't it,
right? You just have an imbalance in the things that make you able to do sports.
No, and don't think about it that way.
but there's neurotransmitters involved in everything and there's some
consistency. We see that correlations have been found between mood disturbances
and the neurotransmitter serotonin, norepinephrin
and acetylcholine. But correlation does not necessarily equal
causation, right.
It could be, it could be that
your low levels of serotonin, for instance,
could cause your depression, possibly.
That's the lay person's understanding of it, right. They say oh, it's a chemical imbalance.
I don't have enought of a neurotransmitter
so I take an anti-depressant to get more of them.
But it could be that your depression is causing low levels of
serotonin.
Or it could be that something else is affecting both,
right. We don't have clear-cut experimental evidence. You can't randomly
assign people to depression
and see what happens, right. Making them depressed.
and seeing what happens. But we, but we do know that there is some correlation here.
But the thing, is when you supply a neurotransmitter
in greater amounts, it doesn't automatically raise mood.
So giving somebody an antidepressant of a selective serotonin reuptake inhibitor
type,
where we are now inhibiting the reuptake of serotonin and thus more of it is in
the synapse, you all remember that from the biology chapter, yes, I hope.
All right, there's more of it. If that was it, if there was just a chemical imbalance ,
well now we have more, almost instantly
pretty quickly after we take the drug but we don't get mood improvement.
We get mood improvement over a period of about four weeks, two to six weeks, depending on
the individual
because you get that downgrade and postsynaptic
receptors that goes along with it. And the process of those postsynaptic
neurons
changing their number of receptors, not upgrading as you would think with more
serotonin
but downgrading the number of receptors takes two to four to six weeks to
accomplish.
And that's when you see the correlation in mood. So it doesn't seem to be the chemicals
themselves so much as the biological processes
involved are correlated with improvements in mood
but where they alone don't often
work any better than psychotherapy. So psychotherapy has
pretty much equal efficacy to medication so
we're not changing any neurotransmitters directly
we're asking people to change their experiences and that might change their
neurotransmitter level.
You all have a great weekend. Maybe we'll see out tomorrow at the next door.
I don't know.