1. Kristin Coad
May 23, 2010
Psych 1
Compare/ contrast essay on major depressive therapy
Psychological disorders are a huge part of learning and understanding psychology,
although, diagnosing and treating the disorder plays an even bigger role. There are many
different types and subtypes of psychological disorders ranging from complications such as
obsessive compulsive disorder (OCD) to the major and more life threatening, schizophrenia.
Aside from schizophrenia, major depressive disorder is one of the most commonly understood
and treated disorders today. Because there are so many different types of disorders, there
comes a wide range of therapies to treat even the most specific. When there is a disorder, there
is a therapy for it whether it is psychopharmacological, cognitive or even shock therapy. This
paper will explore the different types of therapy in the treatment for major depressive disorder.
Whatever the disorder, there are usually ways around to treat it. In psychology, there are
a few main ways of treating the well known major depressive disorder. The three treatments
include cognitive, psychopharmacological, and lastly electroconvulsive. These different types of
therapy are similar in the sense that they are all trying to help an individual overcome
depression, but then they are all fairly different because the process in which they are treating
depression is very broad and dissimilar.
The least harmful approach in treating major depressive disorder would have to be
cognitive therapy. In cognitive therapy, the psychologist talks to the individual with depression to
help sort out negative thoughts and evaluations that are being suppressed, causing them stress
and furthermore, depression. There are nine different sub-types to go along with cognitive
therapy. However, the main sub-types includes: self-evaluation which deals with how we as
humans evaluate the way we are managing life tasks, doing what we are supposed to be doing,
acting they way we’re supposed to act, and things such as that. In this sub-type, the individual
with depression evaluates themselves as being messed up, and not doing the right thing, all the
time. Their overall self-evaluation tends to always be negative and persistently critical causing
them to have a lower self esteem, and always having a sense of being a failure.
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2. Another sub-type is identification of skill deficit which deals with learning how to do
things that are necessary in achieving what they want, and an overall better outcome whether it
is with life or simply a better choice. Unfortunately, the depressed individual doesn’t believe that
they have the effort to change, and act differently to achieve a better outcome for them self.
This sub-type is usually also paired with negative self-evaluation, relating back to the self-
evaluation sub-type.
In addition to evaluation and deficits, irrational ideas and beliefs are known to be at the
heart of most psychological disorders. These irrational beliefs can also be classified as incorrect,
or unrealistic. Irrational beliefs tend to stem from a basis of false assumptions that have been
made by the individual who is depressed. Irrational ideas and beliefs can be about anything, but
what really makes them irrational is that the depressed individual strongly believes that they are
correct.
Lastly, pessimistic thinking doesn’t necessarily cause depression, but it is shown that if a
person who constantly thinks negatively, that it becomes easier to form depression. A key aspect
of pessimism is hopelessness, and strongly believing one-self is hopeless. If a depressed
individual looks at the world through negative, bad, filled with issues eyes, then of course there
is a higher chance of becoming depressed. The feeling of hopelessness stems from believing that
life will never get better, and that there is no future. On the other hand, optimism helps comfort
a person by looking at the world as a good, positive, happy place. People who are more
optimistic tend to increase their chance of never becoming depressed.
Cognitive therapy, in general, is the evaluation of ones self, irrational beliefs and
thoughts, pessimistic thinking, overgeneralization of negativity etc. To overcome depression by
cognitive therapy, realization of all these evaluations is needed, and to look at life and everything
amongst it as good and positive. Psychologists help an individual with depression come to these
realizations through talking sessions. They also help the person with depression overcome any
hardships, by moving on and to look at the world more optimistically. To have an optimistic
outlook on life will highly decrease the chances of someone having depression. Other than
cognitive, there is another type of very important therapy: electroconvulsive. This type of
therapy differs greatly from cognitive in many ways.
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3. Electroconvulsive (ECT) therapy is very dissimilar to cognitive therapy in the sense that
there is no need to come to a realization about self-evaluation or pessimistic thinking.
Electroconvulsive therapy is only used on the worst depression cases because not only is it
dangerous because it requires hospitalization, but it is also expensive and a huge amount of
commitment is needed. If every other therapy fails or when the depression has progressed too
far, or when drugs will take too long, ECT is used because it is the fastest and strongest way to
relieve a person from the extreme state of depression. Because of all these requirements, ECT is
only reserved for the most severe cases, also making ECT a very uncommon solution to cure a
person from depression.
Electroconvulsive therapy is treatment that consists of medically controlled seizures. The
seizures occur when there is an electric current that is passed between two panels that are
placed on either side of the scalp. Prior to treatment, the patient with depression is given a
temporary anesthetic, so that they don’t endure any more stress on the body. Just after the
patient receives the anesthetic, they are given an additional dose of muscle relaxants to help
control the contraction of the muscles throughout the seizure. Because seizures make muscles
strongly contract, this medication is highly necessary. During the controlled seizure, the patient is
given oxygen via facemask because the anesthetic and muscle relaxant interfere with normal
respiration, which may furthermore cause complications throughout the treatment. This therapy
is completed in about 8 to 12 individual treatments, three to four times a week, all including
these steps to start and control the seizure. Antidepressants are started towards the end of the
entire treatment to give further protection from the depression arising later on.
With ECT, there come many risks and side effects that anyone undergoing ECT should
keep in mind. Even though the side effects are usually not extremely serious, they can become
difficult in patients that have undergone the series of treatments. Normal side effects of this
treatment include nausea and headaches that can be easily treated with medications for pain.
Because an electric current is passed through the brain, the more serious and recognized side
effect following ECT is memory loss. Because ECT interferes with memory storage, events that
happen through out the duration of the treatment, or even shortly before, are often not
remembered after it is finished. On the up side, memories that have happened before the
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4. electroconvulsive treatment started do stay intact, and the ability to form new memories goes
back to normal shortly after the 8- 12 treatments have ended. Luckily, there has never been any
recorded permanent brain damage due to ECT.
One last way to minimize brain damage is to only stimulate one side of the brain by only
sending an electrical current through one lobe of the brain. The best solution for this, and to
create no further memory loss is to stimulate only the right side, considering that the left side of
the brain controls more things. The downside to this is that the treatment becomes less
effective, and may take longer to treat the depression, requiring more treatments.
The last main type of psychological therapy to help subside major depressive disorder
includes psychopharmacological therapy, or drugs to help depression in individuals. The common
term for psychopharmacological therapy is antidepressants, including drugs such as Prozac, Paxil,
Nardil etc. This type of therapy, unlike the others, takes a much longer time to treat depression.
A person who is put on antidepressants can be on the drugs for upwards of a year, or even
longer. In the past, physicians have been known to prescribe antidepressants that have increased
side effects, one of them including suicide. Now a day, they have come out with newer
antidepressants that are nontricyclic that cut down the risk of side effects.
The process in which patients go in for treatment are usually acknowledged to bring a
long a family member or a friend, because the antidepressant therapy can be mentally draining
and tedious. Before any antidepressants can be prescribed, the physician should let the patient
know that noticeable improvement won’t show up before 2-4 weeks of being on the treatment.
The overall antidepressant therapy will take a minimum of 6-12 for the depression to diminish,
and for the patient to recover. This process can take longer or even fail because of a low dosage
for an overall too short a time.
If the antidepressant therapy fails, the drug dosage would be lifted to the maximum
recommended amount, and remain on that dose for a minimum 4-6 weeks. If still after being on
the highest dose of medication and the treatment still doesn't work, the therapy is then
considered unsuccessful, and a new approach will be taken. Another way to ensure that the
therapy does work is to relieve the individual of any stress that is getting in the way of the
antidepressant therapy. Stress plays a leading cause in depression, and is needed to be
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5. minimized for the full effects of the therapy to work. Once stress is calmed, a depressed
individual can undergo a full course of antidepressant therapy. Even though stress can be
eliminated, individuals who are clinically depressed may also suffer from anxiety issues. Luvox
and Ativan are the antidepressant of choice for reducing extreme anxiety. Patients can also
benefit from Klonopin or Rivotril if it is added to their dose of antidepressant such as Prozac.
The entire reason behind psychopharmacological therapy is the use of antidepressants,
dose and elapsed time of being on the drug. There are three main types of antidepressants:
MAOI, SNRI and SSRI medication. Firstly, SSRI drugs include the well known Prozac (fluoxetine)
and others such as Paxil (paraoxetine), Zoloft (sertaline), and Luvox (fluvoxamine). These types of
antidepressants should never be combined with MAOI, Nardil (phenelzine) and Parnate
(tranylcypromine) medication. Lastly, SNRI antidepressants includes Effexor (venlafexine) The
average dose of an antidepressant starting off is around 10mg of Prozac or Paxil for a
continuation of 3-5 weeks; It is then increased to 20mg. That is just one example of the
acceptable amount of medication for a patient who is on SSRI or MAOI antidepressant.
If for any reason, a switch between these two types of antidepressants, a minimum of at
least two weeks needs to elapse before the patient can continue on a different medication. SSRI
has a tendency for fewer side effects, like weight gain and suicide, so this becomes the prime
choice for a starter antidepressant. Even though SSRI has a lower chance of suicide, those
patients who are severely depressed do have a higher risk for overdosing with their medication.
There are so many different types of psychological disorders, but even more ways to treat
individuals who have them. One of the most common and understood disorder is major
depressive disorder which effects the life and mental state of the individual who has it. Major
depressive disorder is an extreme disorder that affects many people in very different ways. In
psychology, there are the three main ways for trying to relieve an individual of depression. Firstly
there is cognitive which deals with the realization of negative self-evaluation, self deficits and
pessimism and trying to treat the patient by having them think more optimistically about
themselves and life. Secondly, electroconvulsive therapy is the most effective, yet requires the
most commitment, way of treating a patient with depression. ECT deals with medically
controlled seizures. ECT is the fastest, yet least common type of therapy today. Lastly,
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6. psychopharmacological therapy deals with the use of antidepressant medication to try and have
the patient in a stable state. There are many different types of antidepressants are out and
available, such as Prozac and Zoloft to name a few. Even though there are so many different
ways to relieve someone of depression, not everything can work, and that is what leads to
suicide. The easiest way out to try and prevent psychological disorders, especially major
depressive disorder, is exercise and a healthy life style. If people take the initiative and start
living a healthy life, the amount of psychological disorders would decrease over time. A healthy
life is just as important to us as oxygen; we need proper nutrition and exercise to get the
maximum out of life, which is why it is a key factor in reducing psychological disorders.
This essay was done during Intro to Psychology in my junior year. The basis of the essay was to
depict the different types of therapy to treat major depressive disorder (MDD). I chose to do a caption on
this is because I feel that I learned a lot on not only MDD, but also the different types of therapy. I find
this kind of knowledge is really interesting, that is why I wrote so much. I believe that I did a good job
executing and explaining these therapies. The ways of knowing that are important to psychology include
language, emotion and perception.
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