Showing posts with label psychological disorders. Show all posts
Showing posts with label psychological disorders. Show all posts

Individual Personality and Depression

Individuals with certain personality styles - those who are aggressive and those who have low dependency on other people - are at higher risk for recurrent bouts of major depression, according to a new University of Washington study.



The study comes from the laboratory of UW psychology professor Neil Jacobson, who found that people at risk for relapsing reported lower levels of satisfaction or pleasure from their activities than did people who remained well. The study also indicated that a patient's level of negative or dysfunctional thinking at the end of treatment was not predictive of relapse.



"Depression is a recurrent disease for a lot of people just like cancer," said Gollan, professor assistant, "People who receive cognitive behavioral psychotherapy for depression tend to feel less depressed when they complete it. However, other factors in their lives beyond their mood need to be identified if we are to help them stay well. We need to consider who people are and how they interact with others to understand how patients remain nondepressed."



Researchers are anxious to identify risk factors for recurrent depression because relapse rates among patients who respond to treatment are alarmingly high. Studies have shown that between 50 percent and 80 percent of patients successfully treated with cognitive behavioral therapy suffer a relapse, often within two years of remission. Cognitive behavioral therapy is the standard treatment for depression, often in conjunction with anti-depressant medication.



Depression is the most common mental health problem in the United States, affecting an estimated 17 million people. Individuals with clinical or major depression, the most serious form of the disorder, often can't function, perform at work, need to be hospitalized and may attempt suicide.



In the new study, Gollan and Jacobson followed 78 patients who had recovered from major depression for two years to monitor changes. The patients all received 20 sessions of cognitive behavioral therapy for their depression and were considered symptom-free for at least two months before being accepted into the study. The researchers utilized a variety of interview questionnaires and self-report forms to measure depression, dysfunctional attitudes and pleasant activities at the beginning and end of treatment and every six months during the two-year follow-up. Personality styles were measured before and after treatment.



At the end of the study, 34 people, or 44 percent, had relapsed. Gollan said there seems to be different subsets of people who are at-risk for recurrent bouts of depression. One of those groups is made up of individuals who have a low dependency on other people. People with low dependency are usually independent people who may have little or no social support system, she said.



"Low dependency increases risk for relapse while moderate dependency encourages recovered patients to seek out social relationships that may function, over time, to reduce relapse risk," she said.



People who exhibited aggressive, hostile styles at the end of treatment also were more likely to relapse, "perhaps because they don't make good friends and turn off people," Gollan explained. "In their professional careers they have channeled aggression in productive, socially acceptable ways to their advantage and use people to their advantage. They also are pathologically independent and independence may be a risk factor if you have depression."



She added that clinicians working with depressed patients need to pay more attention to the enjoyment and satisfaction people get from activities rather than on the type and number of activities they engage in.
"We need to focus on how the activities feel," Gollan said. "We don't know why, but it is becoming clear that people are less at risk for relapse when they do things they enjoy rather than working on overcoming their negative thinking patterns. The treatment should be tailor-made to the depressed patient."















Other studies extend the personality factor influence on the potential development of the depressive disorder. It was found that people with the following types are in greater risk of developing depression than others:
  1. People with high levels of anxiety.

  2. Extremely shy people, when it is expressed in forms of “social avoidance” and “personal reserve”.

  3. People with high levels of self-criticism and low self-esteem.

  4. People with high interpersonal sensitivity.

  5. Perfectionists.

  6. People, who are extremely self-focused.



Researches show that people who fit the first four factors description are in substantially greater risk to depression, especially non-melancholic depression. Perfectionists are protected to certain degree from the depression, however, if the depressive disorder episodes occurs, they will be significantly longer than for non-perfectionists. Self-focused individuals are likely to be in greater risk for brief depressive episodes. While melancholic depression development was not found to be in any correlation with patients’ temperament or personality.



Another study reviewed the possible personality changes after depression is over, and concluded that personality traits of people who suffer a period of major depression remain unchanged.



"Our findings do not support the scar hypothesis," says Dr. M. Tracie Shea, associate professor of psychiatry and human behavior at Brown University, Providence, Rhode Island. "Essentially, our findings were that when people get better, they look fine. There aren't changes in the personality traits from prior to the onset of major depression."



In their report, Shea and her colleagues point to numerous studies in which people with a history of depression were characterized by having high levels of certain personality traits, including dependency on others, lack of social self-confidence, submissiveness, irritability, and social introversion.



"Our findings suggest these traits might represent a vulnerability to becoming depressed, rather than being an outcome of depression. Personality changes that might be present during an episode of major depression will resolve following full recovery -- they will not be lasting," she asserts.

Social Causes of Depression



Depression is one of the most prevalent psychological disorders. Depression can be caused by several factors, including interpersonal relationships. Interpersonal relationships are the relationship between individuals and the reactions and emotions of each individual expressed directly and discreetly to each other. Common interpersonal relationships include (a) within the family, such as between the parents and between parents and children; (b) the social environment where differences in ethnicity and social class come into play; and (c) interactions between genders across age groups for both females and males.



Many people suffer from depression at one point in their life. It is inevitable, the feeling of hopelessness, sorrow, or being alone. These are all common emotions associated with depression. For a select few, depression can be hard to overcome, and this is where depression becomes a disorder that requires active treatment. Those 'selected few' account for over 100 million people worldwide and result in 75% of all psychiatric hospitalizations. Yet the question remains, why did these people become depressed? How did they become depressed? One of the answers that lead to the cause of depression would be a person's interpersonal relationship with their surroundings and the people around them. There are many interpersonal instances that can have the ability to lead to the onset of depression, such as the family environment, the socialization setting, and the discrimination against gender in certain cultures and instances.



Family


One could argue that out of all the interpersonal cases that can contribute on the onset of a depressive disorder, the ambiance of a family has the most weight and impact on a depressed individual. In the case of spouses, the well being of one spouse will have a notable impact on the other spouse and on the welfare of their marriage. For example, in 30% of all marriage problems, there is one spouse that can be described as clinically depressed. The reason why a spouse might have a unipolar mood disorder could be due to their relationship being "characterized by friction, hostility, and a lack of affection".



Martial distress can also be caused by the impact of having a child. When a woman is pregnant, she can experience a whole range of emotions due to the changing of interpersonal relationship with husband and the building of a new relationship with the unborn child. For example, the building of a new interpersonal relationship with the child can be very tasking and become a major stressful life event that can cause a mood disorder to develop.



Aside from the martial distresses of spouses, the impact of depressed parents can have an effect on their children as well. In a study on the relation between depressed adolescences and depressed mothers, they found that the depressed children of depressed mothers had more negative interpersonal behavior as compared with depressed children of non-depressed mothers. This is reinforced when a study shows that the parents of depressed children are less warm and caring and more hostile than parents of non-depressed children. Because of this negative interpersonal relation between kids and their parents, children can develop a negative view of their family. This negative view can lead to the feeling of lack of control and having a high risk of conflict, rejection, and low self-esteem.



Cummings (1995) stated that any changes in a family environment due to parental depression increase the risk of developing a mood disorder in children. The result of this can be found as early as preschoolers and infants, due to the insecure attachment they develop with their parents. The emotional distress of children can also have an effect on their parents, causing depression that in turn will also affect the children, theoretically creating a never-ending cycle unless they seek treatment. Sometimes It is not the depressed parents that lead to the onset of depression in their children, but rather it is the change in the family environment that stems from the parents' depression that causes the children to become depressed. Some studies suggest that martial troubles are a better predicator for the onset of depression than the depression of the parents or the children themselves.



Experiencing depression while as a child or an adolescent can also lead to reoccurring slips as an adult. Depressed persons often perform poorly in marriage and relationship with family members and they also might respond negatively to others, which have the ability to create stressful life events, which as a result might drive the person further into depression. Depressed people are dependant on other people and constantly seek reassurance in such a way that drives people away. Hammen and Brennan (2001) found that 13% of the sons and 23.6 % of the daughters who were depressed had depressed mothers as compared to 3.9% of the sons and 15.9% of the daughters who were depressed lacked a depressed mother.



Many people believe that children and parents suffer differently from depression, but not so. Depressed children can be like depressed parents, expressing sadness, anger, shame, and self-directed hostility. Just like adults, depressed children tend to blame themselves for bad events and accredit the environment for good events--they do not give themselves credit when due. This is why oftentimes, children will feel guilty if their parents get divorced and they believe that they were at fault but realistically, it was the parents' martial distress that was the cause of the divorce, not the children's depressive mood disorder.



Socialization
As in the family environment, socialization is key to maintaining healthy relationship and feeling well deserved and part of someone's life. Depression can have an adverse effect on the social capacity of depressed persons, affecting their social functioning and ability to react and deal with stressful situations. Gotlib and Hammen (1992) discussed the social functioning of people with depressive disorders and found that people with the symptoms of depression are found to test low in social activities, close relationships, quality close relationships, family actives, and network contact, yet they test high in family arguments.



One major part in the development of mood disorders in a social setting would be how well one could deal with stressful events. Normally, this is called coping strategies and it allows a person to manage their troubles and not be overwhelmed. Oftentimes, people can become depressed when unable to deal with "drama" from their friends-especially in children. Depressed children reported significantly higher level of hopelessness, lower general self-esteem, and lower coping skills than non-depressed children. Their ability to be unable to cope with stress can lead to fewer and less adaptive coping techniques.



Social settings can also include one-on-one interactions and the rejection that occurs. In a study performed by Joiner, Alfano, and Metalsky (1992), they tested whether a depressed individual would have an affect on other people in one-on-one interactions and they found that affected people did have such an influence on other people. This influence could be described as responding negatively to their constant searching of reassurance and rejecting them, which in turn will "confirm" the affected person's belief that he or she is unworthy as a person.



A depressed individual can impact their social settings by exhibiting a lack of self-esteem, becoming more sensitive to the opinions of others, and more importantly (and interestly), become less physically active. This means that they will not want to go out, that they do not want to exert themselves. A prime example of this would be an athletic in school that becomes depressed. He does not want to participate in athletic activities because he is depressed, but his coach forces him to. As a result, he performs poorly, and his teammates heckle him for his poor performance. As an affected person, the athletic becomes overly sensitive to his teammates' heckling and his self-esteem plummets and he drops out of sports and begins to withdraw and fight with everybody he knows.



The social class can also have a subtle effect on depression. Brown and Harris (1978) reported that the females with children in the working class were more prone to depression than females with children in the middle class. This can be attributed to the working class mother having to leave home to work, having to leave her child alone. This interpersonal relation can cause excessive worry and guilt that the women is not being a good mother as compared to the middle class mom, who can afford to stay at home and take care of the children/her family.



Okazaki (1997) found that Asian Americans are more depressed in a social and academic setting because they have to face more pressure than their white American peers due to the fact that they are part of a visible minority that has different culture values than others. This interpersonal relationship between the two "cultures" can be defined as competitive and stressful due to the fact that in America, white people "have it made" while as other ethnic groups have to work twice as hard to get their foot in the door. This extreme indicator of stress can lead to the dejection of many ethnic groups because they might have failed at succeeding in a competitive environment.



Gender


There are a lot of interpersonal relations when it comes to gender, such as the discrimination against gender in an academic setting. This is very prominent in females, where girls can face increased expectations to conform to the standards set forth by society, to pursue feminine type activities and occupations. It appears that parents tend to have "lower expectations" for girls when it comes to school. As a result of that lowered expectations, parents tend to not push their daughters toward a high-profile job, instead attempting to make their daughter conform to the stereotype of society, like become a teacher or a nurse. In fact, in 1986-1987, women only garnered 15% of the bachelor's degrees awarded in engineering as compared to 76% and 84% for education and nursing, respectively.



Breaking the social norm can also lead to depression; the more intelligent a girl is, the more likely she is to become depressed. This positive correlation could be attributed to the more intelligent girls being able to out-perform the boys yet get punished for doing so. Being depressed as a female adolescent can have consequences in the long run in terms of social functioning, career, and enjoyment of life. Theoretically, if one were to be depressed in high school, then their grades would suffer. If their grades were to suffer, then their chances of entering a good college would dwindle. If they cannot enter a top-notch college, then they might not be able to get the career they want, and with that they would not be able to enjoy their job and feel like they have missed out on life.



The different experiences of each gender can also be the cause of a mood disorder. The experience can vary by the age of the children, adolescences, or adults. For example, after the age of 15, females are twice as likely to become depressed as compared with men and in another study of 11-year olds, only 2.5% males met the criteria for major depression while only 0.5% females met the criteria, however in a study of 14-16 year olds, 13% of the females met the criteria while 3% of the boys did. This abrupt rise of depressive disorders in females during the mid-to-late adolescence years can be attributed to the more concerns a girl has as compared to boys. These concerns and worries can range from their achievements or lack of, body dissatisfaction, sexual abuse, and low self-esteem.



This is reinforced when another study found that between the ages of 15-18, the prevalence of depression in girls will increase to twice the prevalence of boys (20.69 to 9.58) but will taper off during 18-21 years of age for both genders (15.05 and 6.58).



Do not be mistaken that females are the only gender that that can become depressed; a good number of males can develop a unipolar mood disorder. In the average lifetime, 49% of all males will experience a depressive episode (as compared with 63% of all females). Males will become sad and dejected for different reasons, such as intimate relationships. When an intimate relationship ends, males are more likely to become depressed at the loss than females. This could be attributed to the male's primal desire to have a mate so he will be able to continue his family name.



Depression has been around for a long time, spanning over thousands of years, dating back to the time of Saul I, yet even though Depression is a disorder that is hard to understand. Even with all the studies conducted, there is still not much to regarding the causes of depression. There are so many ways one would be able to become depressed, but the most common and most prevalent way thus far would be the interpersonal relationships of a person and their family, social lives, and the relationship between their gender and the discrimination they suffer at the hands of others. Perhaps a better understanding of those relationships can open up new avenues where new options for treatment can be conceived and new ways of interacting to people to create a equality amongst people where they will not feel depressed.



 
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