There are many theories of depression which have different implications for the therapy that is used. All of these theories describe one or several aspects of depression and can be helpful in treatment. Social environment plays a role in depression both directly and indirectly. Theories involving social and psychological aspects fall into the biopsychosocial model where treatment focuses on talk-therapy rather than biological theories stemmed from the biomedical model (Schneider, Gruman, & Coutts, 2005) that only warrant medication. I will use my friend, who- for the purpose of this entry- I will call Jenny, in order to demonstrate theories of depression and how each of those theories can be used in treatment. Because depression is multifaceted and a result of interrelated determinants, better treatment is warranted through a combination of theories encompassing and addressing the various underlying factors of depression.
In high school Jenny had many friends and was well-known throughout school. She was the star and captain of two sports teams and Treasurer of Student Council. She enjoyed being greeted while walking through the hallway. Jenny was very excited to go to college and have a new group of people to get to know and interact with. Her smooth transition did not last long; now no one knew her and she was at the bottom of the social hierarchy. Her ideal situation and what she had imagined was that everyone automatically loved and thought highly of her since that is what she was accustomed to. She could not accept or even understand her new social position and became frustrated and angry. Towards the end of her first semester of college she had become depressed. Based on this description one can apply Rank Theory of Depression to determine why Jenny became depressed. Stevens and Price (2000) proposed that when organisms are demoted to a lower social rank, they will become depressed in order to accept this fact and reduce their desire to get back on top. Moreover, depression is an evolutionary function and adapted reaction to holding a subordinate position. Its benefit in a prior context was to avoid conflict between the new and old leader (Stevens & Price, 2000). Treatment for Jenny based on Rank Theory may focus on Rational Emotive Behavior Therapy. Through therapy she would understand that her expectation of automatically being a leader is irrational (REBT Network, 2006). Her negative emotions about the event would change because she would accept the natural order of beginning something new at the bottom.
Jenny grew up in a strictly Catholic household in an affluent community that prided itself on being perfect. The community had an open communication system and people shared all the information available about themselves and others (unsurprisingly good things about themselves and bad about others). Her mother presented nothing but a perfect family, despite her overbearing and abusive husband. Following her mother's actions, Jenny displayed only positive emotions to her parents. Her father was domineering and mother was overly protective of her children as a result. The Psychodynamic Theory of Depression, presented by Freud, states that depression is a result of anger from imbalanced cognitions and behavior in childhood. Having inconsistent parents (abusive, dominant father versus extremely loving mother in Jenny's case) causes confusion in the child and the resulting anger toward the parents is repressed and directed inward because of knowledge that parents are essential to survival. The child wants to please the parents, but is unable to do so (Nemade, Reiss, & Dombeck, n.d.a). These children strive for perfection and seek love from others around them. True to Freud's theories this occurs unconsciously. Treatment based on Psychodynamic Theory would focus on decreasing the patient's self-punishment because of simultaneous feelings of inadequacy and effort for perfection (Nemade et al., n.d.a). Jenny would consciously become to understand that her parent's contradictory outward perfection and internal struggle caused her to feel subpar. Through therapy, she would come to realize that her parent's relationship with each other as well as the community was not healthy. Perfection is not something that can be reached, so when it doesn't happen she should not be disappointed, only continue to work towards. She should learn how to set small goals to achieve and after each one allow herself to feel accomplished.
Jenny joined many clubs and organizations to meet people and signed up for difficult classes in order to satisfy her parents. She figured that the more she took on the more chances she would have to succeed. Since she was so busy she had no time to relax. In addition to the stressful time of beginning college, Jenny had come to the realization that she was gay. She had refused to previously consider it because of her upbringing, but with a new environment emerged new beliefs and general way of thinking. She saw that this could be a lifestyle and not an internal suppression. Conflicting beliefs caused her psychological distress and confusion and increased the stress she was under. The Stress-Vulnerability Model presents genetic and family history, psychological vulnerability, life events and stresses, and biological factors as causes of depression (Centre for Addiction and Mental Health, 2009). This theory follows a sequential order; a person has a predisposition of vulnerability from genetics and stressful events cause the depression to come about. People who encounter depression have a low tolerance for stress (Vancouver Costal Health, n.d.). Treatment for Jenny based on this model would focus on managing stress. Identifying stressors, self-monitoring, awareness of stress precursors, positive thinking, and relaxation training are effective methods of stress management (Taylor, 2012). Social support is also important in managing stress (Schneider et al., 2005).
Jenny began thinking that she would never be able to please her parents and that she would be stuck in her social position for the rest of her college career. She felt that no matter how much effort she put into her activities she would never succeed. She knew that her parents would not accept her homosexuality, and felt that her future would comprise of either defying her parents or being untrue to herself. Beck's Cognitive Theory of Depression says that the main factor of depression is negative thoughts (Nemade, Reiss, & Dombeck, n.d.b). According to this theory, the concurrence of three thoughts results in depression: feeling inadequate, belief that all efforts result in failure, and thinking that the future is hopeless. In therapy Jenny would adopt an enhancing attributional style to feel hopeful about the future (Schneider et al., 2005). She would be taught how see failure as challenges that are possible to overcome and that she has control over her life's course.
One can see that there were a lot of factors that may have contributed to Jenny's depression and subsequently could be used in treatment. In particular, social environment plays a large role in many of the theories of depression. Continuous flawed or negative perceptions and interpretations of social surroundings can be detrimental to emotional state. In addition to social aspects, psychological and biological factors expand upon our knowledge of depression. Individual theories should be combined to obtain a comprehensive understanding of depression; much like the combination of different schools of psychology provide a holistic view of the mind.
Centre for Addiction and Mental Health. (2009). The causes of depression- Current theories.
Retrieved from http://www.camh.net/About_Addiction_Mental_Health/
Nemade, R., Reiss, N. S., & Dombeck, M. (n.d.a). Psychology of Depression-
Psychodynamic Theories. Retrieved from http://info.epmhmr.org/
Nemade, R., Reiss, N. S., & Dombeck, M. (n.d.b). Cognitive Theories of Major Depression-
Aaron Beck. Retrieved from http://info.epmhmr.org/poc/view_doc.php?
REBT Network. (2006). What is REBT? Retrieved from http://www.rebtnetwork.org/
Schneider, F. W., Gruman, J. A., & Coutts, L. M. (Eds.) (2005). Applied Social Psychology:
Understanding and Addressing Social and Practical Problems. Thousand Oaks, CA:
Stevens A., & Price J. (2000). Evolutionary Psychiatry: A New Beginning. London:
Taylor, S. E. (2012). Health Psychology (8th ed.). New York, NY: McGraw-Hill.
Vancouver Costal Health. (n.d.). Stress-Vulnerability Model of Psychosis. Retrieved from