What causes depression, and how can it be treated biologically and psychologically?
Depression: clinical characteristics, the biological explanation (genes and neurotransmitters such as serotonin) and the psychological explanation (cognitive, negative thinking), and treatments including antidepressants and cognitive behavioural therapy.
A focused answer to the OCR GCSE Psychology J203 psychological problems topic on depression, covering its clinical characteristics, the biological explanation (genes and serotonin) and the psychological (cognitive) explanation, and treatments including antidepressants and cognitive behavioural therapy.
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What this dot point is asking
OCR wants you to describe the clinical characteristics of depression, explain it from a biological view (genes and serotonin) and a psychological view (negative cognitive thinking), and evaluate treatments: antidepressants (biological) and cognitive behavioural therapy (psychological).
Clinical characteristics of depression
To be diagnosed, symptoms usually have to be present most of the day, nearly every day, for at least two weeks, and interfere with daily life (linking to "failure to function adequately" in defining mental health).
The biological explanation
The biological explanation says depression has physical causes in the body and brain.
- Genes. Depression can run in families, and twin studies suggest an inherited predisposition: if one identical twin has depression, the other is more likely to as well. The classic core study Caspi et al. (2003) found a gene (the 5-HTT serotonin transporter gene) interacts with life stress to raise the risk of depression.
- Neurotransmitters. Depression is linked to low levels or poor functioning of serotonin (and sometimes noradrenaline), chemical messengers that affect mood. An imbalance is thought to produce the low mood and other symptoms.
This explanation is the basis of drug treatment that raises serotonin.
The psychological (cognitive) explanation
The cognitive explanation says depression is caused and maintained by negative, irrational thinking. Depressed people tend to hold a negative view of themselves, the world and the future, and to interpret events in a biased, gloomy way (for example, blaming themselves for things outside their control, or expecting the worst). These negative automatic thoughts keep the depression going. This explanation is the basis of CBT, which works by changing the thinking.
Treatments for depression
Antidepressants (biological). Drugs such as SSRIs (selective serotonin reuptake inhibitors) increase the amount of serotonin available in the brain by slowing its reabsorption, which can lift mood. Strengths: effective for many patients, easy to take and act on the proposed biological cause. Weaknesses: they treat the symptoms not the cause, can have side effects, may take weeks to work, and symptoms can return when the drug stops.
Cognitive behavioural therapy (CBT) (psychological). A talking therapy in which a therapist helps the patient identify negative automatic thoughts, challenge them with evidence, and replace them with more balanced thoughts, often with behavioural tasks to test the new thinking. Strengths: tackles the cause (the thinking), no drug side effects, and gives lasting skills that reduce relapse. Weaknesses: needs effort, motivation and time, may not suit severe depression where the person cannot engage, and depends on a good therapist.
Evaluating the explanations and treatments
The biological explanation is scientific and supported by genetic and drug evidence (and by Caspi et al.), but it is reductionist (reducing depression to chemicals and genes) and the gene-only view ignores life events. The cognitive explanation explains the negative thinking seen in depression and leads to effective therapy, but it can seem to blame the person for their thoughts and may confuse cause and effect (negative thinking might be a symptom as well as a cause). The strongest position is that depression usually has multiple causes (a biological vulnerability plus stressful events and negative thinking), which is exactly what Caspi et al.'s gene-by-environment finding suggests, and why drugs and CBT are sometimes combined.
Try this
Q1. Name the neurotransmitter linked to depression. [1 mark]
- Cue. Serotonin (low levels or poor functioning).
Q2. What does CBT aim to change? [2 marks]
- Cue. Negative, irrational thoughts about the self, the world and the future, by identifying, challenging and replacing them.
Q3. Give one weakness of antidepressants. [2 marks]
- Cue. They treat symptoms not the cause, can have side effects, or symptoms return when the drug stops.
Exam-style practice questions
Practice questions written in the style of OCR exam questions on this dot point, with worked answer explainers. The year tag is the paper they imitate, not the source.
OCR 20194 marksDescribe the biological explanation of depression. (J203/01, Section C Psychological problems)Show worked answer →
A 4-mark Describe item rewards the genetic and neurotransmitter components.
The biological explanation says depression has physical causes. Genes: depression can run in families, and twin studies suggest people may inherit a predisposition to it. Neurotransmitters: depression is linked to low levels or poor functioning of the neurotransmitter serotonin (and sometimes noradrenaline), which affect mood. Because chemical messengers in the brain influence how we feel, an imbalance can produce the low mood, low energy and other symptoms of depression. This explanation is the basis of drug treatments that raise serotonin levels.
Markers reward the genetic component (inherited predisposition, twin studies) and the neurotransmitter component (low serotonin affecting mood), ideally linking to drug treatment.
OCR 20216 marksDiscuss the use of cognitive behavioural therapy (CBT) as a treatment for depression. (J203/01, Section C Psychological problems)Show worked answer →
A 6-mark Discuss item rewards a balanced argument with a judgement.
CBT is a psychological treatment based on the idea that depression is maintained by negative, irrational thinking. The therapist helps the patient identify negative automatic thoughts (about themselves, the world and the future), challenge them with evidence, and replace them with more balanced thoughts, often with behavioural tasks to test these out. Strengths: it tackles the cause (the thinking) rather than just symptoms, has no drug side effects, and can give lasting skills that reduce relapse. Weaknesses: it requires effort, motivation and time, may not suit severe depression where the person cannot engage, and relies on a good therapist. Compared with antidepressants, CBT acts more slowly but may have longer-lasting benefits; the two are sometimes combined.
A top answer explains how CBT works, gives developed strengths and weaknesses, compares it with drugs, and reaches a clear judgement (for example, that CBT is effective for mild to moderate depression and offers lasting benefits, but severe cases may need medication too).
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Sources & how we know this
- OCR GCSE (9-1) Psychology J203 specification — OCR (2017)