Describe the treatment and management of depression.

Mark scheme

Marking points from the official mark scheme (Oct/Nov 2019). The mark or mark type is shown in brackets.

1. Treatment and management of depression, including the following:
2. • Biological: chemical/drugs (MAO, SSRIs)
3. • Electro-convulsive therapy
4. • Cognitive restructuring (Beck, 1979)
5. • Rational emotive behaviour therapy (Ellis, 1962)
6. Biological: chemical/drugs (MAOI, SSRIs)
7. MAOI – older antidepressants not frequently used today. Inhibit monoamine oxidase. This is responsible for breaking down norepinephrine, serotonin and dopamine.
8. The other more common medication prescribed is selective serotonin reuptake inhibitors (SSRIs).
9. These can help improve depression by increasing the levels of serotonin in the brain.
10. This can occur in two ways as the SSRI will increase the amount of serotonin in the blood stream as well as prevent it being reabsorbed and broken down once it crosses a synapse in the brain.
11. Electro-convulsive therapy
12. Involves passing electricity through the brain to induce a seizure.
13. Can be bilateral or unilateral.
14. The electric current is applied once the patient has been sedated.
15. The seizure is monitored by the doctor and can last up to a minute.
16. Patients may be given 6 to 12 sessions over a number of weeks.
17. Cognitive restructuring (Beck, 1979)
18. This is where the patient participates in a number of therapy sessions over weeks and/or months to alleviate their symptoms of depression.
19. As it is believed the depressive symptoms are due to faulty thinking the therapist will help the patient to identify their faulty thinking and then correct these thinking patterns to more helpful ways of viewing themselves, the world and the future.
20. Initially the patient and therapist will identify what the thinking patterns are, and the patient will be helped to come up with alternative thoughts.
21. The patient then goes away between sessions and practices these alternative thoughts which should then lead to more helpful behaviours.
22. Rational emotive behaviour therapy (Ellis, 1962)
23. This follows the ABC model:
24. Activating agent – what is the behaviour and/or attitude of the patient towards events in their lives.
25. Beliefs - what is the belief of the patient toward the event.
26. Cognitive - what types of thoughts does the patient have with regard to the event.
27. Ellis believes if a person has constant negative beliefs about events in their lives, they are likely to suffer from depression.
28. The goal of therapy is to identify the unhelpful thoughts and replace them with more rational and constructive thoughts.
29. The patient will go away between sessions and practice developing more helpful thoughts about life experiences.
30. Mark according to the levels of response descriptors in Table A.
31. Other appropriate responses should also be credited.
32. A range of issues could be used for evaluation here. These include:
33. • Named issue - Ethics - Candidates can consider both the ethics of the treatments (e.g. side effects, cost, etc.) or the ethics of the research that investigates the treatment and management of depression.
34. For example, both the drug and ECT treatment have side effects that will be unpleasant for the patient whereas the therapies have no side effects but may be too costly for a patient to afford and therefore they are prevented from feeling better which is unethical.
35. Or the ethics of research where the participants experience side effects or not and/or whether there is a placebo group who is not being given the treatment and therefore may not improve in terms of their depression and this is unethical.
36. Many studies offer the placebo/control condition the opportunity to have the treatment at a later date which is more ethical.
37. • Validity.
38. • Application of psychology to everyday life (with reference to treatments).
39. • Nature versus nurture debate with reference to the various treatments.
40. • Comparisons of different treatments.
41. • Reductionist/holistic nature of the treatments.
42. • Deterministic nature of the treatments.
43. • Appropriateness of treatments (e.g. cost, time, side-effects).
44. • Research support for effectiveness of treatments.
45. • Evaluation of research that shows support for effectiveness of treatments.
46. Mark according to the levels of response descriptors in Table B.
47. Other appropriate responses should also be credited.