Sociological And Biological Approaches

Introduction

The world is burdened with diseases which affect different communities in all parts of the world. Over 350 million people face depression today. In a World Mental Health Survey which was conducted in 2012 across 17 nations, it was discovered that one in every 20 people was reported to have had one depressive episode over the previous year (Marcus, et al., 2012). Often beginning at a young age, depressive disorders are recurrent, and they lead to the reduction of people’s functioning. The nature of this disorder is the reason why it is categorized as a global leader in the cause of disability. Governments and other related institutions worldwide progressively demand means of curbing depression as well as other existing mental health disorders which are on the rise. One of the institutions that are set up to focus on the dynamics of depression refers to the disorder as “a global public health concern” (Marcus, et al., 2012). This paper aims at comparing and contrasting two theoretical positions which define the sociological and biological approaches of working with a service user who has been given a diagnosis of depression. The comparison and contrast of these theoretical positions will be useful in pointing out ways of intervening on the service user’s life.

Depression

Depression is a mood disorder. Typically, people experience moods which change from time to time. Some people experience heightened feelings of joy or sadness which are understood as reactions to events of a day which are less likely to have a high impact on their lives. Moods tend to have a direct impact on the normal functioning of people throughout their interactions. This impact is the reason why people with mood disorders experience adverse changes in life. Depression is a mood disorder where an individual is in a sad and low state that portrays their lives as dark and overwhelming. According to the World Health Organization, depression is a mental disorder which commonly presents people with the feelings of low self-worth, loss of pleasure or interest, disturbed appetite or sleep, poor concentration, decreased energy and a depressed mood (Marcus, et al., 2012). Usually, depression is accompanied with symptoms of anxiety, and along with other long-lasting changes in mood, it becomes recurrent or chronic to the extreme that it results in substantial impairment in one’s ability to engage in daily activities. In worse incidences, depressive disorders result in suicide. On average, 1 million suicide deaths are caused yearly routing from depression. And, for every individual who successfully attempts suicide, another 20, and an even larger number people try to end their lives (Marcus, et al., 2012).

Depression is contrasted with mania, which is the kind of mood disorder where an individual is euphoric or has frenzied energy where they exaggerate the belief that they own the world (Comer, 2001, p. 223). There is a pattern of depression where an individual does not experience mania and regain normal mood at the end of their depressive episodes. This kind is known as unipolar depression. Also, there is another pattern of depression where the episodes alternate with mania which is known as bipolar disorder. The whole world is concerned about depression mainly because it is seen among numerous famous people. Depression is spoken of in the Bible among people like Moses and Saul. Abraham Lincoln appeared to have experienced depression too. Comedians with the likes of Jim Carrey and even artists such as Eminem have been plagued by the disorder. The effects of depression are shared among millions, and billions of currency have been spent on its study and treatment (Comer, 2001, p. 223).

Sociological Approach

Problems with the community as well as communication are recognized as part of the causes of depression. These causes contribute to the essence of the sociological approach towards depression. These social causes are tied with deprivation and isolation among people due to divorce, unemployment and other unfortunate events in life (Kangas, 2001, p. 87). Depression causes isolation and loneliness. The sociological theories approach depression by placing an individual in the broader social view and claim that societal patterns result in the occurrence of the disorder among people. Loneliness comes around when an individual lacks a sense of belonging, and by leading to adverse outcomes in people, the modern world has changed how it perceives this individual state (Kangas, 2001, p. 87). With findings the finding that outside stressors trigger depressive disorders, sociocultural theorists hold that the social context surrounding people has a strong influence on unipolar depression. As a result, two sociocultural perspectives are made with regard to the disorder. They are the family-social perspective and the multicultural perspective. The Family-Social Perspective This perspective eyes on how interpersonal factors role-play in the growth of depression in a person. The family-social perspective recognizes that there is a significant relationship between the decrease of social rewards and the culmination of depression. People with depression have poor communication skills and reflect weak social skills. In comparison with the non-depressed individuals, the depressed tend to speak in a slow, quiet and monotonous tone. They repetitively seek reassurance from those around them. These social deficits cause adjacent people to be uncomfortable and avoid being around depressed persons. Ultimately, depressed

persons decrease what they expect from social rewards and contracts, and they eventually have deteriorated social skills due to the reduced social interaction they have. Diminished expectations from social relationships result in the scaling down of social ambitions. Also, the absence of social support, especially in troubled relationships like marriages, increases depression (Comer, 2001, p. 247). The Multicultural Perspective In this perspective, two types of relationships are considered. One of them is the relationship between depression and gender and the other being the link between depression and the ethnic and cultural background. Concerning depression and gender, it is deduced that women are twice more likely to have depression than men. One of the theories which explain the difference of depression between men and women is the artifact theory. The artifact theory claims that men and women have are equally vulnerable to depression clinicians do not often detect the disorder in men. This is illustrated by men hiding their depression through masculine ways like anger and women exhibiting them emotionally through sadness or crying. Also, some men find it socially unacceptable to display emotional symptoms (Comer, 2001, p. 242). According to the life stress theory, stress is more common in women than men because they are more likely to face poverty, have menial jobs and less adequate housing. The lack-of-control theory relies on the research of learned hopelessness where women are more likely to become depressed due to feeling less in control of their lives than men. In addition, the body dissatisfaction theory explains that Western societies have taught women since birth to aim at having slender bodies and low body weight. These physical goals are unhealthy, commonly unattainable and unreasonable (Comer, 2001, p. 242).

Biological Approach

The history of medical research has unveiled that there exist drugs and diseases which affect one’s mood changes. Different biological processes affect the progress of depression. The biological processes entail mechanisms which are interrelated in terms of brain function and structure, genetic vulnerabilities immune system processes, neuroendocrine and neurotransmitter processes (National Research Council and Institute of Medicine, 2009, p. 73). Despite the multivariate nature of depression, there lacks sufficient evidence from research that can point out a specific set of biological functions which can be regarded as the causal factors of depression.

Several twin studies reveal that nearly one-third of adults are prevalent to major depression due to genetic differences between people. Family degree studies also show that predisposition to the unipolar depression is inherited by a proband’s relatives (Comer, 2001, p. 230). The proband’s relatives are at a higher risk of acquiring unipolar depression (National Research Council and Institute of Medicine, 2009, p. 79). Adoption studies illustrate how the genetic factor impacts unipolar depression. For families who have adopted a child, one research shows that the biological parents of an adoptee are more likely to have extreme depression (Comer, 2001, p. 231).

In addition, genetic polymorphisms are associated with the high incidence of depression during a period of stress (National Research Council and Institute of Medicine, 2009, p. 79). Depression is tied to genes on specific chromosomes. For instance, abnormalities in the 5-HTT gene, found in chromosome 17, is the common cause of depression among people. The 5-HTT gene is a neurotransmitter serotonin which affects a variety of psychological activities like sleep, emotions, appetite, sexual behaviour, sensorimotor activity and pain sensitivity (National Research Council and Institute of Medicine, 2009, p. 80). Abnormalities in the serotonin transmitter cause people to exhibit low serotonin-related activities in their brain, and this leaves them prone to depression (Comer, 2001, p. 231).

Researchers have found a strong link between coronary heart disease and depression. This has guided them to focus on the role played by the human immune system, and precisely pro-inflammatory cytokines, in the relationship between depression and stress. Chronic stress causes inflammation in the immune system which brings about depression symptoms like the underlying pathological processes of heart disease (National Research Council and Institute of Medicine, 2009, p. 83). Inflammation due to intense stress originates from the decreased functioning of the lymphocytes and increased making of the C-reactive protein (CRP) which spreads throughout the body. Dysregulation of the immune system in this manner contributes to the growth of depression.

Relative Efficacy of Treatment Approaches

The sociocultural theoretical influences provide guidance on treatment approaches towards service users with depression. One of the treatment approaches in the sociocultural theories is the multicultural treatment. This involves the use of therapies which are culture-sensitive in treating depression. This will require that therapists acquire exclusive cultural training so as to increase their awareness of the cultural values as well as the stressors originating from the culture of the service user. To add, the cultural therapist will have full knowledge of the stereotypes and prejudices faced by people of a particular culture, and this shall be relevant in helping the service user achieve comfort through bicultural balance and recognition of the impact of their culture in comparison with the dominant culture on personal points of view.
Therapists can also use social and family approaches in treating depression. This is done by helping the service user correct their close relationships in life. The family social treatments include the couple therapy and interpersonal psychotherapy. The couple therapy is applicable to service users who are in dysfunctional relationships. Therapists can help couples alter their bad marital behaviour, and after all, both parties end up satisfied in their marriage. The interpersonal psychotherapy helps solve four interpersonal challenges faced by a service user. They include interpersonal deficits, interpersonal role transition, interpersonal role dispute and interpersonal loss. This psychotherapy is useful in aid in alleviating extreme shyness, giving social skills and support, resolving role disputes and develop ways of seeking new relationships (Comer, 2001, p. 265).

The biological theoretical influences regard depression as an illness, just as any other physical illness. Generally, it perceives mental illness as a medical phenomenon where biomedical interventions are engaged as methods of treatment. This perspective promotes the use of drug treatments for depression. Antidepressants are prescribed to correct the service user’s brain chemicals. Usually, the antidepressants are useful within the first two weeks of subscription. Total benefits can be seen after an average of three months. Where the patients feel that their condition is not improving, the psychiatrists may choose to substitute, add, or change to another antidepressant (Parekh, 2017). For services users with bipolar disorder or intense depression electroconvulsive therapy (ECT) is a treatment option which can be used when other treatments fail to provide effective outcomes. The ECT is given to the service user at least twice a week for a maximum of twelve treatments. However, ECT has been overtaken by the effectiveness of antidepressant drugs in treating depression (Comer, 2001, p. 269).

Bibliography

Comer, R. J., 2001. Abnormal Psychology. New York: Worth Publishers.
Kangas, I., 2001. Making Sense of Depression: Perceptions of Melancholia in Lay Narratives. Health, 5(1), pp. 76-92.
Marcus, M. et al., 2012. Depression: A Global Public Health Concern. [Online] Available at: [Accessed 15 December 2018].
National Research Council and Institute od Medicine, 2009. Depression In Parents, Parenting, and Children. s.l.:National Academies Press (US).
Parekh, R., 2017. What Is Depression?. [Online] Available at: [Accessed 15 December 2018].