Abnormal Psychology

Mood Disorders and Suicide 215

FEEDBACK LOOPS IN TREATMENT: Depressive Disorders

The goals of any treatment for depressive disorders are ultimately the same:

• to reduce symptoms of distress and depressed mood and negative or unrealistic

thoughts about the self (psychological factors),

• to reduce problems related to social interactions—such as social withdrawal—and

to make social interactions more satisfying and less stressful (social factors), and

• to correct imbalances in the brain associated with some of the symptoms, such as by

normalizing neurotransmitter functioning or hormone levels (neurological factors).

Treatments that target one type of factor also affect other factors. CBT, for

instance, not only can lessen psychological symptoms, but can also change brain

activity (Goldapple et al., 2004), improve physical symptoms (including disrupted

sleep, appetite, and psychomotor symptoms), and improve social relations. More-

over, as we saw in Chapter 5, medication for depression works not just through its

effects on neurological functioning, but also through the placebo effect. Thus, a de-

pressed patient’s beliefs (psychological factor) can account for much of the effect of

antidepressant medication. Figure 6.3 illustrates the various treatments discussed;

the targets of treatments for depressive disorders, and the feedback loops that arise

with successful treatment.

Note that Figure 6.3 lists the various types of treatment for depressive disorders,

sorted into the three types of factors; in two cases—medication and CBT—we go one

step further and list specifi c types of drugs and specifi c CBT methods. Why are we

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Figure 6.3

6.3 • Feedback Loops in Treating Depressive Disorders

Treatments Targeting

Neurological Factors

Treatments Targeting

Targeting Psychological Factors

Treatments Targeting

Social Factors

Changes neural

activity

Changes thoughts,

feelings, and

behaviors

Changes social

interaction

Decreases family

conflict

Medication: SSRIs,

SNRIs, TCAs, MAOIs

ECT

TMS

IPT

Family systems

therapy

CBT: Behavioral

activation, cognitive

restructuring