Is it Biological or Cognitive-Behavioral

The issue at hand is whether biological factors or cognitive-behavioral elements are underlying causes of

major depressive disorders (MDD) witnessed today in mental health clinics across the world.
The position and perspective of this author is that the chief cause of MDD seen in clinical practice today is cognitive-behavioral.

Childhood trauma, chronic stress, and anxiety all alter chemical pathways in the human brain which leads to a decrease in key neurotransmitter levels. This in turn correlates to a major depressive episode in later life. These facts are irrefutable and independent of any hypothesized “genetic” predisposition or hereditary component.

Supporting Argument 1:
            In the research performed by Murrough, et al, and published in the 2011 September issue of the Journal of American Medical Association, (JAMA Psychiatry), there is empirical evidence to support the idea that an incidence of trauma at an early age produces neurobiological and behavioral alterations in the human body suggesting a developmental component in the cause of Post-Traumatic Stress Disorder (PTSD) with a high comorbity with MDD (Murrough, et al, 2011).
Supporting Argument 2:
            In another study by Dr. J. Hovens in 2012 and published in the Acta Psychiatrica Scandinavica, a longitudinal study of childhood trauma victims over a two year period resulted in high incidences of MDD with individuals who experienced “emotional neglect” and “psychological abuse” (Hovens, et al., 2012).

Supporting Argument 3:
            In a study by C. Cutrona in 2006, the effects of a contextual involvement for depression becomes clear. Within her research, Cutrona takes into account that a prolonged exposure to stress and anxiety within this context can also produce an “environment” (such as a neighborhood and threats of victimization) that leads to depression (Cutrona, 2006).
Supporting argument 4:
            In his article for the Psychological Bulletin in 2008, Edward Watkins gives the psychological community a link between the outcomes on depression and repetitive thought, or RT. This has to deal with self-esteem and whether or not our repetitive thoughts are “constructive” or “destructive” (Watkins, 2008). Destructive RT can have negative consequences and prolonged exposure can lead to MDD if not held in check.

John

References:
Cutrona, C. E., Wallace, G., & Wesner, K. A. (2006). Neighborhood characteristics

and depression: An examination of stress processes. Current Directions in Psychological Science, 15(4), 188–192.

Hovens, J., Giltay, E., Wiersma, J., Spinhoven, P., Penninx, J., & Zitman, F. (2012).

Impact of childhood life events and trauma on the course of depressive and anxiety disorders. Acta Psychiatrica Scandinavica. 126, 198-207

Murrough, J. Czermak, C., Henry, S., Nabulsi, N., Gallezot, J., et al. (2011) The

Effect of Early Trauma Exposure on Serotonin Type 1B Receptor Expression Revealed by Reduced Selective Radioligand Binding. JAMA Psychiatry, 68, (9), 892-900. Retrieved from Capella University Library, EBSCOhost http://web.b.ebscohost.com.library.capella.edu/ehost/command/detail?sid=9fc5a9ad-f6f5-48d1-8f8e-0a82655e27bd%40sessionmgr113&vid=23&hid=119

Watkins, E., (2008), Constructive and Unconstructive Repetitive Thought,

Psychological Bulletin, (134), (2), 163–206. Retrieved from Capella Library, EBSCOhost, http://web.a.ebscohost.com.library.capella.edu/ehost/pdfviewer/pdfviewer?sid=a0a19980-b2af-48d8-b2ca-d48eab7dfa2c%40sessionmgr4001&vid=7&hid=4201

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Links to Substance Abuse Through Anxiety and Depression

Anxiety, Depression, and Substance Abuse

Unless one is a practicing clinician, depression and substance abuse are not typically thought of as occurring together. Maybe this is because they are two separate diagnoses and people view them that way in the realm of disorders as well. On the other hand, many experts believe that depression can lead to substance abuse and vice-versa. This article will look at major depression, anxiety, and substance abuse, then contrast and compare similarities, as well as differences. Then it will look at how each of these disorders is linked to the other.

Read more about Anxiety, Depression, and Substance Abuse at http://myaddictedmind.com/anxietydepressionsubabuse.html

A Lesson On Ethics in Psychotherapy

The case history of the 17 year-old adolescent male involves delinquency and an apparent indifference (or

inability) by the parents to maintain any sort of stability in the household. The father is a prominent leader in the community with a wandering eye for the females. His accounts of public infidelity have driven a wedge between him and his wife over the years and he has distanced himself from his son as well. The mother did not want the divorce because of her religious upbringing, but could not take the public embarrassment and shame. She thus became more distant, despondent, and turned to alcohol to ease the pain. 

The child has been in and out of trouble since the age of 14 when he and some friends stole a car and crashed after a high-speed chase with law enforcement. The child has since had issues with substance abuse and larceny to support his heroin addiction.  The child is now in therapy as a result of the court’s pressure on the father and threat of admittance to a children’s psychiatric hospital.

At odds with the custodial parent’s wishes for the noncustodial parent not to be involved in the child’s therapy, the psychotherapist takes the position of “do no harm” to the client. (APA, 2010).  The therapist then speaks with the child to better understand his wishes concerning his mother’s involvement. The child is emotionally indifferent and could “care less” either way. However, the therapist believes that having both parents involved would promote beneficence for the child client. The therapist now needs to get answers to his questions from other colleagues.

Read more at My Addicted mind.Com

What is the "Addiction Severity Index"?

The Addiction Severity Index, or ASI, is an interview that appraises history, frequency, and outcomes of

alcohol and drug use, as well as five additional domains that are commonly linked to drug use: medical, legal, employment, social/family, and psychological functioning. The higher the score on the ASI indicates a greater need for treatment in each of these particular areas. The ASI scores can be used to profile patients’ problem areas and then plan effective treatment.

According to Alcohol Rehab.Com, "The ASI focuses on the big picture. It takes into consideration that addiction to drugs or alcohol can result from life events that precede, occur at the same time as, or result from substance abuse problems. Rather than focusing on the client’s substance abuse, the ASI highlights seven potential problem areas" (alcoholrehab.com, n.d.).

Overall, studies typically conclude that the Addiction Severity Index is a consistent and accurate tool for assessing clients and their substance abuse issues. The ASI is able to successfully identify the client’s problem area in which they are experiencing the greatest difficulties, such as alcohol or drug addiction, or legal or familial problems. Once a client’s psycho-social issues are identified, an appropriate course of treatment may be administered.

Read more about Addiction Severity Index at My Addicted Mind.Com

Source:
Alcohol Rehab.Com website: Addiction Severity Index (ASI). Retrieved July 6, 2014 online from http://alcoholrehab.com/addiction-articles/addiction-severity-index-asi/

The Addicted Mind

Addiction can take many forms such as sex, gambling, drugs, alcohol, maybe even Internet Porn sites. Whatever it is, the social stigma related to this addiction can be as problematic as the addiction itself. This paper was created in an effort to provide the layperson a better understanding of addiction. In this paper we will discuss the definition of addiction according to medical experts, causes of addiction, social ramifications, and interventions.



Read more about addiction at My Addicted Mind.Com

A Day in the Life Of....

“Be bold—read much—write much—publish little—keep aloof from the little wits—and fear nothing.”(Edgar Allan Poe, 1843). AND… FEAR… NOTHING! These were the words I came away with when I spent the day with poet and published writer, Edgar Allan Poe. Just the sound of his name stirs dark, soulful metaphors like the doomed, fringe caucuses idolizing tormented surrealism. To say I was very much addicted to this reality is by its very definition an understatement!

During my time with Mr. Poe, he proposed to me the intimate nature of writing and that there is actually a “philosophy of composition”. The well-crafted lyrics, similes, alliterations, and allusions known mechanically by educators are just the tip of the proverbial ice-berg because it is how these “words” and ideas are artfully constructed and shared with the reader to create the reality that writers wish to conveye. Mr. Poe is, by all means, the master lyricist and master story teller. When he narrates, I believe, we all share his vision. “How it hangs upon the trees. A mystery of mysteries. Be silent in that solitude, Which is not loneliness- for then the spirits of the dead, who stood In life before thee, are again in death around thee”(Poe, 1809).

In summary, Mr. Edgar Allan Poe has shared his vision of writing and the grasp of emotional realism with his trainee. Through artful manipulation of words and ideas, the writer (or story teller) can impart a type of catharsis and identification with the players in the tragedy, thereby sharing their story (and emotions) with the reader/listener. The “philosophy of composition” garners favor of the participants as they relate to the plight of the under-appreciated, persecuted, downtrodden, etc…. Mr. Poe would describe it as such, “Be silent in that solitude, Which is not loneliness- for then the spirits of the dead, who stood In life before thee, are again in death around thee”(Poe, 1809)

Obsession Versus Addiction

According to Christine Hammonds,  MS, LMHC,  obsession is "ritualistic" thinking or behavior and addiction has to do with feeling "satisfied". For example, "When you obsess, ritualistic routines are part of your everyday life.  Perhaps you comb your hair the same way you did as a teenager, you recheck all of the doors at night even though you have been told it is already locked, you replay the same conversation over and over again just trying to figure it out".... However, in an addiction, we are seeking an escape. "...you never feel satisfied unless using the substance.  Perhaps you drink alcohol to relax, take prescription drugs to numb the pain, shop for clothing to feel better about how you look, gamble to earn quick easy money, exercise to get the adrenaline high, look at porn to feel desirable, smoke to unwind, watch soap operas to feel romantic, play video games to feel successful or eat sugar to get energy.  All of these behaviors have roots in escaping from an undesirable place to a desirable place and in fantasy living" (Hammonds, C., 2013). This may be all well and dandy,but the major difference is that some experts believe that an obsession can be managed and transformed into  success!  Dr. Alex  Lickerman  sees  obsession as not being as destructive as addiction and can be used to our advantage. "The challenge then is to make our obsessions function positively, controlling them so they don't control us, extracting the benefit of obsession without succumbing to its detriments" (Lickerman, A., 2010). Dr. Lickerman goes on to list several ways to manage an obsession such as: Distract yourself at varying intervals Accomplish a task that helps put your obsession behind you Focus on your greater mission Adopt a practice that grounds you Listen to what others tell you In his article in Psychology Today, Obsession: How to make an obsession function properly, Dr. Lickerman states, "I'm not arguing here that we should seek to extinguish obsession; I'm arguing we should seek to control it. Our ability to bend our emotions to our will is poor, but not our ability to manage them" (Lickerman, A., 2010). References: Hammonds, C., The Difference Between an Obsession and an Addiction. Retrieved May 1, 2014 online from http://christinehammondcounseling.com/2013/03/07/the-difference-between-an-obsession-and-an-addiction/ Lickerman, A., Obsession: How to make an obsession function positively, Psychology Today. Retrieved May 1, 2014 online from http://www.psychologytoday.com/collections/201205/obsessed-or-addicted/obsess-success Read more about addiction at My Addicted Mind.Com

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