Download ESSAY PLAN N3

ESSAY PLAN:
Problem/Questio
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Position:
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The depressive disorder has become an extremely important issue within mental health area. According
to WHO (2016), this mental illness affects 350 million people and it is the leading cause of disability around
the world. Moreover, depressive disorder leads suicide with over 800 thousand people every year. In fact,
some researchers have catalogued it as a “contemporary epidemic” (Rose, XXXX). Different theories have
tried to explain the etiology of this disorder. In this context, traditionally medical models such as
biopsychosocial model seem to dominate this area over other critically approaches proportioned by Social
Sciences. In this sense, the purpose of this essay will be to discuss the status of the individual and social
factor on depressive disorder’ theories. It will be argued that although the traditional psychiatric theories
have achieved a certain understanding of the causes focused on the neuro-psychological level, the critical
approaches tend to understand the problem on the social level. Firstly, it will be defined the depressive
disorder and then it will give an overview about the main theories that have tried to understand this
disorder. Secondly, it will be discussed the main controversies between biopsychosocial model and social
perspectives. Finally, it will be shown the relevance of the social level based on the economic determinants
of health.
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There are different approaches to understanding the depressive disorder. The medical perspectives
conceptualise depression as a pathological alteration of mood, characterized by a decrease of mood that
ends in sadness, accompanied by various symptoms and signs persist for at least two weeks such as
changes in sleep, the interest in activities, feelings of guilt, loss of energy, difficulty concentrating, changes
in appetite, psychomotor processing (retardation or agitation), and suicidal ideation (APA, 2014). However,
from a critical Sociology, the depression symptoms are vague and could account only an "abnormal" mood
alteration (Ehrenberg, 1998).
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The biopsychosocial traditional model states that depression is the result of three different factors:
biological (genetic), psychological, and social. For this perspective the genetic components seem to play a
key role in the shaping of this mental illness. Moreover, some studies argue that 40% of the risk having
depression is associated with genetics (APA, 2014). In this sense, a genetic vulnerability could be activated
by stressful experiences in different moments of the life generating a depressive disorder (XXXX, 2008). On
the psychological level certain types of personality characterized by low self-defeating and self-esteem
could be related to this mental illness; and on the social level, classical stressful events are child abuse
events or poverty contexts. On the other hand, the critic perspective of social determinants has become
in an alternative for understanding the causes of depression. According to the WHO’s Commission on the
Social Determinants of Health (2014: XX) “the social determinants of health are the circumstances in which
people are born, grow up, live, work, and age, and the systems put in place to deal with illness. These
circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics”. Thus,
the social determinants are organised in five field: economic, demographic, social, environmental
structures, and environmental events. This domains represent five different fields of critical mental health
approaches and include non-traditional perspective as both Sociology and Anthropology of Health.
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There is undoubtedly some true in the fact that the biopsychosocial model contributions are diverse, the
most perhaps important being the far-reaching treatment based on three levels. This allows easily
recognise the different professionals and interventions involved in the treatment of depressive disorders:
psychiatric/neurologist, psychologist, and social workers, and so forth. In fact, significant evidence
regarding the various effective forms of treatment for depression is continually generated by the model.
Currently, in the biological level, the research have identified nine neuronal receptors associated to
depressive disorder (XXXX, XXXX). This evidence has allowed designing new drugs being Prozac (fluoxetine)
(Introduction =
219 words)
Definition
(331 words)
Section 1:
Counterargument
Depressive disorder: to what extent should both individual and social factors be considered?
one of the most common in the depression pharmacology treatment with more than 14 million of
prescription only in America (XXXX, XXXX). On another hand, both cognitive-behavioural and interpersonal
psychotherapies have become the most effective for this mood disorder. However, from critical
perspectives, the biopsychosocial model would reflect an emphasis on psycho-pharmacology treatments
for patients with depressive illnesses, reducing the problem to the individual level. Moreover, this trend
has even led to the use of electroconvulsive therapy. Despite this, the validation of electroconvulsive
therapy for patients with depression has been judged by mental health movements that consider an
unethical form of treatment. In this sense, the psychological level is being reduced to the cognitive process.
At the same time, a strong criticism has been supported by colonialist’s studies that argue the
biopsychosocial model tends to homogenise the human suffering and deny cultural differences (Mills,
2014; DelVecchio, 2008). In other words, the shaping of a human being based on the biological level
principally.
and rebuttal
(253 words)
Section 2:
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Another interesting aspect of the biopsychosocial model is the conceptualization of the social level. On the
basis of stressful events, the “social theory” of this model tends to reduce the social level to different
individual experiences. This has enabled easily detect social events that promote or affect different
disorders. In the depression cases, for instance, it has found a strong association between poverty and low
educational level with depression disorder (Patel et al., 2014). Nevertheless, it is possible argued that
clearly treating social level would tend to be reduced to extreme events in an individual area without
considering classical sociological levels that encompass from micro-social to macro-social dimensions. In
other words, the social level is reduced to the micro-social dimension, ignoring the range of process
involved in the social level. This constitutes a major problem for understanding depression because the
model does not recognise both the complexity of the social level and the different aspects involved in the
shaping of the depression disorder.
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The recognition of different dimensions of the social level has been a great methodological contributions
of Social Sciences in the last decades. The range of social processes was delimited by the social researchers,
being possible a wider reach of practices and studies. As discussed above, the biopsychosocial model takes
into consideration the individual experience of certain social events. For the depressive disorder, based on
the outcomes that state a strong association between poverty and this illness, there are more and more
studies with patients’ indicators such as income, debt, occupation, and financial problems have become a
tendency. However, the biopsychosocial model, framed within a medical tradition, has tended to not
incorporate the outcomes of the macro-social dimension proportioned by the social determinants
perspective. This perspective also consider how macroeconomic measures related with poverty, such as
economic growth or income inequality become a key factor in order to understand the depression causes
(XXXX, XXXX). Thus, the social determinants introduce a macro-economic issue. For instance, a research
shows the strong association between economic inequalities in rich countries with mental health problems
and consume of drugs (Pickett, Richard & Wilkinson, 2010). At the same time, a close relationship between
economic inequalities with depressive disorder was proved by recent studies (XXXX, XXXX; XXXX, XXXX).
Some examples of these results may be found both in the American, Chilean, and South Korean cases
where the high rates of mood disorders have been related to economic inequalities and accelerated
modernisation process (XXXX, XXXX). Therefore, the need to include results provided by the social sciences
seems to be a priority.
Counterargument
and rebuttal
(165 words)
Section 3:
Argument
(263 words)
Section 4:
Argument
(XXX words)
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NOTES
The scope of the macro-social dimension
Sociological arguments: Relationship between levels // not only three “vertical” dimensions.
Research about neoliberalism (capitalism) and depression
References: Alain Ehrenberg and Richard Sennett
Conclusions
(XXX words)
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NOTES
Is essential to understand the etiology of mental health disorders, not only from a genetic or individual
perspective, but also from a social perspective.
Understand that social determinants opens up opportunities for interventions at a population.
Limitation: how to measure “social” level and its impact in person??
The need to understand the causes of depression at different levels.
Interventions on a macrosocial level
Not treatment // but promotion and prevention interventions (Public Health, Health Policy)
Not only “mental health professional”. It is necessary to include Sociologists and Anthropologists
Biopsychosocial model tend to use only quantitative approach. However, it is necessary a qualitative
approach to know the meanings related to human suffering and its institutions (e.g. mental health
centre).
References
References