Approaches to explain the aetiology of MDD

The main three approaches that can be used to explain a mental disorder are three: biological, cognitive and sociocultural. A biological approach tends to focus more on a purely physiological-based explanation. Therefore, the brain and genes will be considered as the cause of the mental disorder. In this particular case, the article will be focusing on the aetiology of MDD (Major Depressive Disorder).

Whereas the biological approach is using a more scientific-based explanation, for instance with the use of chemistry, it could be argued that such a method can be seen as reductionistic. This is because by looking only at the “chemistry” of the issue means that the cause has nothing to do with the single individual. An example of where the biological approach was used is the Serotonin hypothesis, written around the 1960s. The hypothesis was formulated with the aim of explaining depression, a relatively complex mental illness which affects most of the world population. What it claimed was that the serotonin neurotransmitter in the brain of depressed people plays a causal role in the pathophysiology of depression. Therefore, SSRIs were invented (Selective Serotonin Reuptake Inhibitors), with the aim to increase the reuptake of serotonin. However influential the Serotonin hypothesis has been, it has been proven wrong several times in the past decades, with the use of better technology.

When it comes to the cognitive approach, researchers are more prone to believe that the disorder is caused by the mind, and that therefore there is a psychological explanation for this psychological problem. Consequently, this approach allows to focus more on the individual, rather than looking at what’s wrong with the chemicals in their brain.

Albert Ellis was one of these researchers, claiming that depressed patients suffer emotionally because of the way they think. He therefore studied about Rational Emotive Behaviour. What he thought was that the solution for MDD was therapy, as the beliefs in one’s mind are cognitive structures, and can therefore be “reconstructed”. Later on, a relatively influential therapy was developed: CBT (Cognitive Behaviour Therapy). What this therapy was based on is that the underlying cause of depression is maladaptive automatic thoughts that have to do with irrational behaviour. Therefore, the two targets of CBT were automatic thoughts and behaviour. The goals were cognitive restructuring and behavioural activation, and these were accomplished by focusing on specific, well-defined problems, therefore, patients are expected to be active in the process. Cognitive Behaviour Therapy is still used nowadays as it’s considered to be almost as effective as medical treatments.

Finally, the sociocultural approach to the aetiology of depression, as the name suggests, focuses on the social and cultural factors which contribute to one’s unwellness. A research of Brown and Harris (1978) examined in particular the role of environmental factors in the onset of depression in women, by looking also at the biographical information and difficulties. What they found out was that there are specific factors which influence depression in the participants: protective factors and vulnerability factors. The protective factors decrease the risk of depression in combination with particularly stressful life events. On the other hand, vulnerability factors increase the risk in combination with stressful life events. The most significant vulnerability factors are the following:

However, it has been argued that what causes depression is, rather than vulnerability factors, a predisposition to having MDD. The diathesis-stress model is an interactionist approach to explaining physiological disorders. Depression may be the results of a hereditary predisposition interacting with the environment. Therefore, it is believed that both sociocultural and biological aetiologies of depression should be used.

Overall, from these three approaches it is clear that there is no best approach to explain the aetiology of a disorder. However, it can be deduced that when using all three at the same time, a wider range of possibilities for treatment of MDD can be considered. Therefore, instead of excluding one approach from another, where one lacks in detail in some areas, a different one should contribute to produce a bigger frame for explaining a mental disorder.

2 Replies to “Approaches to explain the aetiology of MDD”

    1. I believe that certain types of therapy already take into account all approaches, for example psychedelic-assisted psychotherapy. Despite it being a new type of treatment, it must be said that it allows psychotherapy to be more effective with the help of psychedelics. I think the sociocultural approach is taken in consideration by this therapy as there is a bond of trust built between the patient and the doctor. However, there’s still a lot of research to be done in order to incorporate all three approaches.

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