Unemployment, Stress and Depression

Assignment Brief

1. Demonstrate knowledge and understanding of the main theoretical approaches to understanding the nature, prevalence and impact of mental illness.
2. Critically analyse the evidence for how the experience of, and interventions for, a specific mental illness impact on those who are affected by it.
3. Provide evidence of understanding of the diversity of mental health service users, and demonstrate the ability to interpret evidence, and to recognise the occasional ambiguity of evidence.
4. Identify and critically evaluate policies, treatments and services that diagnose, treat and support people living with mental illness. 
5. Explore the validity of prevailing approaches and the ways in which patients and service users respond to them.
6. Utilise a range of mixed methods to establish patterns and to understand experiences of those affected by your chosen illness or disorder.
7. Utilise a range of mixed methods to establish patterns and to understand both the acute and chronic experiences of those affected by your chosen illness or disorder.

Sample Answer

Understanding and Managing Depression: Theoretical Perspectives, Evidence, and Service User Experience

Introduction

Mental illness is a broad term encompassing a wide variety of psychological conditions that affect thoughts, emotions, behaviour, and overall functioning. One of the most prevalent and debilitating mental illnesses globally is major depressive disorder (MDD), commonly referred to as depression. This essay explores the key theoretical approaches to understanding depression, critically analyses evidence on its impact and treatment, and evaluates mental health policies and services. Additionally, it reflects on diversity in service user experience and examines how mixed research methods help illuminate both acute and chronic aspects of the disorder.

Theoretical Approaches to Understanding Depression

Several major theories attempt to explain the causes and nature of depression. The biomedical model is perhaps the most dominant, viewing depression as a result of chemical imbalances in the brain, particularly related to neurotransmitters such as serotonin, dopamine, and norepinephrine. This approach is supported by research showing that antidepressant medications can alleviate symptoms in many patients (Cowen & Browning, 2015). However, critics argue that the model oversimplifies the condition and often neglects social and psychological factors.

The cognitive-behavioural approach, championed by Beck (1967), argues that depression is caused by negative thought patterns, cognitive distortions, and maladaptive behaviours. This model has led to the development of cognitive behavioural therapy (CBT), an evidence-based intervention widely used in mental health services. CBT has been shown to be effective, especially in combination with medication (Cuijpers et al., 2013).

Sociocultural models place emphasis on environmental factors such as poverty, discrimination, and trauma. These models highlight the social determinants of mental health, suggesting that inequalities in society play a major role in the prevalence and experience of depression. This approach promotes community-based interventions and policies aimed at reducing social risk factors.

Evidence of the Impact of Depression and Interventions

Depression affects individuals in diverse ways, ranging from mild, episodic symptoms to severe, chronic impairment. The World Health Organization (WHO) identifies depression as a leading cause of disability worldwide. Common symptoms include persistent sadness, loss of interest, fatigue, and impaired concentration. Long-term impacts may include reduced quality of life, difficulties in relationships, and an increased risk of suicide (WHO, 2021).

Interventions for depression include pharmacological treatments (such as SSRIs), psychological therapies (like CBT or interpersonal therapy), and lifestyle interventions (exercise, diet, social support). The NICE guidelines recommend a stepped-care model, where treatment intensity is matched to severity. However, access to services can be inconsistent, and waiting times for therapy are often long (Mind, 2022).

Service user experiences vary widely. Some report significant benefit from medication, while others find psychotherapy more empowering, particularly when it addresses the underlying causes of depression. A key challenge remains in ensuring that treatment is personalised and that users are involved in decision-making, in line with the principle of shared decision-making in health care.

Diversity and Interpretation of Evidence

Mental health service users are a diverse group, differing in age, gender, ethnicity, socioeconomic status, and other factors. Evidence shows that ethnic minorities and individuals from lower-income backgrounds are less likely to receive adequate mental health care and more likely to experience misdiagnosis or coercive treatment (Barnett et al., 2019). For example, Black service users in the UK are disproportionately subjected to involuntary treatment under the Mental Health Act.

Evidence on the efficacy of treatments also varies. While RCTs (randomised controlled trials) are the gold standard for measuring intervention efficacy, they may not reflect the real-world complexity of service users’ lives. Qualitative research, including interviews and case studies, provides deeper insight into how individuals experience both depression and its treatment, revealing ambiguities that quantitative methods may miss. For instance, while a medication may reduce symptoms, users may feel numbed or disconnected, leading to treatment discontinuation.

Continued...