Melissa Massamu

Teacher: Laura Muir

Major depressive disorder (MDD) is a mental health disorder characterized by non-stop

depressed mood, decreased interest in activities, and weight change, hence causing significant
impairment in everyday life. Psychologists have suggested different approaches to causes of
MDD, thus resulting to various treatments in accordance of the approach. A treatment refers
to a medical care that is given to patient for an illness or injury. The degree to which
psychological and biological treatments of MDD have been considered effective has been
controversial issue for a very long time due to the fact there are still some uncertainties on the
treatments. Therefore, this essay will focus on offering a considered and balanced review on
the effectiveness of one biological and one psychological treatment of MDD.

Psychologists taking a biological approach to treatment assume that MDD is caused by

malfunction of the brain, especially mechanisms involving neurotransmission, thus the most
preferred treatment in this field is Electroconvulsive therapy (ECT). Electroconvulsive
therapy is a kind of psychiatric therapy that involves giving a short electrical stimulus to the
brain through tiny electrodes in the temples. A majority of patients usually receive 6 to 12
ECT sessions for a whole treatment, given one electrical charge per day, two or three times in
a week. ECT has succeeded in lessening the severity of MDD symptoms, thus reducing the
chances of a relapse from happening.

But there is still no clear picture of how it works, which makes its use controversial, and in
most cases it usually results to permanent retrograde and anterograde amnesia which can be
distressing for the patient. In 2010, Read and Bentall conducted a meta-analysis of studies on
the efficiency of ECT for the treatment of MDD. Using databases of studies and previously
conducted meta-analyses, they identified all studies that compared ECT with simulated-ECT
(SECT). They found that there was minimal support for the effectiveness during course of
treatment of MDD, and no evidence of any benefits beyond the treatment period. Therefore,
they argued the cost-benefit analysis for ECT is so poor that its use can’t be scientifically
justified, due to the fact that most patients experience permanent brain dysfunction and have
high chances of dying. Hence this demonstrates that ECT treatment isn’t effective in treating
MDD, as its limitations overweight its strengths.
 Melissa Massamu
Teacher: Laura Muir

On the other hand, psychologists taking a psychological approach to treatment believe that by
restructuring negative thinking, positive changes could be made in the depressed, thus the
most preferred treatment in this field is Cognitive behavioural therapy (CBIT). As the name
suggests, CBIT incorporates both cognitive and behavioural strategies. With regards to
depression, CBIT refers to the use of both cognitive restructuring and the behavioural
strategy of activity or behavioural activation. In other words, the negative thoughts that lead
to depression and helps the person see that the problem is their own faulty thinking, so as to
show them that there is a positive way of thinking, hence helping them having a positive
interpretation towards life. The CBIT model has shown to be effective in treating MDD,
because, unlike biomedical treatments, it puts control in the hands of the client, rather than
the psychologist or psychiatric. Also, cognitive behavioural therapy techniques help to
change maladaptive assumptions and thoughts which is mostly displayed by patients with
psychological disorders, particularly depressive and anxiety. Hugner et al (2012) proved this
when he investigated if CBT was effective for patients who suffered substance abuse due to
MDD. Results from the therapy groups illustrated that CBT was effective in treating patients
as it not only left them with less symptoms but also decreased their substance abuse.

Although, cognitive model is narrow in scope, due to the fact that it only addresses one part
of human functioning, and thus maybe broader (biological and/or sociocultural) issues need
to be addressed. Also, Kraser (2008) argued that CBT doesn’t put enough emphasis on a
person’s emotional life and it isn’t effective for people who have difficulty in expressing
themselves verbally. Thus, this shows that the issue of effectiveness is controversial as
different psychologists have different opinions.

Therefore, we can conclude that the effectiveness of these treatments is still controversial due
to the uncertainties underlying between them. But in the biological field of treatment, it is
correct to assume that a lot more investigation needs to undertaken in this area, as it’s
treatment presumably treats the symptoms of MDD, rather than treating the disorder. Also, in
the cognitive model maybe broader (biological and/or sociocultural) issues need to be
addressed as the therapy is narrow in scope as it only focuses on one part of human
functioning, thinking.