Factors Contributing To The Development Of Depression Social Work Essay

Factors Contributing To The Development Of Depression Social Work Essay Current research by Social Care Institute for Excellence, (SCIE), suggests that one person in six will become depressed at some point in their lives, and, at any one time, one in twenty adults will be experiencing depression. I will discuss the definition of depression and its interpretation along with the biomedical model, interpersonal, psychological and institutional perspectives. Then discuss the social, economic, environmental and political factors that contribute to the developing of depression and their relation to sociological and psychological theory with particular relevance to black and minority ethnic (BME) groups. In England and Wales the Mental Health Act 1983 defines mental disorder as: mental illness, psychopathic disorder and any other disability of mind. There is a dual role of legislation: providing for care while at the same time controlling people who are deemed to be experiencing mental disorder to the extent that they are at a risk to the public or themselves. World Health Organization WHO (2001), marks depression as when Capacity for enjoyment, interest, and concentration is reduced, and marked tiredness after even minimum effort is common. Sleep is usually disturbed and appetite diminished. Self-esteem and self-confidence are almost always reduced and, even in the mild form, some ideas of guilt or worthlessness are often present. Mental health is a contested concept which can be viewed from different medical, psychological and social perspectives, which lead to diverse views on what mental health is. Depression is a mental illness and, can affect anyone at different points in their lives, from every background and occupation. Categorizing populations as experiencing depression, involves making judgments by the use of scales of mental health and these judgments determine cut-off points on a continuum of mental health or illness and are socially constructed. A rating scale commonly used to measure the mental health of populations is the Hospital Anxiety and Depression Scale (HADS). A study by Singleton et al., (2001) found that 76 per cent of the participants, who reported symptoms of mental distress, did not receive any treatment from a health professional for their problems. Sainsbury (2002) study refers to a culture of fear within the BME populace. Causation is affected by the practitioners who diagnose and treat depression and the public perception of depression however there are many perspectives. Biomedical model focus on biological aspects of depression and look for symptoms that relate to diagnostic categories of mental disorder with a view that a sick body can be restored to health. Interpersonal perspectives on depression focus on individual people, experiencing mental distress, together with family and friends, psychologists and counselors also taking account of the views and experiences of service users and survivors. One such perspective is to see madness as a difference rather than an illness, like the social model of disability Oliver (2002). Peoples actions can be open to different interpretations which are influenced by the perspectives of those making the interpretation. However there are commonsense perspectives of depression including personal experience with the people in closest contact, a relative or friend, may form opinions of the likely causes of the distress. Their opinions may include aspects of the persons personality and recognize the impact of externa l stressors such as bereavement, debt or work demands. Overall they are more likely to emphasize the impact of social, rather than biological or psychological, factors. Psychological perspectives on depression explores unconscious thinking, possible past traumas and focuses on helping service users to realize their potential and focus on social support and psychological interventions. This has created the development of psychotherapeutic treatments or talking therapies, such as cognitive behavioural therapies (CBT) has become the psychological treatment of choice in many NHS-funded services. Advantages of CBT include having some support, someone to talk to and developing coping strategies. Disadvantages of CBT include The focus being on here and now, when the person might want to spend more time discussing past issues. CBT is a relatively effective way of helping someone deal with their distress that puts the client back in control of their life. Despite the evidence that has been collected to support the use of different psychological treatments, their effectiveness continues to be debated and funding is mainly offered in private practice or withi n institutions. (McLeod, 2000; Holmes, 2002) By contrast, the prescription route is a commonly referred to and accepted path with no self-criticism or self-awareness required. Institutional perspectives or psychiatric perspectives on depression hold biological and genetic theories of causation for depression, and prescribe biological and physical treatments. Psychiatric perspectives emphasize the diagnosis of symptoms of depression in order to place people into categories of illness. The influence of GPs and psychiatrists is powerful in determining what is and what is not considered to be a mental health problem. Psychiatrists have powers to detain patients for treatment against their will. Psychiatry, through its association with medicine, tends to take precedence over psychological and social perspectives. The bio-psychosocial model introduced by Engel (1980) acknowledges the interactions between the persons biology, their psychological makeup and their social situation as important in understanding their mental distress. It encourages a more holistic approach to treatment. However, it has not provided the hoped-for basis of an accepted multidisciplinary approach. The Social support perspectives believes social factors and the persons experiences cause depression and social support restores the mentally distressed person to wellbeing and social functioning. However it is also viewed as an addition to psychiatric treatment, where the service user is established on their medication, and social issues investigated. Puttnam cited in Gross (2005) refers to social capital as a supportive social atmosphere and discusses bridging and bonding ties and the absence of these can lead to social isolation. Cockerham (2007) makes the connection where depression and illness are most likely among those with little or no social capital. There is also a tendency for the individual to, once diagnosed, to play the sick role, Rosenhan (1975) refers to the stickiness of labels and Goffman (1961) refers to looping and deviancy amplification that is associated with stigmatization and labeling of individuals. However our social standing is not the only element that contributes to our sense of well being. The environment that we live and are brought up in greatly influence our health Ross (2000) cited in Cockerham (2007) compares advantaged and disadvantaged neighborhoods finding that higher levels of depression occur in the latter with individuals suffering psychologically because of their environment although there were links to their individualism female sex, younger age, ethnicity, low education, low income, unemployment, unmarried with the remainder from living in a poor neighbourhood. The daily stressors of living with crime, disorder and danger all link with symptoms of depression. Those living in clean and safe neighbourhoods showed low levels of depression. Distressing neighborhoods produce distress beyond that from individual disadvantage with poverty and single mother households the strongest predictor of depression. However the lack of choice and powerlessness of poverty make the emotional consequences of living in a bad neighbourhood worse. Poverty can lead to poorer mental health where access to employment and welfare benefits, can be seen as health-promoting activities. For most nations, spending on mental health promotion is low Appleby, (2004), and the resources put into mental health promotion are minuscule compared with those used for treating ill health. Schulz et al. (2000) cited in Cockerham (2007) found high psychological distress highest amongst blacks and whites living in high poverty areas, slum living conditions. Wilson and Pickett (2006) cited in Cockerham (2007) stated that stress , poor social networks , low self esteem , depression , anxiety, insecurity and loss of a sense of control are reduced and social cohesion in enhanced when income levels are more equal- however equalizing income is inherently political. Sir Donald Achesons Independent Inquiry into Inequalities in Health Report (1998) recommendations will require policy changes to occur with reference to changes in building design, planning and access to health care treatments, although most research data on interventions tend to be tested on white, middle aged well educated men and women therefore the efficacy with black or mixed ethnic BME is not proven. The report also links depression and anxiety with obesity and inactivity and encourages physical exercise as obesity and inactivity is increasing in lower socio economic classes. The media and the NIMBY phenomenon exemplifies the exclusion that often accompanies a diagnosis of depression. This raises issues of complex ethical and political issues along with human and civil rights. According to Blaxter (2004) health, disease and illness are social constructs; they are categories which have been named, and defined, by human beings. Bowers (1998) argues that diagnostic classification systems are culturally influenced, but involve: careful, detailed observation, publication and peer review. Psychiatric diagnoses are based on social judgments of behaviour and experiences. These judgments can be socially and culturally influenced. For example, you will automatically get well by travelling to a country where your beliefs are widely shared. This obviously does not happen with heart disease. Problems of subjectivity and unrecognized cultural assumptions may complicate the process of diagnosis. Neither minds nor bodies develop illnesses. Only people do (Kendall 2001). Recognition that both physical and mental factors are involved in mental distress could mean that a diagnosis of depression would be no more stigmatizing than having a heart condition. Foucault cited in Giddens (2006) was a post-structuralist theorist who believed that peoples views on depression are the results of discourse that exists to define and subjugate people in society. He also, through the process of social archaeology, examines how the issues of mental health existed in the past and how they are a modern conception of normal and deviant activity , defining them as a construct built on power in society and how that power operates , this therefore links in to social constructionist theory. Social constructionism is the belief that our understanding of depression as a reality, overlooks the processes through which the reality is constructed. Our current sociological thinking is one of a historic white male centred Eurocentric model with women historically viewed as hormonal creatures and this gender difference is still prevalent to day in the way we use language with gender differences in the way society defines these roles. Brown and Harris (1974) model of depression drew links with unhappy life events that can lead to depression when mixed with his four vulnerability factors which he identified as ; 3 or more children under 14, loss of mother before 11, lack of employment, lack of intimate confiding relationships. He established that these factors plus an unhappy life event led to 83% women became depressed with working class women more likely to become depressed. Kasen et al (2010) have conducted a study supporting the effects of enduring earlier stress both in childhood , poor health status and a more rapid deterioration in health and the effects this has on major depressive disorder on women in old age and the need to develop resources to counteract stress exposures in younger generations of women. These factors need to be considered in the understanding not only from a feminist perspective but also from a black perspective as black women are multiply disadvantaged, hooks cited in Giddens (2005). Immigration has played a major part in the creation of culturally diverse communities in UK society. The majority of the UK population in the National Census (2001) census was white (92 per cent). The remaining 7.9 per cent were from different minority ethnic groups. Karlsen et al. (2002) states that ethnic groups experience significant racism, unfair discrimination and social exclusion. This needs to be considered when understanding their mental health experiences. Social inequalities in education, employment and health disproportionately affect members of minority ethnic groups. This all leads to increased mental distress. Also black males lives are much harder as they have to live to a set of unconscious rules written in Westernised psychiatry which leads to their current diagnosis. People from minority ethnic groups find that mental health services are not sympathetic to their particular needs. A report from the Sainsbury Centre (2002) concluded, black people are disproportionate ly disadvantaged and their experiences of mental health services are characterised by fear and conflict. Delivering Race Equality was launched in January 2005 and requires health authorities, and NHS trusts to ensure equality of services. The Department of Health has set action goals for the mental health care of minority ethnic communities and service users; these include, reduction in fear and seclusion in mental health services. Race is a contested concept with the difference between race, having its origins in 18th and 19th century colonial assumptions about the differences between white and non-white people. The concept of race is socially constructed and is now embedded in how we identify, understand and think about people. Ethnicity is an alternative concept to race that is more acceptable to groups in society . Ethnicity refers to a sense of identity that is based on shared cultural, religious and traditional factors. Ethnic identities are always changing and evolving. Approaches to cross cultural psychiatry according to Pilgrim (2005) are either orthodox or skeptical. Orthodox definitions of depression state that culture shapes the expression and prevalence of mental disorder. Cultural sensitivity enables GPs to read symptoms and translate them into an orthodox, western diagnosis. A sceptical reading questions the validity of applying diagnostic labels from Western culture to other cultures. Cultural d ifferences lead to people explaining and experiencing depression in different ways. Imposing western diagnostic categories leads to misinterpreting the persons mental distress. It is important to be cautious in making cross-cultural comparisons in diagnosing with different illnesses being stigmatized in different cultures, and so expressed differently. Beck cited in Giddens (2005) felt that depressed peoples thinking is dominated by a triad of negative schema of, ineptness, self-blame and negative evaluation although this doesnt take into account any social factors that have impacted on the individual. Freud cited in Gross (2005) thought that people were victims of their feelings. That the psycho-analytical theory with fixation in psycho sexual stages and repressed desires feelings are what causes mental illness as the ego is unable to exert control over our feelings and this inability to express may cause anxiety and depression. He took this further with enforcing the belief of intra psychic loss, loss of sense of self, esteem, loss of job or the loss of a major sustaining relationship. Hayes (1998) links Bowlbys functionalist perspective in his attachment theory being the loss of significant carer and lack of maternal attachment had far reaching effects. Skinner cited in Gross (2005), believed in radical behaviourism and that lea rning is conditioned and emphasized the role of environmental factors. Seligman (1974) takes a humanistic approach purporting that learned helplessness is a cognitive psychological explanation of depression, where there is learned helplessness and passivity, people become dependant and unable to make decisions for themselves. Oakley (2005) remarks on the tendency for women to specialize in mental illness and that many more women in Westernized society are classified as having neurotic disorders and women dominate in psychosomatic disorders. A correlation exists in the study of mental illness being higher in men living alone and higher in married women however women are also suffers of post partum depression which is viewed by society through the biomedical viewpoint. Oakley (2005) places this within the self perception and ideals within a male patriarchal culture where women have been, historically, subject to social, economic and psychological discrimination, as have black people. However we are all damaged in some extent, this being a state of humanity; however, connectedness is not possible without the qualities of vulnerability, weakness, helplessness and dependency. A paradox exists in that all these qualities are seen as feminine, and are, not only negatively described, but are also associated with depression. This also links to learned helplessness as a psycho social explanation that women are gendered and stereotyped into this through socialization Weissman et al (1982). Calhoun et al (1974) established data that indicated a trend for females to hold themselves more responsible for unhappy moods than males. There are a myriad ways of thinking, behaving and experiencing the world through a combination of care and control using medical, psychological, and social support with interventions done to reduce negative factors such as poverty , unemployment racism etc, and promote social inclusion. Research will play a large part as new factors are established as demonstrated in the recently publicized link between teenagers sleep patterns and depression Gangwisch et al. (2008) Word Count 2747

then who do we believe? Essays -- essays research papers fc

The Ultimate Dilema   Ã‚  Ã‚  Ã‚  Ã‚  There are several safety precautions that we as humans take to ensure our safety. Humans most commonly test things before selling or using them. This can avoid liability and make sure products are safe. Cosmetics are among the many types of products that are being tested such as fragrances, toiletries, and cosmetics that are tested on millions of animals each year. This has created several controversies between animal rights activists and cosmetic manufacturers. Especially in the European Union Council of Ministers where they want to ban animal testing as soon as they can develop enough alternatives (Milmo, 6). This is because several animals are used in experimentations to test if products are safe for us to use. Tests like the Draize Irritancy and Skin Tests, where products are put in the eyes of rabbits to test irritations, and the LD50, where several animals are exposed to a chemical are considered ways of torture. But luckily several corporations are discover ing new and reliable ways to replace animals with science and technology to help reduce the amount of animals used. So because testing on animals are absolutely necessary for our safety, as consumers, we do not have the right to use animals in this type of manner, but we should reduce the amount of tests by replacing many with alternatives.   Ã‚  Ã‚  Ã‚  Ã‚  Although this seems wrong, it is the ultimate necessity for human safety in cosmetic use. Animals have been used in cosmetic safety testing primarily because they share similarities to humans. They are quick and easy to use because they live short lives and are easily accessible. Most animals are raised only for testing, and experimentation is really all that they know. So they really are not taken out of their natural habitat for testing. Testing has been so important to corporations because they are trying to avoid being branded as unsafe. Testing also has been so important that they help avoid liability lawsuits and bad publicity from unsafe products (Hunter, 30).   Ã‚  Ã‚  Ã‚  Ã‚  It all started in 1933 when a woman wanted to thicken her eyelashes. But after applying the dye to her lashes and accidentally to her eyes, she suffered for about three months. This woman, that the Federal Drug Administration calls â€Å"Mrs. Brown†, eventually went blind. Congress then passe... ...re are so many alternatives available now there really should not be a reason why a corporation would not reduce the amount of animals used. The newer techniques offer chances to obtain data faster, less expensively, and more humanely (Hunter, 26).  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Works Cited Anthes, Gary H. â€Å"P&G Uses Data Mining to Cut Animal Testing.† Computer World 33 (1999): 44-45. Finsen, Lawrence, Susan Finsen. The Animal Movement in America: From Compassion to Respect. New York: Twayne, 1994. Fox, Michael Allen. The Case For Animal Experimentation: An Evolutionary and Ethical Perspective. London: University of California Press Ltd., 1986. Hunter, Beatrice Trum. â€Å"New Alternatives in Safety Testing.† Consumer Research Magazine 83  Ã‚  Ã‚  Ã‚  Ã‚  (2002): 26- 30. McCoy, J.J. Animals in Research: Issues and Conflicts. New York: Franklin Watts, Inc., 1993. Milmo, Sean. â€Å"Ultimate Showdown Looms For Animal Tested Cosmetics.† Chemical Market Reporter 261 (2001): 6, 28. Planet for the Taking Series: Ultimate Slavery: Dir. Nancy Archibald. Film Incorporated. .   Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  

How far is the pardoners tale gothic? Essay

The gothic genre, thought to be introduced in 1769 by Horace Walpole’s noel The Castle of Otranto, was remembered for its crude, grotesque, exaggerated nature. Although in medieval times the Gothic movement had not commenced, Chaucer’s can be considered a forerunner to this movement as many aspects in the pardoners tale are clear gothic, however Chaucer did not perceive his writing as Gothic, he did not intentional write a Gothic tale like later authors did. The pardoner’s tale is considered the most Gothic out of all the ‘Canterbury Tales’ as it is the most abundant with gothic elements. These elements include Chaucer’s description of the Pardoner, the attractiveness of evil in the text, the presence of supernatural and horror, the digressions, and the personification of death. It’s because of the gothic elements this text that modern interpretations have viewed The Pardoners’ Tale as one of the earliest examples of a Gothic tex t. A common element that is found in the gothic style is the breaking of conventional moral or ethnic code. Morals and ethics in the 13th century originated from the Church which had the authority in medieval England. The Church was known by many to be corrupt because of its hypocrisy and exploitation of the society. Common peasants in the society were expected to be 10% of their wage to the Church, which is how it attained its extraordinary wealth. Although the majority of people were aware of the Churches corruption no one would challenge it in fear of the punishment of eternal hell therefore the Churches established authority was able to prevail while the people carried on being exploited. Chaucer acknowledged this corruption, and with his presentation of the Pardoner he attacks the established Church. The Pardoner breaks all of the moral conventions set by the Church, his fraudulent nature is exposed by Chaucer as â€Å"he hadde a pilwe-beer, which that he seyde was Oure Lady veyl.† The role of the Pardoner in society was to allow people to buy pardons for their sins from him. There were gullible or fear stricken people who would often do this, in fear that their sins would prevent them from going to heaven, the Pardoner was one of the most corrupt of the clergy and is a perfect exampl e of the corruption of the Church in Medieval England, Chaucer shows the Pardoner’s exploitation as he uses a pillow case to claim it was Mary’s veil. This would have shocked and horrified the minority of readers who would have had hope for their salvation through the  Pardoner. From the Pardoners description in the General Prologue it’s also clear that he breaks conventions of the Church as he unusually rides with â€Å"hood, for jolitee, wered he noon† just in the fact he doesn’t wear his cap shows that he’s not as dedicated to the Church as he likes to portray, it also hints at vanity which in medieval times was considered a sin. There are more inferences in his description that hint he breaks conventions of the Church. He is described to have â€Å"heer as yelow as wex† which is significant as the blonde hair was usually associated with cunningness, reinforcing the Pardoner as a sinister character. Blonde hair was also associated with effeminacy, it’s clear that he had intentions of making the Pardoner into a feminine character as he had â€Å"no berd† and â€Å"he were a geldyng or a mare.† Chaucer’s mockery of the pardoner’s manhood has lead to many modern interpretations of the Pard oner as a homosexual. This would have been subtle to the medieval audience as homosexuality was not the same in the middle ages, however, to those readers who picked up on this undertone, it would have horrified them as this went against all the moral and ethnics they’d been taught. Chaucer’s presentation of the pardoner breaks morals that the Church set, and therefore is a convention that most modern interpretations would recognise as being Gothic. *The text is filled with a macabre atmosphere; this is particularly achieved with Chaucer’s depiction of the attractiveness of evil. Avarice is one of the most stated sins preached in the Pardoners tale, to the contemporary medieval Christian, avarice was strongly against their morals. Avarice was considered a curse and the Pardoner refers to it as â€Å"swich cursedness† because it takes away people’s attention from trying to achieve eternal life. In the tale, the attractiveness of avarice is evidently shown in the presentat ion of treasure found by the rioters â€Å"florins fine of gold, y-coined rounde †¦ so faire and brighte’, a ‘precious hoord.† The young rioters are clearly overpowered by the lust of riches and money, this is echoed by the Pardoners own lust for money, despite preaching ‘radix malorum est cupiditas’ he commits avarice as his daily job. The medieval doctrine would condemn this for the reason that he jeopardises other people’s chance of achieving eternal life for his own profit. The Pardoner often preaches about various the sins that cause bodily corruption. Bodily corruption was viewed a sin as everyone was expected to take care of their body since it was given to them by the divine. The  pardoner preaches about gluttony, which destroys the body due to greed for food, the pardoner states that â€Å"corrupt was all this world for gluttony†, he also condemns sex and drinking, this makes it a chilling medieval tale as destroying one’s body was a haunting fear in the society. The most Gothic element that appears in the pardoner’s tale is the theme of death and the depiction of the supernatural in the mysterious man. In the 14th century England was hit with the black plague. This was a tragic disease that wiped out 70% of the population in London. As a consequence, death clearly surrounded everyday life. A common theme in medieval times was death. Many artists and authors personified death, this is most clearly shown in the picture â€Å" the dance of the dead† where death is represented as dancing skeletons. Chaucer also personifies death in the pardoner’s tale. Death in itself is a very gothic theme, it’s included in many later gothic texts, just as the works of Edgar Allen Poe, Stokers ‘Dracula’ and Wildes ‘Dorian Gray.’ The personification of death makes it chilling and horrifying as there’s no way to escape it. Countless Gothic texts, such as Frankenstein and Dracula embody their society’s biggest problems into their ‘supernatural.’ Since the black plague was a massive issue, the old man in the text represents death, one of society’s biggest problems. Chaucer, in his representation of the old man, perverts the usual depiction of them being wise and instead gives him an air of mystery. Mystery is key in Gothic literature; it tampers with the audiences emotions as they deal with the unknown. Chaucer presents the old man with an eerie atmosphere â€Å"this olde man gan loke in his visage.† This line would endorse a sense of horror into the reader as the man just stares at one of the young men. The pardoners tale follows many of the conventions of Gothic, although it was written many years before the Gothic period is thought to have started it’s still considered a Gothic text to an extent as it would have haunted the medieval audience.

The Fire Essay - 1243 Words

The door creaked open as the young boy stepped out but was quickly slammed shut by the viscous wind the noise echoed through the hills disturbing some pigeons roosting in the near by trees. The moon was illuminating the night sky with a milky glow which illuminated all land creating large disturbing shadows. The trees bent in submission to the howling wind which forced their branches to brush along the ground sweeping the dust away from the track. The solitary building which could barely be described as a house stood alone and solitary on the hillside. The walls were crumbling from the water logged plaster and only one window still contained a pain of glass. The door had almost come off its hinges†¦show more content†¦Then from nowhere a rogue cloud streaked across the sky to shield the moon from view. Suddenly the land turned black like some giant hand had just turned off the huge light floating in the sky. The moon fought hard to pierce the shield formed by the cloud but t o no avail. The cloud appeared to slow down as it passed by the moon but gradually it began to pass and then suddenly two large streaks of light shot out from the side of the moon the whole land gradually began to reappear under the moonlight. Within a matter of minutes the moon had reappeared from its shade and was shining with extra brightness to make up for the time which it was blocked. Once again the shadows of the trees began to dance in the moonlight. Swaying like mystical dancers in the wind. The child continued on his journey along the moonlit path leading up over a hill and off in to the distance. The road began to climb the boy slowed his pace wrapping his long trench coat even tighter round his small frail body. Suddenly the wind grabbed hold of his jacket pulling him back he fell and stumbled for a few seconds he sat there with his hands and knees resting on the ground. He composed himself stood up and once again cocooned himself within his jacket. The gradient of the road climbed even higher slowly he began to crawl higher up the hill. Eventually he reached the top of the hill and stoodShow MoreRelatedEssay On The Fire705 Words   |  3 Pagestwo buildings that caught fire along our block on the same side just four doors down in each direction. Both occurred at night displacing families that saw the buildings boarded up with fresh plywood that never quite did cover all the black tinge of the flames that tore through the windows. It stayed that way for some time accompanied by that exclusive and ever-present burnt odor that wafted through the neighborhood reminding everyone of the destructive force of fire. For a young boy, it was intimidatingRead MoreA Report On The Fire1451 Words   |  6 Pagesmature. 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