1.Psychoanalytic school
Psychoanalysis was founded and developed by Sigmund Freud at the end of the 19th century and the beginning of the 20th century as a discipline to study the unconscious mind of human beings. It believes that the occurrence of mental illness is due to unconscious conflicts, and depression is no exception, the cause of which is hidden in the unconscious. Psychoanalytic therapy is to first realize the hidden conflicts in the unconscious and then to treat them. Depression was one of the first clinical syndromes to be explained psychodynamically by psychoanalytic theory, and over the past 100 years, psychoanalytic theory has evolved from the early theories of drive and its release, to the formation of psychological structures, the emergence of the ego, and the emphasis on object relations, and the explanation of the etiology of depression has been revised.
(1) Drive theory
This theory suggests that personality development is driven by instinctual drives and aggression. The sequence of personality development is divided into five stages: oral, anal, genital, latent and reproductive, each with tasks to be accomplished in the individual’s psychological development, such as the oral period (birth-1.5 years), when the infant leaves the mother’s womb after birth and begins contact with the new environment, and has to endure suffocation in the birth canal and external noise. By sucking the mother’s milk to satisfy oral desires, while the mother’s touch, diaper changing, bathing and other behaviors can form a secure attachment to the mother through the tactile-motor system, this attachment gradually extends to form a basic sense of trust in others and society, a sense of security, and the core of an individual’s healthy personality. The satisfaction of the infant’s desire for food and security and trust during this period depends entirely on the degree of care provided by the mother. If this oral desire is not satisfied during the breastfeeding period, the “oral personality” is formed, which is characterized by strong dependence, self-centeredness, and less demands and payments, and is characterized by a preference for alcohol and tobacco, eating disorders, and fantasies. Re-exposure to external stimuli in adulthood can cause the psychological level to regress and fixate on this stage.
Clinical observations of depressed patients often show problems in the oral phase, such as resolving depression in contradictory ways: refusal to eat on the one hand, and overeating (especially sweets) on the other, which symbolizes the psychological fixation of depressed patients in the oral phase. Some infants have more nerve endings in the oral mucosa and thus develop a depression-prone quality structure that requires more orality satisfaction than the average person, making it very easy for them to regress to orality patterns of behavior in adulthood to seek childhood satisfaction and reestablish a sense of security in response to stressful events. Such individuals would have experienced intense disappointing experiences during infancy and early childhood, e.g., realizing that their mother did not always love them and that there were times when their mother did not satisfy them, thus creating a pathological disappointment with love. Adults who suffer from susceptibility factors are easily motivated by the experience of disappointment in love and lead to depression.
(2) Object relations theory
The core of this theory is that an individual’s present interpersonal relationships are influenced by relationships that have been formed in the past, i.e., object relationships (mother-child relationships) that were introjected in early childhood are reproduced in later interpersonal relationships. For example, the individual and the mother formed an abusive-abusive relationship in their early relationship, and the mother often blamed and criticized the young individual until she cried, for which the individual had low self-esteem believing that she was not a good child. The failure to form a positive experience between the mother and the child is the origin of depression, and this failure leads to the formation of a not good enough object in the individual’s self. When encountering a person or situation similar to that of the mother in real life, the early internal object relations are activated and reproduced, resulting in anger and suspicion toward others and the external world, and a widespread sense of “badness” in the internal world, which explains the symptoms of self-hatred in depressed patients.
(3) Autopsychology
This theory considers the ego, the self, and the superego as an energy system, and the changes in the various energies cause different psychological phenomena, while emotions are a release of energy, which is accompanied by a specific subjective experience. Emotions simultaneously have specific structural patterns: for example, tension within the ego produces sexual arousal, anger; tension within the self causes realistic fear, physical pain, love, hate; tension between the self and the ego leads to fear of instinct, anxiety, disgust, shame; tension between the self and the superego causes guilt, depression. Thus, from the structural point of view, depression is an emotional state caused by the tension between the ego and superego. Among them the loss of self-esteem is the key issue in the formation of depression, and the moral judging function of the superego causes the ego to produce negative emotions that lead to depression. Inadequate and immature superego leads to leaving a very negative (aggressive) psychological representation of the ego in the psychological organ of an adult, which is an important factor of the individual’s vulnerability to depression and is a developmental defect in the process of psychological development. Because of the great aggressive energy present in the psychological organ of such an individual, when he or she is faced with an experience of loss and frustration, the first reaction is anger. If this reaction does not correct the threat faced, then the anger is directed at oneself and a series of depressive symptoms of self-denial, self-punishment, and self-resentment occur.
2. Behaviorist psychology
Unlike psychoanalysis, which emphasizes the study of individual subconscious activity, behaviorism advocates ignoring consciousness and focusing on the direct connection between stimulus and response, and studying “externally observable behavior”.
(1) Learned helplessness
It can be explained that human passive behaviors are “learned after something”, and when individuals face external stress, if they cannot avoid failure after several attempts, they will have a habitual feeling of helplessness, which makes them reluctant to try any more behaviors, and leave them to their fate, apathetic and numb, losing confidence and suffering in silence.
(2) Reinforcement model
Reinforcement refers to the tendency of an individual to perform a behavior again after a certain behavior occurs and the consequences of the behavior cause the individual to gain some benefit or avoid some disadvantage. Therefore, researchers believe that depressive behaviors occur repeatedly because they are “positively reinforced”, for example, once an individual becomes depressed, he or she receives attention from family and friends, which is called “secondary benefit”, so that at an unconscious level depressive symptoms Therefore, at an unconscious level, depressive symptoms become a means to control the relationships around the individual and to gain the attention they need from others, and often patients with such intrinsic motivation lack the will to actively get rid of depression and tend to be persistent and depressed. From another perspective, when individuals receive less affirmative reinforcement in their social behaviors, such as not receiving positive responses from others in interpersonal interactions, the lack of “positive reinforcement” will lead to a decrease in social behaviors and thus a lack of social skills, which in turn leads to a decrease in affirmative reinforcement, and this cycle tends to induce depression. So it is easy to produce depression, frustration and depression, which in turn can induce low self-esteem, pessimism and guilt.
(3) Punishment model
Punishment is the opposite of reinforcement. When an individual is given a negative stimulus such as disgust, reprimand, ridicule, etc. immediately after a behavior, the chances of the individual reappearing with the behavior are greatly reduced. For example, if a female college student who is introverted and reserved expresses her affection for a male classmate, but is politely rejected, this “failure” becomes a punishment that causes serious damage to her self-esteem and makes her feel that everyone is ridiculing her, so she does not dare to approach the opposite sex anymore, and even “generalizes” to all interpersonal relationships. This “failure” became a punishment, leaving her with a severely damaged self-esteem, a feeling that everyone was ridiculing her, a fear of approaching the opposite sex, and even a “generalization” to all relationships. The mechanism by which the punishment model leads to depression lies in the way the individual responds to negative stimuli by withdrawing from behavior, gradually becoming withdrawn from the initial ability to communicate with the outside world, from reducing social outings to being afraid to meet all people around her, and developing serious impairments in social functioning.
3.Cognitive psychology
Cognitive psychology is a school of psychology that studies cognitive processes from the viewpoint of information processing [22], and it can be said that cognitive psychology is equivalent to information processing psychology. It views human as a system of information processing and considers cognition as information processing, decomposed into a series of stages of transformation, parsimony, processing, storage and use of sensory input. Each stage is a unit that performs some specific operation on the input information, and the product of the operational unit is the response. The components of the information processing system are all interconnected in some way. Two of the more representative theories are ABC Theory of Rational Emotion and Beck’s Theory of Cognitive Behavior.
(1) ABC theory
The representative figure of this theory is Ellis, whose basic idea is that the root of human psychological problems is the existence of irrational beliefs, comments, and interpretations. It refers to the arousing event, B (belief) refers to the beliefs arising from the individual’s perception and evaluation of the arousing event A, and refers to the results of the individual’s emotions and behaviors. According to Ellis, the arousing event A is only the indirect cause of the triggering emotion and behavior C, while the individual’s belief B is the direct cause. For people with depressive tendencies, many irrational beliefs have been formed in previous experiences, and they are prone to negative interpretations and evaluations of stressful events, which in turn lead to undesirable emotions and behaviors, which, in turn, become new stimuli and generate a new round of A-B-C reactions. As this repeats, the individual will repeatedly fall into low self-esteem and withdrawal, which eventually leads to depression.
(2) Cognitive distortion model
The cognitive theory represented by Beck believes that the individual’s dysfunctional perceptions are the key factor in the production of depression. Dysfunctional perceptions are overly rigid ideas that people have about themselves and the world. Depression is related to people’s self-evaluation. Depressed people tend to view the self, the world, and the future negatively. When looking at the self, the world, and the future, they use a stable negative schema. This negative cognitive schema makes them view reality distortedly and tend to overestimate negative behaviors and underestimate their affirmative behaviors when perceiving the self, the world, and the future.
4. Humanistic psychology
Depression is parsed in terms of dependence and independence. Depression can occur when people lose friends, jobs, or health, so these “losses” force individuals to be independent, and this independence is difficult for the person to deal with. The lost person or environment helps support a false self-image, and once they are gone, the broken ego collapses and all that remains is despair. Existential humanist psychologists view depression as the result of the individual facing his or her ultimate powerlessness.