Describe and evaluate two treatments of unipolar depression Essay Example for Free

Describe and evaluate two treatments of unipolar depression Essay Describe and evaluate two treatments for unipolar depression (25 marks). It has been believed that psychological disorders, like physical illnesses, have organic causes. Therefore, mental disorders are treated just like physical ones. Earlier treatments have included things like trepanning which was carried out in the stone again. Nowadays we have much safer and effective treatments such as therapies and drug treatment. Low levels of both noradrenaline (nora) and serotonin (sero) have been found as being important in unipolar depression (UD) and so it seems logical to treat depression with drugs which increase the availability of these neurotransmitters. Tricyclic, a type of anti-depressant, appears to work by blocking the reuptake of nora and sero. They block the transport route that would normally allow these neurotransmitters to be taken back into the pre-synaptic neurones. This means that nora and sero remain in the synapse longer which leads to an increase in the synaptic activity in the neurones. This helps the transmission of impulses to neurones which use up nora and sero. Another type of drug treatment is the use of selective serotonin reuptake inhibitors (SSRIs). SSRIs work in a similar way to tricyclics but affect only the levels of serotonin in the synapses. In order to make efficient use of the body’s resources there is a system whereby serotonin isn’t wasted in the synapse but ‘taken back’ by the pre-synaptic neuron. If this mechanism is impaired by using inhibitor drugs then the sero which isn’t received by the post-synaptic neuron remains in the synapse. This extends the duration of the message being transmitted and/or increases the message intensity. Both SSRIs and tricyclics reduce the symptoms of depression and improves mood. However, these drug treatments don’t always work. The success rate for them is around 60% but it varies from person to person, as do the side effects. There is, however, many different types of drug and each may have a  different success rate. It must be remembered that the ‘success’ of drug treatments for one person may be seen as something completely different to another. Kirsch et al collected data for the licensing of four new-generation anti-depressants. These were all SSRIs. A meta-analysis was carried out comparing the improvements seen in patients taking SSRIs with the improvements in control patients who had received placebos. They found that there was ‘no difference at moderate levels of initial depression’ between the improvements of those receiving SSRIs and those receiving placebos. This shows that the placebo appeared to benefit moderately depressed individuals. This could be due to the sufferers being presented with hope of reducing their symptoms. This contrasts with the results found of severely depressed groups who experienced lessened symptoms, which discredits the placebo effect. It could be argued that the drug itself may have a ‘placebo effect’ where a person feels that they are getting better because they are taking a pill, no matter what the pill is. It could be that the person is helping themselves and the drug is simply supplying the idea that they’re getting better when it does nothing to them. Geller et al found that double blind studies showed anti-depressants to be more effective than placebos for children and adolescents. This could be because there are differences in development between children’s and adult’s brains concerning their neurochemistry. Therefore, children and teenagers may not need to use chemistry altering drugs and could just take a placebo instead as they seen to work better than anti-depressants. Furthermore, Ferguson et al found that those treated with SSRIs were twice more likely to attempted suicide than those treated with a placebo. However, a later review found that a higher risk of suicide was amongst adolescents and decreased amongst adults. This supports Geller’s theory that SSRIs are more effective on adults than adolescents, reinforcing Geller’s view. Drugs have been found to be appropriate and effective at preventing relapse and giving the sufferer a good quality of life meaning they can integrate  back into society and return to everyday tasks. Alternatively, research such as Kirsch, Geller and Ferguson is based on correlational studies. This makes it difficult to say whether UD is caused by low levels of neurotransmitters or if it’s visa-versa. Cognitive behavioural therapy (CBT) is a therapy which treats depression by combining both cognitive and behavioural techniques. The aim of this is to help people who have mental disorders to cope better with their lives and coincidentally feel better. Ellis suggests that depression is due to irrational beliefs but is also maintained by reinforcement. Rational Emotive Behavioural therapy (REBT) aims to replace self-defeating beliefs with adaptive beliefs and uses the ABC model. An example of this is a student getting a good grade for their essay. This is the ‘activating’ of an event. How the person interprets an event or situation is where the ‘belief system’ comes in. The emotional response is then observed which is the ‘consequence’ of the action is. The aim of REBT is to develop a ‘D’ aspect adding a ‘dispute system’ to replace B, adding an adaptive belief, so the person realises they do not have to be perfect. The therapist will ‘test’ patient’s beliefs with actions which challenge their faulty thinking. Often they can be blunt with clients and not show sympathy in order to avoid reinforcing the problem. Cognitive therapy (CT) by Beck involves the use of ‘thought catching’ and ‘behavioural activation’. Thought catching involves the observation of client’s thinking and see how their thoughts influence their feelings. This brings around the realisation that even though their thoughts can seem factual, they are often not. Behavioural activation is where the client is encourage to find activities they might enjoy and put themselves in a position where they may have to deal with ‘cognitive obstacles’ so they can see that they are getting better whilst being active. Butler et al looked at a meta-analyse of the effectiveness of CBT in the treatment of a variety of conditions and found it was ‘somewhat superior to anti-depressants in the treatment of adult depression’. This shows that CBT  is highly effective for treating UD as supporting evidence was found across an entire range of data, making the results more reliable due to the large amount of information covered. However, Holmes reported that in ‘the single largest study’ of treatments for depression, CBT appeared to be less effective than other psychotherapies and drug treatments. It was also pointed out that evidence for the effectiveness of CBT comes from studies of patients who have depression but no other symptoms. This suggests that CBT may be less effective for people who have multiple diagnoses or are considered to have comorbidity. It may be that CBT’s nature is to only focus on one mental illness due to how quick it is compared to other treatments for mental health disorders and therefore isn’t able to relieve all. In conclusion, the diathesis-stress model would suggest that someone is born with a predisposition for UD but something from their environment must trigger it in order for them to suffer from it. Therefore it makes sense that a physiological treatment such as drug therapy should be used alongside a psychological therapy such as REBT in order to ensure that the treatment does in fact work as Holmes’, Geller’s and Ferguson’s research has shown it may not.

A Comparison of Great Expectations and Oliver Twist :: comparison compare contrast essays

A Comparison of Great Expectations and Oliver Twist      Ã‚   Great Expectations and Oliver Twist are representative of the works produced by Charles Dickens over his lifetime. These novels exhibit many similarities - perhaps because they both reflect painful experiences that occurred in Dickens' past. During his childhood, Charles Dickens suffered much abuse from his parents.1 This abuse is often expressed in his novels. Pip, in Great Expectations, talked often about the abuse he received at the hands of his sister, Mrs. Joe Gargery. On one occasion he remarked, "I soon found myself getting heavily bumped from behind in the nape of the neck and the small of the back, and having my face ignominously shoved against the wall, because I did not answer those questions at sufficient length."2 While at the orphanage, Oliver from Oliver Twist also experienced a great amount of abuse. For example, while suffering from starvation and malnutrition for a long period of time, Oliver was chosen by the other boys at the orphanage to request more gruel at dinner one night. After making this simple request, "the master (at the orphanage) aimed a blow at Oliver's head with the ladle; pinioned him in his arms; and shrieked aloud for the beadle."3 The beginning of Oliver Twist's story was created from memories which related to Charles Dickens' childhood in a blacking factory ( which was overshadowed by the Marshalsea Prison ).4 While working in the blacking factory, Dickens suffered tremendous humiliation. This humiliation is greatly expressed through Oliver's adventures at the orphanage before he is sent away. Throughout his lifetime, Dickens appeared to have acquired a fondness for "the bleak, the sordid, and the austere."5 Most of Oliver Twist, for example, takes place in London's worst slums.6   The city is described as a maze which involves a "mystery of darkness, anonymity, and peril."7 Many of the settings, such as the pickpocket's hideout, the surrounding streets, and the bars, are also described as dark, gloomy, and bland.8 Meanwhile, in Great Expectations, Miss Havisham's house is often made to sound depressing, old, and lonely. Many of the objects within the house had not been touched or moved in many years. Cobwebs were clearly visible as well as an abundance of dust, and even the wedding dress which Miss Havisham constantly wore had turned yellow with age.9 However, similarities are not just found in the settings.

Bhopal Ethics Essay

The Bhopal gas leak was a terrible tragedy in which thousands of helpless civilians were killed and hundreds of thousands were injured as they slept. Determining who was at fault and, consequently, who should compensate the victims and clean up the site are questions that have plagued the affected parties, my Rotman classmates and the world at large for over 25 years. The analysis to follow, in attempting to present the roles and responsibilities of each major player, will demonstrate the incredible difficulty involved in assigning conclusive responsibility for the tragedy. This will be followed by my personal reflections on the incident in which I present an additional culprit to those discussed in class. Union Carbide Corporation (US): In seeking to assign responsibility for the incident, there are two clear opportunities to point the finger at Union Carbide Corporation. Firstly, pressure from the corporate office to stop losses backed Union Carbide India into a corner that led to the cost-cutting proposal that ultimately produced the disaster. If, as Milton Friedman said, the social responsibility of a business is to increase profits, then Union Carbide Corporation is under a purely fiduciary, and not a moral or ethical, responsibility to the company’s shareholders and their decision to approve the cost-cutting plan seems appropriate. Friedman’s view, however, is far from universally accepted. Many believe that corporations’ responsibilities to their shareholders, employees, customers and communities extend past fiduciary and enter the realms of ethics and CSR. These people will lay blame for the incident at Union Carbide Corporation for putting profits before people. A second criticism often leveled at Union Carbide Corporation is the fact that their inspectors had visited the Bhopal plant a year before the incident and noted sixty-one safety issues. A grand total of zero of these recommendations had been implemented by the time of the incident. While responsibility for implementation certainly rests with Union Carbide India, the parent company cannot escape blameless as they bear responsibility for following up and ensuring their plants are meeting their own safety guidance. This negligence led to disaster. Union Carbide India Limited: The Indian subsidiary of Union Carbide’s level of responsibility for the Bhopal tragedy is also difficult to determine. It clearly bears responsibility for non-functioning safety and emergency equipment that greatly exacerbated the scope of the tragedy. It is simply unacceptable that the cooling unit had been disabled for over one year. Union Carbide India also failed its responsibilities by hiring under-qualified and illiterate employees, and then failing to train them appropriately. These employees did not understand the dangers and worked in a world where minor leaks were commonplace and corroded instruments could not be trusted. As well, the subsidiary surely deserves blame for not correcting any of the safety violations identified before the incident. Defendants of the Indian subsidiary, however, will remind their critics that cutting these corners were required to keep their plant open and preserve their jobs and important pesticides. Without pressure from their US parent to eliminate losses, they argue, such drastic measures would not have been necessary. Here again we see how easily complications arise when attempting to assign responsibility for ethical lapses. Government of India: The government of India was the strongest proponent in bringing a Union Carbide plant to Bhopal as the prospect of jobs and much needed pesticides led to an offer Union Carbide could not refuse: cheap labour, tax breaks, few workplace safety restrictions and a guaranteed market for 100% of their output. The Government of India, in addition to economic growth, also bears responsibility for the safety and well-being of its citizens; here, they failed to live up to their full mandate. Firstly, the decision to favour economic growth over safety was questionable ethically and ended up costing them dearly. Secondly, the Government neglected the densely-populated shanty town that had grown up near the plant on land deeded from local officials. Its residents were the first and main victims of the poisonous gas. Still, many will argue that a cost-benefit analysis made creating jobs and accessible pesticide for a poor and hungry region the proper priority. While many were ultimately harmed by the leak, how many more had benefitted from the poverty-alleviating jobs and hunger-alleviating crops? Here again we find valid points and counter-points, leaving us no closer to assigning conclusive blame and responsibility for the tragedy. Dow Chemical: While Dow certainly protected itself in the purchase agreement from a legal standpoint, there are those that suggest the proper ethical action is for Dow to assume responsibility for any outstanding clean up and compensation. While this may innately feel like the right thing to do, the counterpoint that Dow had nothing to do with the incident and should not be punished after paying fair market value for Union Carbide is also valid. Personal Reflection: Analyzing the conduct of the major parties has not produced any conclusive allocation of responsibility. It is clear that each party deserves significant blame but no party deserves total blame. There is, however, an overlooked culprit that I believe deserves the bulk of the blame: the expectations market that has hijacked the decision making of US corporations(1). Ever-increasing emphasis on the expectations market (stock prices) instead of the real market (products/services, relationships with customers and communities) has left businesses making short-term, profit-chasing decisions at the expense of their reputation, ethics and long-term viability. Approving cost cuts that jeopardized safety in Bhopal is just one of all too many such instances. This juxtaposition of ethics vs. eeting financial expectations, however, is fatally flawed – there are many examples where ethical decisions produce long term financial success (Tylenol and Maple Leaf Foods recalls, for example). Queens University took the ethical route vis a vis the Radler donation and the class poll revealed that only a very small percentage of us had heard of that incident. I believe that if Queens had ta ken the easier, unethical decision and never offered to return the donation, this story would have been much more widely publicized and Queens would have suffered in the long run. Moreover, there is no shortage of examples where short-term unethical decisions destroy companies and make them miss their projections forever! (Enron, Bre-X, Nortel, etc – sadly this is a very long list indeed). In short, I disagree with Friedman and lay the bulk of Bhopal blame at the financial system in which Union Carbide operated. Fear of getting hammered by the expectations market led to corporate’s threat to close the Bhopal plant which set off the chain reaction that ultimately ended in tragedy. Fear of incurring further losses after the tragedy than focused Union Carbide’s efforts on avoiding liability, rather than taking the ethical high-ground and assuming fair responsibility for compensation and clean up. Corporate promotion of hypernorms such as integrity, compassion and responsibility will ultimately benefit all stakeholders and provide corporations with the enduring financial rewards that accrue to those that are respected and well-liked by the real market (ie. onsumers and communities, not analysts and speculators). We need to usher in a new era where businesses chase solid reputations and community longevity instead of quarterly earnings expectations. The default corporate reaction to adversity must shift towards upholding these hypernorms, rather than hiding behind lawyers and waiting until the blame has been transferred elsewhere. Realizing that employing the ethical strategy does not compromise, but actually enhances long term financial viability is a cruc ial first step.

Corruption of the Catholic Church - 1166 Words

Why is the Catholic Church so corrupt in its teaching? They have found ways to control the knowledge that their followers contemplate on. The control of knowledge and power is the foundation for every successful religious organization. The Catholic Church have acquired this power through strategic control on the mind of its follower. The Catholic Church propagate their ideals as righteous in order to be accepted; for without this acceptance, they are faced with the task of initiating this power through force. So to beguile their followers, they present themselves in â€Å"sheep clothing† (KJV, Matt 7:15). They are accepted as blameless, peaceful, loving and harmless but in actuality, â€Å"they are ravening wolves† (KJV, Matt. 7:15). According to†¦show more content†¦Union of minds, therefore, requires, together with a perfect accord in the one faith, complete submission and obedience of will to the Church and to the Roman Pontiff, as to God Himself†( Leo XII, p 3). These men have slowly deviated from the very foundation beliefs that held as holy. It is almost as if they created considered themselves inimical to Christ- a direct substitute. The followers of the Catholic see nothing wrong with the worship of their pope, which is a direct contradiction to their beliefs of a monotheistic God, and the Words of Christ, in whom they supposedly put their trust in. We are going to rewind back to the 15th century when the Catholic Church was known as the Roman Catholic Church and it was the strongest force to be reckoned with, because the Roman Empire because a combination of both a Religious Church and a Nation, in turn creating the papal State, that were of course governed by the Papacy. The Roman Catholic was so drunk with power that anyone who challenged their teachings and false doctrine, were either killed or excommunicated because they were considered followers of the devil; A group named the Albigenses, a group of French Bible believers, became the Catholic biggest enemy because they simply choose not to worship the almighty Pope, and for that, they were killed one by one. And these actions were justified because the pop e-their God,-declare it to be a righteous cause.Show MoreRelatedCorruption Of The Catholic Church1517 Words   |  7 PagesCorruption in the Catholic Church was real; the Church has always had a strong present in Mexico since the beginnings. For instance, those in the strong circle of the Church who are not part of the clergy have always been men of power who hold swayed over the government. They have passed laws that benefit the Church, such as the example I pointed out before of Title 1. Precisely, for this reason, was why the Mexican liberals hated the clergy. The main problem and reason why the anti-clerical liberalsRead MoreThe Corruption And Immorality Of The Catholic Church1285 Words   |  6 Pagesthe corruption and immorality of the Catholic Church. La Mandragola describes a great, wise, and virtuous woman, Lucrezia, who is turned sour and spoils. Lucrezia is manipulated by men to adhere to their wants and needs and, in the end, she becomes what every husband fearsâ€⠀unfaithful. This is very comparable to the behavior of the Catholic church during the same period; thus, Machiavelli thought to draw a parallel between the two. Many times throughout history and literature the Roman Catholic churchRead MoreChaucers Revelation of Corruption in the Medieval Catholic Church884 Words   |  4 Pagesvictims of the corrupt clergy of the Church. Author Geoffrey Chaucer shows how he views the Church in his acclaimed work The Canterbury Tales. 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When Martin Luther nailed his 95 Theses to the doors of Castle Church in Wittenberg, Germany, his goal was to reform the Catholic ChurchRead MoreThe Spread of Protestantism in the 1500s Essay805 Words   |  4 Pageswere cries for the restructuring of the Catholic Church. These cries grew into more than just a simple remodeling of the Catholic faith they grew into the Protestant Reformation. Martin Luther is credited for the reformation movement against the Catholic Church that began in 1517. The reformation began because of the corruption in the Catholic Church and the enormous amount of power the church had over Europe. During the sixteenth century the Catholic Church had tremendous sovereignty over theRead MoreMartin Luther And The Protestant Reformation1349 Words   |  6 Pages the Catholic Church was under siege from criticism based off of corruptions and Catholic wrongdoings; this time in history was known as the Protestant Reformation. 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