21 behavior fosters or threatens individual and group well-being p. 5. Seen from
that perception, abnormal behavior is stated as maladaptive behavior. That behavior includes the traditional categories of mental disorders, such as
alcoholism, assault, hostility, and political corruption, in spite of whether that actions condemned or excused by given society. Those actions can lead to
personal distress that often results in destructive group conflict p. 6. From the delineation above, there are the foremost things that must be
ruled out, that abnormal behavior is manifestation of a behavioral dysfunction or disability. In addition, abnormal behavior is culturally sanctioned that means it
based on the societies’ values and culture, by putting beside the fact that perhaps for others society asses that it is not logic. Seen as behavior as maladaptive,
Carson, Butcher, and Mineka state and define it as manifestation of mental disorder that continually diverge from individual and group well-being. It shows
that behavior as maladaptive can make result harmful and risky consequences for others p. 6.
6. Depressive disorder Unipolar disorder
Carson, Butcher, and Mineka state that the depression happens as results of sadness, discouragement, pessimism, and hopeless. Depression is unpleasant
feeling when we are in those situations, but it usually does not last long p. 212. Coleman 1976 asserts that in depressive type, the individual tends to
experience sadness and loneliness feeling. Further, he also mentions the in this depressive type the individual speaks slowly in a monotonous voice. He limits
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22 himself to brief answers to questions. He rarely asks questions: he avoids people
and has a listless facial expression and a stooping posture. Commonly, individual who suffers this depressed accuses himself that he is guilty for all of what he has
done p. 340. Carson, Butcher, and Mineka explain that in the depressed phases of mild
to moderate, a person’s mood is dejected, and the individual experiences loss of interest or pleasure in usual activities. In addition, the individual may show sleep
irregularity too much or too little, low energy levels, feelings of inadequacy, decreased efficiency, productivity, talkativeness, and cognitive sharpness, social
withdrawal, restriction of pleasurable activities, including relative lack of interest in sex, a pessimistic and low-spirited attitude, and tearfulness pp. 219-210.
Carson, Butcher, and Mineka 2000, pp. 224-255 mention some causal factors of unipolar disorder, which come from biological, psychosocial, and
sociocultural factors. a. Biological
Causal Factors
They say that a variety of diseases and drugs can affect feeling or mood disorder. And even, sometimes it can direct to depression, and sometimes to
elation or even hypomania. The researchers have considered the biological factors into genetic or heredity factors and other factors, such as neurophysiological,
neuroendocrinological, biochemical alterations. 1 Hereditary
Factors Here, Carson, Butcher, and Mineka review some outlooks of some studies
related to heredity factors and they also conclude that since it is difficult to
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23 separate heredity and environmental influences, however, a higher rate disorder
among family members cannot be always concluded as a proof of genetic causation. Plomin et al. state “the prevalence of mood disorder is higher among
blood relatives of persons with clinically diagnosed mood disorders than in the population at large”. Katz McGuffin and Plomin also affirm that “the case for
some hereditary contribution in the causal patterns of unipolar major depression is quite strong, although not as strong as for bipolar disorder” as cited in Carson,
Butcher, and Mineka, 2000, pp.224-225. 2 Biochemical
Factors This theory of biochemical factors has been developed starting in the
1960s. This theory explains that depression may appear as a result of neurotransmitter disequilibrium. The function of that neurotransmitter is to
regulate and mediate the activity of the brain’s nerve cells. The disturbance that happen in neurotransmitter may comes as a result of using electroconvulsive
therapy or antidepressant drugs, which is used by the biological therapies to treat the sufferers of severe mood disorders, since those therapy and drugs may have an
effect on the concentrations or the activity of neurotransmitters at the synapse and also can cause the brain pathways are relatively unstable and slow in conducting
message. 3 Neuroendocrine and Neurophysiological Factors
These factors are correlated to hormonal aspects that influence on mood. That is affirmed by some researchers. Some of them are Checkley and Shelton
who mentioned that there has also been a good deal of research on the possible
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24 neurophysiological and neuroendocrine hormonal correlates of some
distinguishable forms of mood disorder as cited in Carson, Butcher, and Mineka, 2000, 226. In conclusion, some hormones in human body have significant effect
to the condition of individual mood or feeling. 4 Sleep and Other Biological Rhythms
The findings of sleep disturbances have existed as long as depression has been studied. Further, Carson, Butcher, and Mineka reveal that depressed patients
show a variety of sleep problems, starting from waking up in early morning, decreasing sleep or periodic awakening during the night poor sleep maintenance,
and difficulty falling asleep. 5 Sunlight
and Seasons
Some researchers state that sunlight and seasons are related to the alteration of mood disorders. Oren and Rosenthal state that “in this type of mood
disorder, most patients seem to be responsive to the total quantity of available light that accepted in the environment”. The same idea also mentioned by Wehr et
al and Whybrow that say “most patients will experience depression in winter and fall and they become normal in spring and summer” as cited in Carson, Butcher,
and Mineka, 2000, p. 228. Those views explain that the patients will be better if they accept the sunlight in quite great quantities, since sunlight itself can help
some hormones in the body to make the feeling joyful and pleased. There are also some researchers consider that basic activities such as sleep, activity, and appetite
are correlated with the amount of light in a day.
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25 b. Sociocultural
Factors These factors are related to the society and culture where the sufferers live
in. Since society and culture itself can affect the psychological or mental condition of those who suffer the manic-depressive disorder. These factors as mentioned by
Carson, Butcher, and Mineka 2000, pp. 249-251 consist of: 1 Relieving
Losses One study stated by Seligman explains that the society which still has
reciprocity custom, the possibility of the depression to exist is low as cited in Carson, Butcher, and Mineka, 2000, pp. 249-250. That case may happen since
the reciprocity custom can help the individual who suffer the mood disorder to attempt against loss becoming helplessness and hopelessness and also it can help
to prevent loss from becoming despair that then it breaks up the process of depression.
2 Demographic Differences in Society Kaelber et al. say for unipolar disorder the poor have higher rates of major
depression. In association with marital status, it is stated that single and divorced persons tend to experience unipolar depression than do those who are married as
cited in Carson, Butcher, and Mineka , 2000, pp. 250-251. For the treatments of unipolar disorder, there are some treatments
mentioned by Carson, Butcher, and Mineka pp. 251-255. They also note the side effects or outcomes of these treatments. The treatments that mentioned as follow:
a. Pharmacotherapy and Electroconvulsive Therapy
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26 The patients who suffer this unipolar depressive are commonly given
antidepressant drugs. Carson, Butcher, and Mineka also propose that unfortunately these drugs have unpleasant side effects, such as dry mouth,
constipation, sexual dysfunction, and weight gain. 1 Selective Serotonin Re-Uptake Inhibitors
Since those antidepressant drugs have bad side effects, physicians increasingly prescribe another antidepressant drug to help their depressed patients.
The antidepressant was chosen from the selective serotonin re-uptake inhibitors, or that abbreviation is called SSRIs, which is called Prozac. As antidepressant
before, Prozac also has unpleasant side effect that the patients often complain. Many of these drugs can affect orgasmic problems or lowered interest in sexual
activity. 2 The Course of Treatment with Antidepressant Drugs
Carson, Butcher, and Mineka note that antidepressant drugs may give those effects at least for several weeks. The patients who use these drugs
continually, at the situation the symptoms have decreased, it may cause the symptoms to relapse again. Whereas, if the depressed patients stop using of these
drugs because they feel better, the possibility for the symptoms to relapse again may likely increase since the symptoms still exist.
3 Electroconvulsive Therapy
Electroconvulsive therapy or ECT is often used for the patients who experience severely depression, for instance the patients who want to risk their life
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27 for suicide. ECT is also used for the patients who cannot respond the
pharmacological treatment very well.
b. Psychotherapy Psychotherapy either in individual or group therapy that followed by the
using of drugs or even electroconvulsive therapy can help the patients to develop more stable alteration within long range. In addition, some forms of this therapy,
either they are combined with drugs or without combination, can help much the sufferers to reduce the increasing relapse within a two-year period.
1 Cognitive-Behavioral Therapy
This therapy is one of the best-known of specific psychotherapists for unipolar disorder, which is proposed by Beck and colleagues. Another is the
interpersonal therapy IPT program proposed by Klerman, Weissman, and colleagues. This cognitive-behavioral therapy associated with cognitive-
behavioral techniques directed to convert and direct the negative thoughts and beliefs of the patients so that they can identify and correct their distortions of their
assumption and beliefs as cited in Carson, Butcher, and Mineka , 2000, p. 254. 2 Interpersonal
Therapy IPT
It is noted that this therapy as strong and well as the cognitive one. That is also evidence that show this therapy as effective as antidepressant drugs in which
able to run the course of milder cases, and even severe, of major depression. Further, the patients who receive this therapy continually within once a month are
much less to have recurrence.
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28 3 Family and Marital Therapy
This therapy included because as mentioned a little bit more before that family and marriage problem can be stressors in a patient’s life, in which the
correlation is those unpleasant life situations may cause the depression to relapse again and may require longer treatment. Therefore, the interference of family
member or spouse or couple needed to reduce the level of expressed emotion and to prevent recurrence. It is also suggested that for married people who are
depressed and having marital conflict can join this marital therapy, in which this therapy has been studied as well as cognitive therapy in reducing unipolar
depression.
7. Manic-Depressive Disorder Bipolar Disorder
