Understanding Types Of Depression And Treatment

[anthony]

Definition

• Clinical Depression is an emotional, physical and cognitive state which is more intense and long-lasting, and which has more negative effects on a person's day-to-day life.
• Robs us of finding meaning in life.
• Inhibits personal growth.

Types of Depressive Illness

• Unipolar mood disorders
  • Mood swing one direction > Down
    • Reactive; stressful events; gradual
  • Major Depression
    • Sudden
    • Endogenous
• BiPolar mood disorder
  • Mood swings up and down
• Seasonal affective disorder (SAD)

Symptoms (5+)

• Depressed mood.
• Suicidal ideation or self-harm.
• Feelings of guilt and worthlessness.
• Loss of interest and pleasure, including sex drive.
• Lack of motivation.
• Sleep disturbance.
• Decrease or increase of appetite or weight.
• Psychomotor retardation and agitation.
• Tiredness and loss of energy.
• Inability to concentrate or indecisiveness.

Causative Factors

• Some biological predisposition
  • Heritability
• Life events
• Cognitive distortions (thoughts)
• Ineffective use of coping skills
  • Problem solving skills (helplessness)
  • Assertiveness
  • Self award (self reinforcement)

Neurotransmitters

• The brain lacks chemicals responsible for mood.
  • Norephinephrine, seretonin, dopamine
  • They regulate sleep, appetite, pain, etc.
  • Carry messages between nerve cells.
• Only part of the problem.
• Not the same for everyone.
• The role of stress.

Co-Existing Conditions

• Panic disorder
• Generalised anxiety disorder
• Post Traumatic Stress Disorder (PTSD)
• Alcohol and substance abuse
  • Seeming benefits
  • Depressant
• Agoraphobia
• Social phobia

Associated Physical Conditions

• Physical illness (epilepsy, cancer)
• Pharmacological (steroids, amphetamines, sedative withdrawal)
• Endocrine (hyper or hypothyroidism, diabetes, Cushing's disease)
• Viral infections (hepatitis, AIDS, influenza)
• Neurological (MS, parkinson's, head trauma, stroke)
• Hormonal imbalance (postnatal, menopause)

Normal Depression

• Feeling blue, sad, down, normal upsets.
• Attitude: pessimistic or optimistic.
• Depression and creativity.
• Grief and loss.
• Life circumstances, i.e., poverty or loneliness.
• Normal life changes, i.e., puberty, childbirth and menopause.

Myths

• "Pull yourself together"
• "Snap out of it"
• Weak and/or mentally incompetent
• No visible problem
• Someone has "caused" the depression
• Unforgivable sin or being punished

Treatment

• Medication
• Counselling
  • Supportive counselling
  • Cognitive Behavioural Therapy (CBT)
  • Group therapy
  • Problem solving training
  • Assertiveness
  • Couples therapy
• Electro-Convulsive Therapy (ECT)
• Self-help

Self Help

• Nutrition
• Sleep
• Assertiveness: say NO
• "Pleasure days"
• Use of "time out"
• Reward yourself
• Decrease self criticism
• Enhance self esteem