The Treatment of Major Depressive Disorder - Essay Example

Major Depression Disorder Major depressive disorder, also known as the Unipolar disorder, involves changes in the mood of an individual (Faces of Abnormal Psychology Interactive Application, 2012). Such moods include sadness, anxiety, and apathy. In addition, other moods that can characterize depression disorder include numbness, vitality and self-regarding feelings of guilt, unworthiness, pessimism or even feelings of committing suicide. Marla says that her relationship with her husband was fine until he started becoming violent and drunkard. Ever since, her romantic life has spiraled to the ground. Further, the disorder may sometimes be characterized by changes in sleep patterns, as well as significant changes in appetite and weight (Barlow & Durand, 2005). Major depressive disorder, in other terms, is a situation whereby a person may be experiencing serious disturbance of the mood, actions, attention processes, and bodily health. In the case of Marla, depression has been brought about her divorce and unsocial life. Major depressive disorder should not be taken for granted, nor should it be related with feelings felt when a loved one dies or divorce. In most cases, sadness and grief are used to react to normal life challenges. With time, and in most cases without taking prescription drugs, sadness and grief fade away, and Marla may continue with their normal lives. On the contrary, without good treatment, Marla’s depression resulting from Divorce and the care of her children who have been forced to live in a single parent life situation often persists. But with careful specialized treatment, most people improve significantly (Faces of Abnormal Psychology Interactive Application, 2012). In most instances, major depressive disorder is recurrent, episodic illness. This can mean that the individual, who may have been depressed once and has been treated, is likely to experience more depression or more episode of depression in their lives, mostly within 2 to 3 years. If depression is not treated, or is not treated adequately; it can pose serious dangers to human health. According to American Psychiatric Association (2000), nearly one in six people with severe, untreated depression commit suicide. However, it should be noted that seeking help or other health care practitioners is important and in most cases a decisive step in the right direction towards recovery. Many people with major depressive disorder often do not realize that they have a health problem. Their loved ones and their family members may consider depression to be a sign of personal weakness. Some depressed individuals, often blame themselves for having the moods and feelings that are linked to their illness, they therefore choose not to seek medication. The signs and symptoms of major depressive disorder should not cause shame and discomfort to any person. The symptoms are very important in instances when medical help in required. Medical practitioners are becoming more and more informed that depression is a very serious illness. The route of an incident of major depressive disorder is expected, and there are many treatments that tackle different aspects of the illness and, in the several majorities of cases, produce a positive effect (American Psychiatric Association, 2000). Major depressive disorder is one type of depressive illness or mood disorder. Other types of depressive illness consist of bipolar disorder also known as manic-depressive illness and Dysthmia. Bipolar disorder involves a condition of depression alternating between conditions of mania and Dysthymia (Faces of Abnormal Psychology Interactive Application, 2012). Mania involves a situation whereby an individual experiences high and extreme feelings that may be dangerous to the individual, Marla has had bad relationship experiences in her life that are really disturbing her mind. On the contrary, Dysthymia involves conditions similar to those experienced in major depressive disorder. The symptoms are milder but may last for some time, and even though they might be disabling, they inhibit an individual from feeling good or operating at full strength. In most cases, a person with Dysthymia may also experience depression symptoms (American Psychiatric Association, 2000). Origin of Depression Disorder Depression was originally known as melancholia by several health practitioners in the early medieval periods. In the medieval periods in ancient Greece, the disorder was thought to be caused by the disparity in some of the body fluids or humors. Human personality was also thought to be as a result of the dominant humor in an individual. Further, those patients who had this disorder in the early 1980s thought they were simply suffering from normal day stress. However, medical practitioners took long to find the appropriate treatment for the disorder which was characterized by lack of interest in virtually all spheres of their lives. Further, the American Psychiatric Association introduced the idea of major depressive disorder to their system commonly known as the Diagnostic and Statistical Manual of Mental Disorders (DSMIII). During this time, the disorder was not well known by the psychiatric society; therefore, effective treatment for the disorder was not adequate. Further, electroconvulsive therapy was the main type of treatment used during the early 1980s for the patients who felt moods of extreme sadness (Barlow & Durand, 2005). Cognitive Model Behaviorists assert that human actions are determined majorly by their experiences in life; Marla’s less social life and the husband abuse have led to the depression. The behavioral model majorly outlines on behaviors and responses individuals make to their surroundings. Behaviorists have also classified behaviors into internal and external type of behaviors. External behaviors in this case involve going to work or not going to work, while internal behaviors involve feelings or thought, Marla experienced a lot of domestic violence. Major behaviorists base their arguments and treatments of depression on the principles of learning. This involves the processes by which actions of individuals in relation to the environment (Rush, 2012). Several accepted behaviors help human beings to cope with numerous daily challenges so as to lead a happy and fulfilling life. On the contrary, unexpected behaviors can also be acquired by human beings. Behaviorists who try to explain Marla’s disorder might view her as a person who has received improper training on how to handle life challenges but this should not be the case since domestic violence is a major cause of depression, particularly if it can lead to psychological torture. She has learnt behaviors that affect her normal life activities such as sleep and work, these behaviors constantly work against her. Cognitive Behavior therapy (CBT) actions to the handling of depression are often cited as being suitable for the older population since they focus on the immediate needs and interventions. In addition, CBT focus on the development of skill and practice, and the well planned nature of sessions. Depression clients are taught the link between thoughts, behaviors, and mod to enable them gain a better understanding of the factors causing depression, Marla says that “My relationship with my husband was fine until he started becoming violent and drunkard. Ever since, my romantic life has spiraled to the ground.” Throughout the cognitive behavior treatment process, patients are made to realize that skills are important in managing their depressive symptoms. CBT treatment process can be done in the following sessions (Rush, 2012). Early Session of CBT In this session, the focus is on collecting important past information on why the client is seeking treatment at this time. The therapist already knows that the causes of depression to Marla are as a result of domestic violence, and divorce. Mental health information may involve any prior experience with therapy, patient needs for therapy, and then making Marla to adapt to the social environment of the CBT process so as to develop a working therapeutic relationship. At the beginning of therapeutic relationship, the main aim is to collectively come up with common goals for treatment. Coming up with common realistic goals is important because they may provide psycho-education made for the effective client understanding, while also trying to control the situation that made the client to seek for treatment. In the treatment process, aims should be tackled in a way that consistently encourages and honors Marla’s personal resources in her attempt in achieving maximum functioning (Rush, 2012). During the early sessions, therapists need to observe for and attend to any sensory deficits the clients may have. Approximately 14 percent of community-dwelling older adults have some type of sensory deficit and the prevalence increases with age. (Rush, 2012, p 45). Further, any issues that the depressed Marla may have about therapy in this session must be adequately assessed and addressed in a collaborative manner during this session, for instance, Marla says that “I have been close to my parents and brother but I stay a long distance away from them. I rarely had time to spend time with my aunts, uncles and grandparents as they live in a different state.” The therapist should help Marla find a way of connecting with her extended family members. Measures including relaxation techniques can be put into the session so as to help the patient learn how to manage distress and to reduce mood disturbances that can lead to unfortunate overall well being and cognitive capacity. During the middle session, the focus in treating Marla should be on education and skill development. In this session, Marla should be taught more about depression, its prevalence, and its common causes. Further, Marla should be introduced to the CBT framework of thoughts, behavior and mood. Most important aspect is that clients are taught the factors that influence depression and how their views, actions, and relations with others affect their mood, and the connection between physical health and mood, as well as how positive change of behavior in one of these areas affect other areas (Beck, Rush, Shaw & Emery, 1987). During session two, clients are taught to identify maladaptive thought patterns and their antecedents, attending to the specific negative/harmful thoughts and positive/helpful thoughts that they have about a particular situation as well as examining the consequences of these patterns of thinking. (Beck et al, 1987, p 78) Further, therapists and patients collectively determine adaptive techniques that can alienate negative thoughts in the mind of the patient, Marla rarely socializes with neighbors. The client is then shown how to replace destructive thoughts thereby helping him/her build a perception a perception of control over performance at work. Later sessions involve determining potential barriers to task completion of an individual suffering from depression. In addition, the later session is also viewed in terms of trying to find solutions to the problem affecting the client suffering from depression such as divorce and domestic violence as well as the lack of capacity to socialize with friends. The therapist concentrates in the assessment of the patient’s support network ant tries to maintain or improve the support network. In addition, the interpersonal relations that might be causing depression are assessed; such interpersonal relations include role changes such as restlessness at work, or changes in grief that might lead to depression. If there are conflicts arising in relations with loved ones, the therapist concentrates on skills training in the form of assertiveness training. Further, listening skills or setting limits may also be crucial in the third session of therapy (Beck et al, 1987). In the problem solving session, the therapist is expected to follow some five important steps. The steps involve identifying the problems, brainstorming possible strategies to solve these problems, encouraging evaluation, identifying possible solutions and trial of the chosen solution. These steps can be used to empower depression patients increase a sense of mastery. In addition to these strategies, great importance is put on recognizing when symptoms may recur or cause further complications so that the patient may get support earlier. Determining extra physical health problems that could lead to depression such as sleep difficulty and pain is important since the therapist will be able to address them as required. The problems of sleeping difficulty and pain can be addressed by the therapist through the teaching of relaxation skills and improving good sleep hygiene. These skills are very important in the third session of therapy. Sessions of therapy should also be spaced evenly during the last phase of treating depression so as to give the client enough time to independently to use the skills that have been taught during treatment. The client should also explore areas that remain problematic while still consulting with the therapist (Beck et al, 1987). Conclusion Depression disorder, if not well addressed by both the therapist and the client, can lead to serious problems in life. Many people with major depressive disorder such as Marla often do not know that they have a health problem. Their loved ones and their family members may believe depression to be a sign of personal weakness. Some depressed individuals, for instance, Marla, often blame themselves for having the moods and feelings that are linked to their illness; they, therefore, choose not to seek treatment. The signs and symptoms of major depressive disorder should not cause humiliation and distress to any person. The symptoms of depression are very important in instances when medical help in required to help the patient return to normal life. Medical practitioners are becoming more and more informed that depression is a very serious disorder. The route of an incident of major depressive disorder is expected, and there are many treatments that tackle different aspects of the illness and, in the several majorities of cases, produce a positive effect. It should be noted that in most cases, sadness and grief are used to respond to normal life challenges. With time, and in most cases without taking prescription drugs, sadness and grief fade away, and people continue with their normal lives. On the contrary, without good treatment, depression often continues affecting individuals. But with careful specialized treatment, most people improve significantly. References American Psychiatric Association (2000). Diagnostic and Statistical manual of mental disorders, Fourth Edition. Washington, DC: American Psychiatric Publishing. Barlow, D. & Durand, V. (2005). Abnormal Psychology: An integrative approach (5th ed.). New York, Thomson Wadsworth. Beck, T., Rush, J., Shaw, B. & Emery, G. (1987). Cognitive therapy of depression. New York, Guilford Press. Faces of Abnormal Psychology Interactive Application. Retrieved from http://www.mhhe.com/socscience/psychology/faces/#. Rush, J. (2012). Fundamentals of abnormal psychology (6th ed,). New York, NY: Worth. Appendix: Check Point Clinical Interview Questions 1a). What is your age bracket? i) Below 15 years [ ], ii) between 15 and 20 [ ], iii) between 20 and 25 [ ], iv) above 25 [ ] b). What is your marital status? i) Married [ ], ii) Single [ ], iii) Divorced/Separated [ ], iv) Widowed [ ] c). What is your religion? i) Christian [ ] ii) Muslim [ ] iii) Hindu [ ] iv) Others [ ] (specify)- d). What is the highest of level of education that you have attained? i) Primary [ ] iv) Diploma [ ] ii) Secondary [ ] v) Undergraduate [ ] iii) Certificate [ ] vi) Post-graduate [ ] vii) Others specify …………………………… e). Which is your most comfortable social environment? i) Family [ ], ii) Friends [ ], iii) Extended family [ ], iv) Boyfriend/ Girlfriend [ ] f). Specify why the choice for number 5 is your preferred answer....I am greatly attached to my two children. They are the source of my joy................................................ 2 a). Who is your favorite family member? i) Mother [ ], ii) Father [ ], iii) Sister [ ], iv) Brother [ ], v) All are equal [ ] b). According to your answer in 2a above, what is the reason for your choice? Since childhood, I have always been more attached to my father compared to any other family member. I spent a lot of time with him while my mum went working as an expatriate in my younger days. 3. Give a brief explanation of your family in the following respects: i). its size (I have a small family consisting of my two children, father, mother and brother) ii). its members (My two children, father, mother and brother – I am closest to my two children although they mostly spend time in school) iii). your residence (previous and current) – When I separated from my husband, I left home and went to stay in a different city with my two children. iv). extended family ties – I have been close to my parents and brother but I stay a long distance away from them. I rarely had time to spend time with my aunts, uncles and grandparents as they live in a different state. 4a). In your own opinion, how would you describe your childhood life in terms of family and friendship experiences? (Comer 70) – Our family was close knit, parents very supporting. Had several friends during my childhood and was quite social. b). Give a description of your current or recent general social life experiences in various settings including: i). school life (concentrated more on studies than social life) ii). neighborhood life (rarely socializes with neighbors) iii). religious life (not very religious) 5a). Have you had a bad relationship experience that you want to erase in your life? i) Yes [ ], ii) No [ ] b) If yes in 5a above, give a brief description……Lived with a violent and alcoholic husband for over 10 years. I experienced a lot of domestic violence…………………………………….. 6. What is your take on the impact of family and social interactions you had in childhood and in adult life? i) Comment on impact of childhood interactions – I was less social during my childhood. I preferred to stay with my immediate family and concentrated on my studies…………………………………….............. ii) Comment on impact of adult interactions – I am not very social today, this began during my childhood…………………………………….............. 7. What is your account on personal experience with romantic relationship? My relationship with my husband was fine until he started becoming violent and drunkard. Ever since my romantic life has spiraled to the ground. 8. At what age did you engage in a romantic relationship? i) Below 18 years [ ], ii) Above 18 yeas [ ] 9. Have you had an abusive relationship in your entire life? Yes [ ] No [ ] i) If yes, specify ii) The age at which it occurred………30-41……………… iii) The perpetrator of the abuse…Husband……………………. 10 a). According to your estimation, how would you rate your performance in terms of dealing with disappointments? i) Excellent [ ], ii) very good [ ], iii) Good [ ], iv) Fair [ ], v) Poor [ ] b). What is your personal rating on your ability to deal with different social pressures? i) Excellent [ ], ii) very good [ ], iii) Good [ ], iv) Fair [ ], v) Poor [ ] c) Which relationship environment is easier to deal with in terms of disappointments and stress? i) Family [ ], ii) Friends [ ], iii) Girlfriend/ Boyfriend [ ] Read More