Depression in the context of abnormal psychology - Essay Example

Running Head: A study of Depression A study of Depression in the Context of Abnormal Psychology of Abstract Depression refers both to a serious mental disorder and to a normal mood involving sadness that all people occasionally experience. The duration and grouping of symptoms distinguishes depression as a mental disorder from occasional feelings of sadness. This article discusses depression as a disorder. Medical experts believe that depression causes more disability throughout the world than almost any other medical illness or disorder. As the number of patients suffering with different types of depression is showing an abrupt increase over past few years, it has become imperative to evaluate its causes and treatment modes. This paper intends to analyze a number of research studies in the context of symptoms, causes, diagnosis and treatment and even the results of various modes of psychotherapy and antidepressant medicines. A study of Depression in the Context of Abnormal Psychology Introduction The evolution in our understanding of abnormal psychology is revealed by the changes in the way we have treated those suffering such disorders. For most of history, the emotionally disturbed were considered to be society's castoffs. They were commonly locked up in prisons or workhouses alongside criminals. No exception was made for children, who were generally considered to be merely small adults. (Coriat, 1999) The predominant method today is based on the Diagnostic and Statistical Manual of Mental Disorders (DSM), first published by the American Psychiatric Association in 1958. It contains descriptions of symptoms of each recognized form of abnormal psychology. It is similar to the International Classification of Diseases (ICD), compiled by the World Health Organization (WHO), but contains more detail. Both the DSM and the ICD are revised periodically to include new research findings and to reflect the changing views of abnormal psychology. (Coriat, 1999) The basic categories of abnormal psychology are schizophrenic disorders, anxiety disorders, mood disorders or depression, dissociative disorders, personality disorders, and organic disorders. This paper intends to study only one aspect of abnormal psychology in detail, that is, Depression. This paper will shed light on various research studies about symptoms causes and treatment of Depression. Lets proceed to what Depression actually is and how can it be treated. Depression According to Ainsworth (2000) a mental state that is characterized as uncomfortable and regarded as discouraged, blue or dejected is referred to as Depression. In layman's words it is a mood state that in medical terms maybe referred to as the Dysthymia that is comparison to the Euthymia that is normal state, and the other opposite one that is Elation. The depression itself maybe a mental disorder or be a symptom of another disorder. In the category of the transient depression, some normal human behaviors or reactions to certain situations may be included. For instance, mourning is usually and normally considered to be one reactions after some kind of loss, however it is the case that it is usually considered to be depressive. A considerable depression, in world's population, occurs in about 10 to 20 percent in the course of a lifetime, where women are more prone to it as compared to men with a 2:1 ratio. The primary reason for this difference is usually due to the social and cultural aspects rather than the biological ones. People that are relatives of the patients that have major depression are usually at higher risk of getting depressed, and about 2 percent of the populations may have depressive personality that is a chronic disorder. Some conditions that may be referred to this state are the materially stimulated mood disorders also entail periods of depression, bipolar disorder, and cyclothymic disorder. (Ainsworth, 2000) Symptoms According to Randolph (2009) there are significant symptoms of depression that determine it. According to American Psychiatric Association's list of Diagnostic and Statistical Manual of Mental Disorders following are some symptoms: 1. exhaustion and loss of liveliness; 2. Frequent feelings of casualty or suicide, or suicide try. 3. Sleeplessness, or amplified sleep; 4. Thoughts of unimportance, guiltiness, or unnecessary or unsuitable guiltiness; 5. Confrontation, or retardation, of progress and contemplation; 6. Reduced facility to ponder, or vacillation; 7. Reduction of attention or contentment in customary behavior or reduction in sexual drive; and 8. Reduced desire for food and considerable weight loss, or the vice versa. It is not the case that all of the above symptoms may be observed simultaneously in a person who is depressed; as all or some may be present though, and the subject may not him as being depressed at all. For the purposes of the psychiatric medication, is someone demonstrates a considerable depression phase as if he or she shows loss of pleasure and interest in either all or some of the usual practices and demonstrates at least four of the symptoms discussed above, then the professional and medical assistance would be considered as necessary for such person. (Randolph, 2009) Reasons for Depression Dozois et al. (2009) elucidate in psychological context, depressions are perceived as the reactions to the isolation from a values object or person or due to a loss; such depressions are referred to as the neurotic depressions or the reactive depressions; usually these depressions are compared to the other severer types of depressions of which it is easy to determine a source with substantial precision. Theses depressions, in medical terms, are known as the psychotic depressions or the endogenous depressions or the depressions that are common of hallucinations or delusions. Moreover, Melancholia was the term used to refer all sorts of depressive states in earlier days, however now only the severer ones are known as this. As these distinctions are not easy to be determined they aren't helpful to let professionals decide that what means of treatment is appropriate for a particular depressed patient.(Dozois et al., 2009) Unfortunately, there is a common perception among the older adults and their assistance providers that depression is expected and normal in older age. Also it may be the case that these adults may not be comfortable with the treatment they are receiving, thus making the diagnoses and treatment difficult. Therefore it can be suggested by these results that there is a dire need for the state health intervention to better enable the care providers and receivers to realize this particular situation. (McFarlane, 2009) In the following content, the recent developments are discussed that help to better understand the symptoms of depressive disorders and also particular attention is given to the overview of diagnoses practices, public influences of these disorder, risk issues and prevalence. Overview of Diagnostic Methods Diagnostic Criteria for Dysthymia and Depression Chapman and Perry (2008) in their research study explain that the occurrence of major depression is said to have occurred if at least five or more of the following have been observed during the current two week intermission, with at least one of these symptoms have to be either loss of interest and happiness in practices and activities that were pleasuring previously or the depressed mood. These five indications are as follows: persistent feelings of death damaged attentiveness sleeplessness or hypersomnia exhaustion considerable weight loss or gain thoughts of triviality Psychomotor confrontation or retardation failure of concern or satisfaction in formerly pleasant actions or inapt remorse disheartened temper The diagnoses of dysthymia may seem to be analogous to the detection of depressive states, as only two or more than two of the following symptoms are enough to express that dysthymia has occurred, these are: - thoughts of despondency - wakefulness or hypersomnia - inappropriate deliberation - low self-respect - weakness - poor desire for food or eating too much Moreover it is also necessary to prove the occurrence of Dysthymia if, for most part of the day person demonstrates depressed mood or more days in an interval or time of two years, and also he or she is not asymptomatic for not longer than the duration of two months during the same two year time. Therefore it can fairly be said that, unlike, Dysthymia is a more chronic situation, though with lesser disabling symptoms in contrast to depression. Even though, perceived to be less eroding than depression, Dysthymia is not at all am illness that should be treated with ease. According to a research carried out by Joiner et al, it was shown that people who suffered from double depression that is 'depression and Dysthymia at same time' had significantly higher rates of hopelessness in contrast to those who suffered form only depression or only dysthymia. (Joiner et. al., 2007) Risk Factors, Co-morbidity, and Prevalence A longitudinal revision of records from three districts that are East Boston, Massachusetts; New Haven, Connecticut; and two counties in Iowa), The Established Populations for Epidemiologic Studies of the Elderly, evaluated over a six year period 5751 elderly adults who weren't depressed whereas 496 who were depressed. The disheartened grouping had a comparative peril of 1.67 (95 percent CI, 1.44-1.95) for incapability to perform daily activities and chores and of 1.73 (95 percent CI, 1.54-1.94) for mobility mutilation. These outcomes propose that even though depressive ailments may not be exceedingly common in old age adults, they create severe influences to fitness and performance. (Drayer et.al, 2005) According to Serebruany et al (2005), amongst patients with Acute Coronary Syndromes (ACS), the finding of melancholy is a sovereign jeopardy feature for transience. One category of antidepressant prescriptions is thought to restrain a platelet commotion that is the serotonin-specific reuptake inhibitors (SSRIs), which may defend the heart autonomous of its use as an antidepressant (30). And as depression usually pursues the ACS, this feature may be predominantly important because it is connected with an augmented risk of death (23). Glassman et al (23) found, in a randomized, double blind, panacea proscribed study of 369 people with depression and ACS that fifty three percent of depressive phases instigated before hospitalization for the index episode of ACS. The subsequent groupings of patients gained from management of an SSRI agent: patients with experiences of depression foregoing their ACS, over four year research duration, patients whose periods were rigorous and patients with an account of depression. The results lead to the significance of considering both psychiatric and somatic issues for trying to optimize treatment for the elderly with the cardiovascular disease, and more generally, they point toward the interconnectedness of the pathophysiology of appendage systems. Treatment of Depression Combination of Psychotherapy and Antidepressant Medicines (TADS) An experimental tryout of around 500 people having foremost depression resulted in a blend of both drug therapy and psychotherapy as an operative management. This study was financed by the NIMH (National Institute of Mental Health) which evaluated CBT (cognitive-behavioral therapy) through Fluoxetine, presently the single antidepressant medicine by FDA (the U.S. Food and Drug Administration) to be used for the treatment of depression specially among young patients. The report of its findings was presented by the Duke of University Dr. John March and was published in JAMA the journal of Medical Association in August issue, 2004. (Combination Treatment Most Effective in Adolescents with Depression, 2004) The TADS (Treatment for Adolescents with Depression Study) conducted these trials all through the country at 13 different places. The findings of initial 12 weeks revealed a positive response to the combination among around 70% patients, whereas, around 40% responded only to Cognitive Behavioral Therapy and around 60% only to Fluoxetine. The results of the first 12 weeks of the Treatment for Adolescents with Depression Study (TADS), conducted at 13 sites nationwide, show that 71 percent responded to the combination of fluoxetine and CBT. The other three treatment groups, of participants between the ages of 12 and 17, also showed improvement, with a 60.6 percent response to fluoxetine-only treatment, and 43.2 percent response from those receiving only CBT. The response rate was 34.8 percent for a group that received a placebo. The disparity in reaction paces on behalf of last two healing factions seems to be statistically unsubstantial. (Combination Treatment Most Effective in Adolescents with Depression, 2004) Further Research on Antidepressants for Treating Depression Dr. Gijsman, Harm J. conducted this research with his colleagues with an objective to analyze protection of patients using antidepressant medications for immediate management of depression, through verification from randomized and restricted tests. Methodology The instigators executed a methodical assessment and investigation of randomized, proscribed tests. They pursuit for the Cochrane Collaboration Depression, Nervousness, and Obsessions Proscribed Tests Record, integrating effects of explorations of LILACS , MEDLINE, , CINAHL, PSYNDEX, PsycLIT, and EMBASE. The major result procedures had been the fraction of patients who reacted to handling and the pace of controlling obsession. (Gijman et al., 2004) Outcomes There were more than one thousand patients who were allocated at random for around twelve randomized tests. One or more than one antidepressants were compared with the placebo in first five tests; mood stabilizers were being given to around 75 percent of them and the antidepressants proved to be further successful than the placebo. Antidepressants were not more stimulated for controlling the mania. Almost six tests permitted contrast concerning both antidepressants. (Gijman et al., 2004) Conclusion Antidepressants medicines are useful for immediate handling of depression. The test statistics declined to recommend that swapping is a general initial impediment for management with antidepressants. It may be careful to use a selective monoamine oxidase inhibitor or serotonin reuptake inhibitor somewhat than tricyclic antidepressant as initial treatment. Provided the incomplete substantiation, persuasive necessitate exists for more learning with extended record phases and cautious description and transcribe of rising obsession and limited diminution. References Ainsworth, P. (2000). "Understanding Depression". University Press of Mississippi. P. 3-21. "Antidepressants for Bipolar Depression: A Systematic Review of Randomized, Controlled Trials". American Journal of Psychiatry, 161:1537-1547, September 2004. Chapman, D. P. & Perry, G. S. (2008). "Depression: As a Major Component of Public Health for Older Adults". Preventing Chronic Disease, Jan, 2008. Health and Human Services Department (HHS) Centers for Disease Control and Prevention (CDC). pp. 1-9 "Combination Treatment Most Effective in Adolescents with Depression". National Institutes of Health (NIH) News Release Aug. 17, 2004 . Coriat, I. H. (1999). "Abnormal Psychology". Routledge. P. xi-xvi. Dozois, D. J. A., Seeds, P. M., & Collins, K. A. (2009). "Transdiagnostic Approaches to the Prevention of Depression and Anxiety". Journal of Cognitive Psychotherapy. New York: 2009, Vol. 23, Iss. 1; pg. 44, 16 pgs Drayer, R. A., Mulsant, B. H., Lenze, E., Rollman, B. L., Dew, M. A., Kelleher, K., Karp, J. F., Begley, A., Schulberg, H. C., & Reynolds, C. F. (2005). "Somatic Symptoms of Depression in Elderly Patients with Medical Co morbidities". International Journal of Geriatric Psychiatry, Vol. 20, Iss. 10. Pp. 973-982 Gijman,H. J., Geddes, J. R., Rendell, J. M., Nolen, W. A., & Goodwin, G. M. (2004). "Antidepressants for Bipolar Depression: A Systematic Review of Randomized, Controlled Trials". American journal of Psychiatry, 161:1537-1547 Joiner, T. E., Cook, J. M., & Gordon, K. H. (2007). "Double depression in older adult psychiatric outpatients: Hopelessness as a defining feature". Journal of Affective Disorders, Aug. 2007, Volume 101, Issue 1, Pages 235-238 McFarlane, A. C. (2009). "The Duration of Dployment and Sensitization to Stress". Psychiatric Annals. Feb, 2009, Vol. 39, Iss. 2; pg. 81, 8 pgs Randolph, N. M. (2009). "Evolution, Emotions, and Emotional Disorders". American Psychologist, Vol. 64(2), Feb-Mar 2009, pp. 129-139 Serebruany, V. L., Suckow, R. F., Cooper, T. B., O'Connor, C. M., Malinin, A. I., Krishan, K., vanZyl, L. T., Lekht, V., & Glassman, A. H.(2005). "Relationship between Release of Platelet/Endothelial Biomarkers and Plasma Levels of Sertraline and N-Desmethylsertraline in Acute Coronary Syndrome Patients Receiving SSRI Treatment for Depression". American Journal of Psychiatry, June, 2005, Vol.162 Issue 6, pp. 1165-1170. Read More