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Transcript of Depression Presentation
Depression Assess for Suicide Risk Do you have a plan? Pharmacological
Interventions The Impact of a
Healthy Lifestyle "Spontaneous
by Andrew Weil, MD Behavioral Therapy Core Approach: Interpersonal Therapy The Power
of Hope! At least 2 weeks of depressed mood or loss of interest/pleasure in most activities nearly every day Thoughts A journey of a thousand miles starts with the FIRST STEP. Western world's
debilitating ailment Prevalence:
Lifetime - 20.8%
12-month - 9.5% Women twice as
likely as men to
suffer a major depressive episode Stress-related events kick off 50% of depressive episodes Accompanied by four of following symptoms:
Significant weight loss/gain or decrease/increase in appetite
Observable psychomotor agitation or retardation
Fatigue or loss of energy
Feelings of worthlessness or excessive/inappropriate guilt
Diminshed ability to think/concentrate or indecisiveness
Suicidal ideation and/or plan to commit suicide All symptoms must cause significant distress or impairment in social, occupational or other functioning Symptoms not better accounted for by loss of loved one, unless symptoms persist 2 months beyond loss or include marked impairment or intense feelings of worthlesness, suicidal ideation, psychotic symptoms or psychomotor retardation Cognitive
Behavioral Therapy How would you do it? When would you do it? Have you ever tried? What do you think it would accomplish? What stopped or stops you? IF THERE IS A GENUINE SUICIDE RISK:
Have them covenant not to kill themselves before a future time when you will talk/meet and to pledge to call you before any attempt prior to that time.
Immediately notify important support persons like parents, spouse or close friend.
Immediately refer for psychological assessment and treatment. For an emergency, take to the hospital.
Leave a suicide hotline number in their hands. Depression Hurts Not just the spirit, but the body... the Brain the Heart the Bones SSRIs MAOIs Tricyclic Antidepressants Atypical Antidepressants Benefits: Effective for
use of other therapies
damage to brain Costs: Side Effects
4-6 weeks for full effect
First drug not always right drug
Residual symptoms and
danger of relapse
Concerns with pregnancy Diet Exercise Sleep Reducing Stress Depression results when the context of a person's life provides low levels of positive reward and high levels of aversive control. Less rewarding lives sadness and pulling away and disruption of basic more depressed mood...eventually leads to depressed mood routines Targets: Escape, avoidance, ruminative thinking narrowing of adaptive behaviors and diminished problem solving ability. Activity Scheduling
& Mood Rating Graded Tasks Guided Activation Arbitrary Reinforcers &
Aversive Contingencies Secondary,
then Primary Tasks Core Approach: Depression is a biopsychosocial disorder - Faulty cognition influences subsequent negative emotion and maladaptive behavior. Depressed individuals have negatively biased view of the self (deficient or unlovable), of their environment (overwhelming and filled with insuperable obstacles), and of the future (as hopeless and unchangeable). Targets: Faulty Cognition & Maladaptive Schemas Feelings Behaviors Identify Automatic Thoughts Thinking Errors &
Rational Responses Test Automatic Thoughts
as Hypotheses Reattribution Schema Therapy Core Approach: Chronic depression can be caused by extremely stable and enduring negative themes that have their root in early unmet childhood needs, such as the need for safety, autonomy, realistic limits, predictability, love, attention, and validation of feelings/needs. These maladaptive themes, called schemas, operate mostly outside the person's awareness. Such schemas are activated in the present tense through child, maladaptive coping, and dysfunctional parent modes. Targets: Examining Maladaptive Modes and Strengthening the "Healthy Adult" Mode Depression is a treatable medical illness that is often connected to a current or recent stressful life event. Stressful life events can precipitate a depressive episode and depression can make it difficult for an individual to manage such stressful events. Stressful life events fall into four primary categories - complicated bereavement, role disputes (conflict with significant others), role transitions (in work, relationships, or life events/stages), and interpersonal deficits (lack of adequate social support network). Core Approach: Targets: Interpersonal Problems Blame Symptoms on Depression to Distance Patient from Illness Catharsis Problem Resolution Activation or Building
of Support System Communication Coaching