Depression in the US - Research Paper Example

?Topic Introduction Depression is worse than sad disruptive moods. It is about losing interests and appetite as well as a dramatic decline to daily zealous routines to the point of meaninglessness. They often experience erratic pattern of sleeplessness; gain or loss weight; or probably have an unceasing need or food craving; increase restlessness and irritability; physical pains and symptoms; anxiety and sense of hopelessness (Pearlsprogram.org, 2013). For most adults who have passed the cycle of hurts as couples or had coping difficulties in some of their problems, depression is indicated by sheer resignation from events; expression of fatalistic views; and significant ideation and commission of suicide as the means to an end (Pearlsprogram.org, 2013). Depression in US Experts contend that there is 1 per 10 adults in United States of America that have suffered the debilitating effects of depression. Medical providers contended that depression can lead to “chronic conditions of arthritis, asthma, cardiovascular disease, cancer, diabetes, and obesity… and thus, weaken one’s zeal to work, reduce capacities, self-worth and productivity (Center for Disease Control and Prevention, 2013, p. 1).” The levels of depression however, are classified as “non-specified depression and dysthymia/minor depression (CDCP, 2013). In a study conducted with 235,067 adults, about 9.1% suffer depression or showed the indications of depression and another 4.1% demonstrate actual condition of depression and most of them are within the age of 45-64 years old, women, attained secondary education, and either unemployed or are bereft of the capacity to work (CDCP, 2013).” The latter are often without health insurance coverage (CDCP, 2013). Medical practitioners defined depressions as either major, minor, and dythymic disorder. Major depression refers to “depressed mood most or loss of interest or pleasure in a two-week period accompanied by significant loss of weight or gain, insomnia or sleeping disorder, psychomotor agitation or retardation, fatigue or loss of energy, feelings of worthlessness or guilt, inability to think or concentrate, or recurrent. There are cognitive symptoms demonstrated by ideation of death amongst elderly and sense of disorientation, memory loss, and distractibility (CDC Healthy Aging Program, 2013, p. 5).” Minor depression, on the other hand, is depression that would happen within a period of two week or more with less symptoms and impairment but demonstrate episodic sadness, depressed mood and lack of energy to many activities (CDC Healthy Aging Program, 2013). Dysthymic disorder or dysthymia mode of depression is somewhat long-term in depression accompanied with “poor appetite or overeating, insomnia or sleeping disorder, fatigue and lack of zeal, poor self-esteem, absence of concentration and decision-making, and there is evident feeling of hopelessness (CDC Healthy Aging Program, 2013, p. 5). It is for this reason that health providers collaborate to provide accurate medication for those are undergoing depression; understanding that such mental disorder require the need to “enhance the routine screening and diagnosis of depressive disorders; make use of evidence-based approach for pro-active depression management; and enhance clinical or community support for active patient engagement to improve their self-management (TheCommunityguide.org , 2013, p. 1).” In a collaborative care models, case managers are assigned as ‘primary care giver to help patients educate self about the causes, roots, and effects of depression; track their treatment and adherence to medication; and, provide adjustment of patients’ treatment plan (TheCommunityguide.org , 2013, p. 1).” These carers provide routine diagnoses and screening; treatment and may indorse patient to a mental health facility if deemed essential (TheCommunityguide.org , 2013, p. 1). The latter can best accord the patient of clinical advise and decision for primary care providers and managers. The collaborative care in managing depression is the best evidence-based approach in dealing with depressed “patients because the treatments are done in accordance to scientific findings and the responses progressed from remission to the recovery (TheCommunityguide.org , 2013, p. 1).” The effectiveness of this intervention is proven in a systematic studies and meta-analysis conducted in 2006 using 37 researchers that collaborative model in caring for depressed patients “reduced the number of depression symptoms from patients undergoing medication and there is increased use of antidepressant treatment as shown in a separate 28 studies (TheCommunityguide.org , 2013). In 2009 review, collaborative care management affirmed lower depression symptoms with patients; adherence to prescribed treatment for patients that took medication; increase number of pro-active response to treatment; significant percentile of patients showed remission as response to treatment; acquisition of quality life and functional status among patients under collaborative care; and there is evident satisfaction in the delivery of treatment (TheCommunityguide.org , 2013). The model of medication has high applicability, as a program for adults and young adults alike notwithstanding their diverse organizational settings (TheCommunityguide.org , 2013). Researcher’ undertaken using meta-analysis studies proved to be without issues on ethical in the delivery of services provided the primary care providers behaved with utmost diligence and in accordance to the ethics of medical care. The nurses therefore could take part of fulfilling the role of the primary care provider and could also help document the history of the patient and the progression of medication. They monitor the developments and make reports as well. There is less records thus far suggesting that the collaborative and evidenced-approach of medicating depression have barriers as a practical model in healthcare. One barrier identified by medical practitioners is that stigmatizing feeling depression that would result to mental illness One barrier is that many older adults and society itself tends to have a stigma against mental illness, viewing depression as a personal weakness or character flaw (Kobau, 2010). Elders are afraid of seeing a mental health specialist believing that “mental health disorders and treatment are shameful, represent personal failure, or will lead to a loss of autonomy (Steinman & Frederick, 2007).” As consequence, they deny and feign medical treatment based on studies made by the White House Conference on Aging (Steinman et al., 2007). In a separate study for the elders, researchers raised the following questions to depressed elders to seek agreement for medication: (a) does “treatment can help people with mental illness lead normal lives and 2) ?people are generally caring and sympathetic to people with mental illness? (Steinman et al., 2007). Added to problem on the feeling of stigma are “ageism and erroneous assumptions that depression is a normal part of aging may cause practitioners to miss a potential depression diagnosis (Steinman et al., 2007, p. 33).” It is therefore advanced that an important step in addressing stigmatism is to educate the public and practitioners to holistically understand that depression can be medicated and can be done with primary care supports (Steinman, 2007). It will also help if family will be able to convince their patients should undertake scree depression to receive quality treatment and to remove the barriers for medication. Educating them will help them hurdle through in resolving the inability of the patient to decide for higher level of medication (Steinman et al., 2007). Education of patient, their treatment and advising for mental facilities intervention for severe cases remained the methodical options in responding to depression cases. The program can therefore be sustained as medical approach in resolving the problem of depression among elders. Increasing the patients’ knowledge on self-management of depression and on adopting healthy lifestyle and relations should be sustained. The cost of the project will be determined by the administration of health care facilities but budgetary allocation will be focused on education, medicines for actual treatment and support services to carry out the operational services of the healthcare provider, including cost in advising patient to seek mental health institution for severe cases. Considering all these, the program will cover the following projects to support the collaborative medical services for mental health. A. Conduct series of seminars and trainings for mental health care providers to advance the effective strategies and approaches in mental health care; B. Develop and organize stakeholders for mental health care providers that would comprise medical professionals, nurses, psychiatrists, government health department representatives, pharmaceutical companies, and the communities. C. Improve the clinical services e.g. screening, treatment and other support services for the patient and increase their level of awareness on self-managing their depression by dealing with issues responsibly and by adopting healthy lifestyles; D. Scale up advocacy on mental health care to encourage the government and its health agency to allocate more resources to improve mental institutions and the medical services in psychiatric institutions as well that are providing primary mental health care. E. Maximize innovative information technology to promote mental health care and support services. Conclusion Depression is not cared well or not given proper attention can worsen to mental disorder. It is therefore essential that medication should be sought from professional experts who can provide medical support services; educative awareness on self-management when in depression; and actual treatment for mental health or cognitive health therapy. An interdisciplinary support from these professional could resolve personal issues of the elderly and of their respective family. Collaborative model of medical advice and provision of primary care are helpful program as therapeutic measures and endorsement for mental health facility services is significant if evidences proved that professional care are already needed to mitigate the impact and effects of depression. Also, public education remained helpful to empower families and communities about the significance of mental health. Through this, they will be made aware that depression can be medicated and must not be considered as an illness that could socially marginalize a patient (and their respective family) or result to stigma. Medical institutions and the government must nurture professional support to improve the capacity of nurses, as primary care giver as well as allocate sufficient budget for mental health development. Government’s allocation of financial resources to improve mental and health services for the elderly patients will help subsidize the needs of patients, especially those that are bereft of insurance policies that could cover their medical expenses. References Center for Disease Control and Prevention, (2013). An estimated 1 in 10 US Adults Report Depression, US: CDC. p. 1 Center for Disease Control and Prevention, (2008). Effective Programs to Treat Depression in Older Adults: Implementation Strategies for Community Agencies: From Research to Practice, US: prc-han.org, p. 1. Kobau, R (2010). Attitudes about mental illness and its treatment: validation of a generic scale for public health surveillance of mental illness associated stigma. Community Mental Health Journal, vol. 46(2):164-76. TheCommunityguide.org (2013). Improving Mental Health and Addressing Mental Illness: Collaborative Care for the Management of Depressive Disorders, US: The Guide to Community Preventive Services/The Community Guide, p. 1. Pearlsprogram.org (2013a). About Depression, US: Pearls, p. 1 Pearlsprogram.org (2013b). Diagnosis and Types of Depression, US: Pearls, p. 1. Snowden M. & Steinman, L. (2008). Treating depression in older adults: challenges to implementing the recommendations of an expert panel. Prev Chronic Dis. Vol. 5(1). Steinman LE & Frederick JT, (2007). Recommendations for treating depression in community-based older adults. Am J Prev Med. Vol. 33(3):175–81. Read More