Types of Depressions and Treatment Recommendations for a Client Facing Depression - Essay Example

Essay Question 1: Describe the Differences Between Unipolar, Dysthymia, Cyclothymia, and Bipolar Depression and Their Symptoms Unipolar Depression (Major Depression) It is a mood disorder that is associated with the occurrence of depression. It is characterized by feelings of worthlessness and futility, intense sadness and withdrawal from the others (Sue, Sue and Sue 304). The symptoms of unipolar depression can be categorized into the following categories; (a) emotional symptoms – intense feeling of guilt, and absence of enjoyment in previous company or activities, (b) cognitive symptoms – blame themselves, regular negative thoughts, irrational hopelessness and low self-esteem, (c) motivational symptoms – great difficulty in making decisions and initiating an action, and (d) somatic symptoms – restlessness, and disturbance of sleep, weight and appetite (Hill 210). Dysthymia (Dysthymic Disorder) In adults, it is a chronic depression of mood and it is linked with symptoms such as sleep disturbance, appetite disturbance, fatigue, poor concentration, low self-esteem, feeling of hopelessness and difficulty in making decisions. It is similar to major depression though it is less severe and more chronic (La Rue and Spar 91). Cyclothymia The term cyclothymia refers to an individual who has the characteristics of hypomania and depression but not to an extent that may require treatment. It is a condition that is seen at the last part of the spectrum of severity and at times it can be categorized as a normal personality trait. It is associated with creativity – the characteristic swing of moods found in particular individuals such as the comedians and writers (Gournay and Newell 80). Bipolar Depression (Manic Depressive Illness) It is a mood disorder that is associated with the occurrence of depression and it is accompanied by mania. The condition is characterized by expansiveness, elevated mood, and irritability which often results in hyperactivity (Sue, Sue and Sue 304). The symptoms of bipolar depression can be categorized into the following categories; (a) emotional symptoms – increased pleasure in activities and irritable mood, (b) cognitive symptoms – racing thoughts and ideas, inflated self-esteem, and distractibility of attention (National Institute of Mental Health [NIMH 1]), (c) motivational symptoms – increase in pleasurable and goal-oriented activities that consist of high risks of painful results, and (d) somatic symptoms – decreased sleep, pressured speech, talkative and psychomotor agitation (Hill 210). Describe the Cause of Unipolar Depression and Bipolar Depression There are three theories that explain the causes of depression and they are biological, psychological and environmental theories. In the biological theories, genetics and neurochemicals are the main causes of depression. In the psychological theories, learning theory, cognitive theory and psychoanalytic theory attempt to explain the causes of depression. In the environmental theories, life events, socioeconomic background and seasonal variation are the main causes of depression (Hill 211). Unipolar and Bipolar Depression Statistics Unipolar depression is the most common and it occurs in about 10 percent of the men and 20 percent of the women. Bipolar depression on the other hand, occurs only in 1-2 percent of the entire population (it affects both genders equally) (Christensen, Martin and Smyth 80). Question 2: A List of Treatment Recommendations for a Client Facing Depression Due to presence of different factors that cause depression, there are also varying treatments for depression to increase specificity and accuracy in treatment. Most of these treatments aim at the supposed cause of the depression. The treatments include the following: Psychotherapy – it is also referred to as talk therapy. It is the most preferred method for depression that necessitates treatment. Psychotherapy is of different types and they range from supportive psychotherapy to those that alleviate the symptoms of depression, to those that reveal the psychological basis for depression. The therapy may also assist the patient in developing changes and insights in the personality behaviors and characteristics that may avert the reappearance of depression (Greist and Jefferson 41). Pharmacotherapy – used for the treatment of major depressions and they include antidepressant medications. Issues in the selection of the best medication and the reduction of side effects are very important (Gaynes et al, 600). Electroconvulsive therapy (ECT) – it has been sidelined for many years but it is the most effective treatment for severe depression and lessening suicidal risks. It is an important treatment when all other treatments have failed. Other treatment regimes include sleep deprivation, exercise, psychosurgery and light therapy. These methods are controversial although some appear to be helpful to some of the patients (Greist and Jefferson 42). For which would you advocate most strongly and why? Psychotherapy and pharmacotherapy are perhaps the better interventions when dealing with a wide range of depression related disorders. However, due to the fact that various patients respond differently to the various options of intervention and medication that they are subjected to, the most appropriate intervention regime in that case would be a hybrid regime. In view of the uncertainty that exists regarding which intervention would work well on which patient, the Sequenced Treatment Alternative to Relieve Depression (STAR*D) should offer improved accuracy regarding the same (University of Pittsburgh, 1). In this approach, various treatments are introduced at various stages of the intervention program. The main support for this approach is the minimization of side effects while increasing chance of arriving at the right choice of intervention. Reasons for treatment failures Besides the major failure cause that is occasioned by prescription following failures, there are isolated patients’ systems failures to appropriately respond to a particular drug regime. Besides, there are reports that some interventions are ineffective despite their popularity in depression treatment (Pigott, 7). The general premise on which STAR*D intervention is built on is that certain antidepressant drugs fail to deliver desirable results in the treatment of depressive disorders. Some other disorders fail to be corrected due to poor timing of intervention due to progression to a critical stage that makes chances of correction remote (Hughes et al, 1138). Question 3: Compare the presentation of Nash's symptoms in the film to the text's description of schizophrenia: what symptoms did he have? The film “A Beautiful Mind” revolves around the legendary John Nash whose schizophrenic character is significantly brought to light. The interaction he has with various psychotic treatment and the frequent hallucinations that he suffers from demonstrate the congruence that available text has with the topic. Throughout the film, certain symptoms are exhibited to portray the psychotic problems encountered by the victim. One of the most dominant symptoms is mental disturbance that is manifested in a host of different disorders. The mental disorder affects the normal learning process as expected of the character who is a university student in the beginning of the film. He however exhibits another symptom that enables him to have extraordinary capabilities in mathematics (Goldsman, 64). Throughout his time at the university as a student, he demonstrates very poor social skills that make him withdrawn in social life but does well in academics. He progresses to graduate from the university with excellent mathematical economics abilities that land him a job at Massachusetts Institute of Technology (Goldsman, 32). Until completion of his studies, the most troublesome symptoms had not clearly manifested in his condition. Delusional moments start to interfere with his life when he is teacher of mathematics at MIT. Rare mental abilities are exhibited in the main character’s involvement in a difficult encryption cracking assignment with the secret Department of Defense. Erratic mental perceptions end up in hallucinations that almost tragically end the character’s life. He ends up in psychiatric facility just to understand that the secret decoding assignment among other episodes were delusional and mere hallucinations. When he absconds mediation later in the film, fully expressed psychosis attacks him as a consequence of the medication relapse. What types of treatment did he experience? Nash is paced under various treatment regimes in an attempt to restore his normal state of mental functioning. Insulin shock therapy is particularly brought out in the film as an intervention that the psychiatric facility prescribes and effectively follows to contain his condition (Goldsman, 144). Additionally, antipsychotic medication is also administered soon after the insulin shock therapy, a type of medication that has serious implications on his normal body functions. He opts to secretly abandon this medication on the grounds of hazardous side effects on his life. Although he does not mention what type of medication he opts to proceed with in the end, there is a mention of the character using a better regime of drugs that will assist him out of the mental disorder that he finally accepts to live with. Works Cited “Bipolar Disorder,” National Institute of Mental Health (n.d.). Web. 16 April 2011. “What is STR*D?” University of Pittsburg, 22 September 2008. Web. http://www.edc.gsph.pitt.edu/stard/ (accessed 15 April 2011) Christensen, A. J., Martin, R. & Smyth, J. M. Encyclopedia of Health Psychology. New York, NY: Springer, 2004. Print. Gaynes, Bradley N., Nierenberg, Andrew A., Rush A. John, Warden Diane, Wisniewski, Stephen R. “Can Phase III Trial Results of Antidepressant Medications be generalized to Clinical Practice? A STAR*D Report,” The American Journal of Psychiatry, 166.5(2009):599-607 Goldsman, Akiva, A Beautiful Mind. London, UK: Nick Hem Books, 2002. Print Gournay, K. & Newell, R. Mental Health Nursing: An Evidence-Based Approach. Philadelphia, PA: Churchill-Livingston, 2009. Print. Greist, J. H. & Jefferson, J. W. Depression and Its Treatment. Arlington, VA: American Psychiatric Publishing, Inc., 1992. Print. Hill, Grahame. A Level Psychology through Diagrams. New York, NY: Oxford University Press, 2001. Print. Hughes, Carroll W., Pilowsky, Daniel J., Talati Ardesheer, Tang Min, Wickramaratne Priya, “Children of Depressed Mothers 1 Year after the Initiation of Maternal Treatment: Findings from the STAR*D-Child Study,” The American Journal of Psychiatry, 165.5(2008):1136-1147 La Rue, A. & Spar, J. E. Clinical Manual of Geriatric Psychiatry. Arlington, VA: American Psychiatric Publishing, Inc., 2006. Print. Pigott, H. Edmund “STAR*D: A Tale and Trail of Bias,” Ethical Human Psychology and Psychiatry, 13.1(2011):6-28 Sue, D., Sue, D. W. & Sue, S. Understanding Abnormal Behavior. Boston, MA: Cengage Learning, 2008. Print. Read More