Which statement is false regarding psychodynamic therapy and unipolar depression
Family physicians usually are the first to diagnose and treat patients with depression. They should inform patients that psychotherapy and pharmacotherapy are valid options, and that cognitive therapy, and therefore CBT, is the most studied psychotherapy. If the patient and physician initially elect to use pharmacotherapy, and the patient does not respond adequately, the physician should again suggest adding psychotherapy or CBT. CBT should be strongly considered as initial therapy for patients with severe or chronic depression or for adolescents. If the patient declines referral, or if the family physician provides CBT, longer appointments could be scheduled. Resources are available for the physician and patient (Table 2), and further physician training should be considered.
Unipolar depression is a very serious and common mood disorder. Individuals that are affected by this form of depression experience continuous feelings of sadness, or lack of interest in interacting with the world around them.
At some point in their life, around 7% of adults in the U.S. have experienced an episode of unipolar depression.
While bipolar depression refers to frequent mood changes between depression and mania, the focal point of unipolar depression is the negative emotions and feelings that an affected individual experiences.
The unipolar designation indicates that the depression does not alter between the two mood states.
Additionally referred to as major depressive disorder (MDD), major depression, or clinical depression, this mood disorder is a medical condition that can impact many critical areas of one’s life. It affects the mood, behavior, and several physical functions (such as sleep or appetite), preventing affected individuals from living healthy and fulfilling lives.
One of the commonalities between people with unipolar depression is loss of interest in activities and hobbies that they previously enjoyed, as well as difficulty in performing everyday tasks.
At times, people with this disorder may experience suicidal thoughts, and feel as if living isn’t worth it.
Unipolar depression (or other types of depression) aren’t the same states as being sad, or “feeling the blues”. It’s not something that a person can “snap out” of, and often requires long-term professional care and treatment.
The majority of people with severe depression feel marked improvements in overall mood and health with medication, psychotherapy, or a combination of both.
Unipolar Depression Symptoms
The majority of people with unipolar depression experience sadness or negative feelings at some points in their lives. However, this type of depression is distinguishable from other types (such as bipolar) in that a depressed mood can last the entire day, and persist for longer-periods (longer than 2 weeks).
In order to determine whether someone is affected by this mood disorder, doctors and mental health professionals assess their feelings, behavior patterns and symptoms. Typically, they will ask specific questions about your mental well-being, or present you with a questionnaire which after completion will indicate whether or not you have unipolar depression.
In order to be diagnosed with unipolar depression, you must fulfill the symptom criteria that is listed in the Diagnostic Statistical Manual of Mental Disorders. Also referred to as DSM, this manual acts as a guide for doctors and mental health workers to diagnose mental health conditions.
In order to meet the DSM criteria for unipolar depression, you must experience 5 or more of the following symptoms, at least once per day, and for a period that’s longer than 2 weeks:
- Sadness or irritability, lasting most of the day
- Loss of interest in the majority of activities that were enjoyable before
- Change in appetite, or sudden weight loss/gain
- Difficulty falling asleep, or wanting to sleep more than before
- Feelings of restlessness
- Lack of energy and increased tiredness
- Feelings of worthlessness or guilt, often linking to things that normally wouldn’t have this kind of effect
- Difficulty concentrating, making decisions and thinking
- Suicidal or self-harming thoughts
Causes & Risk Factors of Unipolar Depression
Unipolar depression doesn’t have an exact cause, as there are many factors that can contribute to developing the condition, or put one at risk of developing it.
These risk factors can be split up into three primary categories:
On the level of brain chemistry, a combination of stress and genetic predisposition can alter the chemical balance within the brain and diminish the ability to maintain stable moods. Also, changes in hormonal balances can also increase the likelihood of developing unipolar depression.
One of the widely accepted theories is that unipolar depression is caused by lack of balance in the naturally occurring chemicals known as neurotransmitters, that are present in the brain as well as the spinal cord.
It has been concluded that serotonin and norepinephrine are two of the neurotransmitters that are responsible for symptoms of the disorder.
External events affect all individuals in different ways, and every person’s thoughts dictate how they will experience their lives. This can also affect the level of happiness they feel in their lives, as well as whether or not they will develop a mood disorder like unipolar depression.
The way in which we view the world is shaped by our experiences, with the most impactful phase being in our childhood and teenage years.
Parenting also plays a very important role in shaping the psychological health of children.
As an example, abusive upbringing full of negative comments will most likely change that person’s view of the world for the worse. Later in life when faced with negative situations, individuals with this kind of past can view situations or themselves worse than others around them, ultimately contributing to their emotional suffering and predisposing them to mental illnesses like depression.
As we go through life, it is natural that we become victims of very stressful and unfortunate events, which can trigger unipolar depression or other mental disorders.
Some of the common triggers include:
- Extended periods of conflict in relationships, whether with a partner or with family, friends or co-workers
- The passing of a loved one, divorce, financial struggles, moving, or job loss
- Lack of socialization or social isolation
- Stress in the workplace due to relationship conflicts or pressure to perform
- Health challenges, particularly when a person experiences chronic health issues.
Unipolar Depression Treatment
Medications along with psychotherapy have shown to be effective at treating unipolar depression for most people. Primary care doctors or psychiatrists have the ability to prescribe appropriate medications to ease (and in some cases, cure) the symptoms associated with depression, although it’s advised that people with the disorder also see a mental health professional to work through underlying issues that may be triggering it.
In the case that the depression is very severe (especially if you feel like you’re a danger to yourself), you may require a hospital stay, or take part in an outpatient treatment program until the severity of the symptoms reduces.
Once a patient has been diagnosed with unipolar depression, treatment often starts with the prescription of antidepressant medications.
Selective serotonin reuptake inhibitors, otherwise known as SSRIs are a class of antidepressants that are most commonly prescribed.
People with unipolar depression often suffer from deficiency of serotonin, which is the neurotransmitter responsible for regulating moods and sleep patterns. SSRIs help to slow the breakdown of serotonin, which allows the brain to have a higher level of this important neurotransmitter.
Between 40-60% of people that start an SSRI treatment begin to feel an improvement of their symptoms within six to eight weeks.
Some of the well-known SSRI medications include fluoxetine (prozac) as well as citalopram (celexa), which have been shown to have low occurrence of side-effects in most people.
Other medications include tricyclic antidepressants, which are typically prescribed when after treatment with SSRIs proved to lack effectiveness. The side effects of these types of antidepressants are more severe, and include sleepiness as well as weight gain.
Also, if you are pregnant (or planning to become pregnant) it is important to make your doctor aware, as certain antidepressants may not be safe for pregnant or breastfeeding women.
Psychotherapy (also known as “talk therapy”) involves meeting with a psychiatrist on a regular basis to discuss your mental well-being and talk about issues that relate to your condition.
While it may not be enough to fully treat severe depression on its own, numerous studies support therapy as a highly effective treatment, and some indicate that combining antidepressants with talk therapy can play a very important role in recovering from the mental illness.
In 2013, a large-scale study involving more than 400 participants concluded that patients with treatment-resistant depression saw a significant reduction of symptoms after going through a talk therapy treatment alongside depression medication.
Psychotherapy has been shown to help with:
- Increasing feelings of worth and esteem
- Identifying new ways of solving challenging life situations, or learning to cope with them
- Improving communication skills
- Adjusting to stressful events or getting through a crisis
- Changing the belief system to be more positive
- Regaining life control
- Replacing bad habits with more healthy and positive ones
- Increasing the sense of life satisfaction
Types of Psychotherapy
When people think of therapy, they typically imagine the experience as one-on-one sessions with a mental health professional. However, there are different types of therapies, and depending on your situation and you as an individual, you may benefit more or less from other psychotherapy treatments.
The different types of psychotherapies include:
- Psychodynamic Therapy – A psychoanalytic therapist will help the patient talk about whatever they have going on in their mind, with the goal of identifying unconscious processes that manifest in the patient’s behavior during the session. The process of having a conversation with the therapist helps the patient to understand and become aware of how their past is impacting their present behavior.
- Cognitive Behavioral Therapy (CBT) – focuses on how a patient’s thoughts and beliefs are linked to feelings and behaviors. The therapist teaches new ways of thinking that help the patient to deal with challenging or stressful situations.
- Cognitive Analytical Therapy (CAT) – combines technique from psychodynamic therapy and CBT in order to identify and provide solutions for how a patient’s behavior causes issues, as well as how they can improve it with self-help and experimentation.
- Interpersonal Psychotherapy (IPT) – examines how events involving relationships between a patient and others in their life impacts their happiness and level of mental health. This form of psychotherapy is based on the idea that the psychological issues one experiences stem from the quality of their personal relationships.
- Systemic Therapy – also known as family or couple therapy, this type of psychotherapy addresses people not only on the individual level, but as one single unit and aims to solve their issues together.
- Humanistic Therapy – examines the patient not only from the view of the therapist, but also from the perspective of how the individual sees themselves. The emphasis of this form of therapy is on a patient’s positive behaviors and traits, as well as their potential to use their personal strengths to acquire new growth, healing and fulfillment in their lives.
Additionally to therapy and medication, it can also be helpful to make positive lifestyle changes in order to improve your unipolar depression symptoms. Making a few adjustments in your daily habits can go a long way in helping you become better at handling life situations and improving your mental health!
Below are a few ideas of healthy habits that can help:
Getting Enough Sleep – It is recommended for most people to get at least 8 hours of sleep to feel energetic and be in a stable and positive mood. If you’re having trouble sleeping, talk to your doctor to learn more about what you can do to get consistent and better sleep.
Eating The Right Food – Studies have found that foods that are rich in Vitamin B (whole gains, meat, legumes, dark leafy vegetables) can have a positive effect on some people with unipolar depression. Additionally, protein-rich foods like beans and peas, lean meat, and yogurt have shown to boost alertness and energy.
Avoiding Alcohol – Alcohol is a nervous system depressant and therefore can worsen one’s depression symptoms, and heavy alcohol use can also reduce the effectiveness of antidepressants. In addition, people with unipolar depression are more likely to develop an addiction to alcohol.
For these reasons, it’s advised that people with mood disorders avoid drinking altogether, or take precautions if they do (such as, learning if alcohol use is compatible with their antidepressants).
Regular Exercise – Research has shown that in some people, exercising regularly can work just as well as antidepressants in reducing the symptoms of depression. Exercise (especially high in intensity) releases chemicals in the brain called endorphins, which have positive psychological effects.
Depression Clinical Trials Registry
At Clara Health, we have our own patient-focused [FREE] Depression Clinical Trials Registry to help you keep up to date with current depression clinical trials that best fit your life situation!
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