Depression - ttiinc.orgclinical depression Common but serious mood disorder Alters thoughts,...
Transcript of Depression - ttiinc.orgclinical depression Common but serious mood disorder Alters thoughts,...
T r a i n i n g a n d T r e a t m e n t I n n o v a t i o n s , I n c
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DEPRESSION
DEPRESSION DEFINED
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Also known as major depressive disorder or
clinical depression
Common but serious mood disorder
Alters thoughts, feelings, and behaviors
Affects the ability to cope with the stressors involved with activities
of daily living like sleeping, eating, or
maintaining hygiene
Symptoms need to be present for at least two
weeks to be diagnosable
Affect: observable behaviors that express a feeling
(emotion)
Blunted: reduced intensity in expression
Flat: little to no sign of any expression
Anhedonia : lack of enjoyment from, engagement in, or
energy for life’s experiences
Dysthymia : while depressed, two or more of the following:
poor appetite or binging, insomnia/hypersomnia, fatigue, low self esteem, poor concentration, or feelings of hopelessness
Dysphoric mood : an unpleasant mood, like
sadness/anxiety or irritability
COMMON TERMS RELATED TO
DEPRESSION
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KINDS OF DEPRESSIVE DISORDERS ( D S M - V )
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Disruptive mood dysregulation disorder
Major depressive disorder
Persistent depressive disorder (dysthymia)
Premenstrual dysphoric disorder
Substance/medication induced depressive disorder
Depressive disorder due to another medical condition
Other unspecified or specified depressive disorders
Unspecified depressive disorder
COMMON SYMPTOMS AMONG ALL
VARIATIONS
Significant weight loss/gain
Insomnia or hypersomnia nearly every day
Psychomotor agitation or retardation
Fatigue or loss of energy nearly every day
Feelings of worthlessness/inappropriate guilt
Diminished ability to think or concentrate
Recurrent thoughts of death/suicide and or suicide attempt
Recently added to the DSM; used for children 12 and younger Used to reduce the potential for misdiagnosis of bipolar disorder
Age of onset of symptoms (10 years and younger historically)
Presentation in children with persistent irritability and frequent episodes of behavioral dyscontrol present Severe recurrent tempter outbursts that are not appropriate for the
situation
Inconsistent with developmental level
Happens on average, 3 or more times per week
Mood in between outbursts/episodes is persistently irritable or angry
DISRUPTIVE MOOD DYSREGULATION
DISORDER
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Major depressive disorder is characterized by one or more depressive episodes
Has to include either depressed mood most of the day/nearly every day, or, lost of interest in pleasurable activities (anhedonia)
Some individuals will report having no feelings, feeling ‘blah’ or anxious
While others may emphasize somatic symptoms like bodily aches and pains
In children and adolescents, irritable/cranky mood may manifest as opposed to a sad or dejected mood
MAJOR DEPRESSIVE DISORDER MDD
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MDD VS. GRIEF
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Major Depressive Disorder:
• Mood and thought Patterns are almost constantly negative
• Feelings of worthlessness and self-loathing are common
Grief:
• -Painful feelings come in waves, often with positive memories of the deceased/or loss are mixed in
• Self-Esteem will remain in tact
Chronic form of depression that is consistently present over the course of at least two years in adults, 1 year in children
Can refer to a low level symptoms of depression for extended periods of time
“Down in the Dumps” most of the time
Also known as Dysthymia
PERSISTENT DEPRESSIVE DISORDER
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BIPOLAR DISORDER
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Recognized on the list due to the extreme ‘low’
moods reported by those diagnosed
Meets criteria for depression
Mood: sadness, general discontent, guilt/hopelessness, loss
of interest or pleasure in activities
Behavioral: disorganized, crying spells, agitation, fatigued
speech
Cognitive: unwanted thoughts, slowness in activity, delusion
Psychological: depression, agitated depression
Sleep: insomnia/hypersomnia
SEASONAL DEPRESSION
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Seasonal affective disorder Characterized by the onset of depression during cooler months
Less natural sunlight
Generally is relieved during Spring and Summer
Winter depression symptoms include: Social withdrawal
Increased sleep
Weight gain
& predictability it will return next season
DEPRESSION IN PSYCHOTIC DISORDERS
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Depressive symptoms are a common feature
Disturbing false fixed beliefs (delusions)
Or, hearing/seeing upsetting things that others cannot hear or see
(hallucinations)
Psychotic Symptoms usually have a depressive
“theme”
Delusions of guilt, poverty, or illness
Include the same criteria of a combination
of depressed mood or diminished interest or
pleasure in all or almost all activities
Depressive symptoms are only present either
during intoxication, withdrawal, or after
exposure to medication
SUBSTANCE/MEDICATION INDUCED
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Drawing our Depression:
https://www.youtube.com/watch?v=coSbBsTGs_A&t=7s
DIFFERENT REPRESENTATIONS
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Not all symptoms present the same, be on the look out for the following:
Frequent, varied, and vague complaints that have all been examined but ruled out of any medical cause
Interpersonal struggles
Barriers to upholding responsibilities like job roles/family roles
Struggle to maintain medication adherence or compliance with recommended treatment
Change in affect
Complaints of fatigue or pain
Exhibiting violent or impulsive behaviors
ATYPICAL SYMPTOMS TO BE ASSESSING
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ASSESSMENTS
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•Contains 9 questions
•High reliability and validity
•Available in numerous languages and at no cost
•Valuable tool to gauge progress if used at periodic visits
Patient Health Questionaire-9
(PHQ-9)
•Contains 21 questions scored on a scale from 0-3
•Higher scores indicate more severe symptoms
•Takes 10 minutes to complete on average
•Used on ages 13 - 80
Beck’s Depression
Inventory – (BDI)
ILLNESSES THAT INVOLVE SIMILAR
SYMPTOMS TO DEPRESSION
Neurological disorders (dementia, Parkinson’s, etc.)
Cardiovascular Disease
HIV
Cancer
Fibromyalgia
Chronic Fatigue
Sleep Disorders
Infectious Diseases (Lyme Disease)
Traumatic Brain Injury
Mineral and Vitamin Deficiencies
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Although there are no blood tests
to determine depression, a blood test can
rule out the following illnesses
COMMONLY PRESCRIBED MEDICATIONS
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Cognitive Therapy Assists in recognizing and combating negative thinking that
contributes to depressive episodes
Changing maladaptive thought patterns to rational, accurate, and
helpful ones
Behavioral Activation Implementing into schedule specific activities with high potential for
positive reinforcement
Interpersonal Psychotherapy Time limited approach
Addresses interpersonal stresses and improving social functioning
Interpersonal issues are the main focus of treatment
OTHER MODALITIES OF TREATMENT
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DIVERSE REPRESENTATIONS
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Women:
• biological, lifecycle, and hormonal factors unique to women can be linked to higher rates.
• Symptoms include: sadness, worthlessness, and guilt
Men:
• typical affect is tired, irritable, and sometimes angry.
• Lack of interest in activities, sleep disturbances, reckless/maladaptive behaviors.
DIVERSE REPRESENTATIONS
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Younger children:
depression looks like pretending to be sick, refusing to attend school, attachment
issues to parent or anxiety about the death of a parent
Adolescents:
behavioral issues, get into trouble at school, irritable. Co-morbid conditions
like anxiety, eating disorders, or substance use/abuse
Older adults:
less apparent symptoms, less likely to admit to feelings of sadness or grief. More likely to
be linked to medical conditions like heart disease
DEPRESSION IN THE U.S
• Feelings of numbness, disbelief, anxiety or fear
• Changes in appetite, energy level, and activity
• Difficultly concentrating
• Change in sleep patterns/ insomnia or nightmares
• Physical reactions like gestational issues or skin rashes
• Worsening of present health problems
• Increased anger or outbursts
• Substance misuse / maladaptive coping mechanisms
Even though you may not be diagnosed with depression, the uncertainty of the current health climate could possibly be making you feel:
COPING WITH COVID-19
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Open Communication: Talking openly and
honestly can help lessen children’s
confusion and ease their fears
Help by labeling feelings so connections are
made to better express and manage the strong
emotions
Non-Verbal Communication: Observing
behavior can help you understand their
needs.
This goes for anyone struggling to communicate
their feelings
HELPING CHILDREN COPE
Rosita the Grouch: https://www.youtube.com/watch?v=Akx0o0Mg2zg
Seasme Street Communities Website: https://sesamestreetincommunities.org/
Practice Self-Care Eat healthy, exercise regularly, drink fluids, and maintain a sleep
routine; avoid substance misuse
Stay connected with others Through various outlets like phone calls, letters, make cards, use social
media platforms, or organize drive-by’s to celebrate birthdays/holidays/showers/graduations
Take breaks Physical and mental breaks; meditate, take deep breaths
Stay informed/monitor the amount of news intake Be aware there might be rumors; watch, listen to, or read the news for
updates from officials
Seek professional help as necessary There are a lot of outlets to seek help during this time, virtual therapists
are available
MAINTAINING YOUR EMOTIONAL HEALTH
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PREVENTATIVE FACTORS
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Some form of activity or exercise
Delegate tasks or break tasks up into smaller ones
Prioritize, think SMART
Implement high quality relaxation activities into daily routine
Postpone big life decisions until mental health is recharged
Avoid self medication/maladaptive behaviors
https://www.nimh.nih.gov/health/publications/depression/index.shtml#pub1
https://adaa.org/understanding-anxiety/depression
https://adaa.org/understanding-anxiety/co-occurring-disorders
https://www.healthline.com/health/depression/facts -statistics-infographic#3
https://emergency.cdc.gov/coping/selfcare.asp
Diagnostic and Statistical Manual of Mental Disorders - 5 th Edition ( DSM-V )
https://www.integration.samhsa.gov/clinical -practice/screening-tools
seasmestreetcommunities.org
https://www.ismanet.org/doctoryourspirit/pdfs/Beck -Depression-Inventory -BDI.pdf
tti inc.org
REFERENCES & RESOURCES
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