Presentation on theme: "Depression and Other Mood Disturbances"— Presentation transcript:
1Depression and Other Mood Disturbances Dr. Manasi Kumar, Ph.D., CPsychol.PsychotherapistLecturer in Clinical PsychologyDepartment of PsychiatryUniversity of Nairobi, KenyaPhone:
2What is Depression?Needs to be understood on a spectrum Disturbance of mood- feelings, affects, emotions Persistent and chronic gloom (feeling empty, dark and low constantly)Chronic unhappiness, loss of energy and motivationFeeling low, gloomy and low motivation
3Why do people get Depressed? Several factors work in tandem2. Physiological processes, neurotransmitter functioning that contributes to dysfunction3. Stressors in life and ones mental capacities to deal with itOnce neurotransmitters have sent their message, they return and can be reabsorbed by the sending neuron in a process called reuptake. Reuptake allows the messengers to be reused. Two of these neurotransmitters are serotonin and norepinephrine. Low levels of serotonin and norepinephrine in the synapse are associated with depression and sadness. Some medications used to treat depression work by increasing the amount of certain neurotransmitters that are available to carry messages.1. Individual personality shaped by early experiences and interpersonal relationships
4Parts of the Brain implicated in Depression Receives most sensory information and relays it to the appropriate part of the cerebral cortexpart of the limbic system and has a central role in processing long-term memory and recollection- ‘emotionally colours experience/memoryDirects high-level functions such as speech, behavioural reactions, movement, thinking, and learningpart of the limbic system, a group of structures deep in the brain that’s associated with emotions such as anger, pleasure, sorrow, fear, and sexual arousal, also emotionally charged memoriesSource: Harvard Depression review. 2012
5How do we know it is depression? 1. Emotions or feelingsFeeling sad, guilty, upset, numb or despairingLosing interest or enjoyment in thingsCrying a lot or unable to cry when a truly sad event occursFeeling alone even if you are in companyFeeling angry and irritable about the slightest thingsSource: Synopsis of Psychiatry. Kaplan and Saddock, Kluwer Press, th revision & NHS Camden & Islington Booklet on Depression 2011
6Signs of depression 2. Physical or bodily signs Tiredness Restlessness Sleep problemsFeeling worse at a particular time of day – usually morningsChanges in weight, appetite and eatingLoss of interest in sex.
7Signs of depression 3. Thoughts Losing confidence in yourself Expecting the worst and having negative thoughtsThinking you hate yourself/feeling worthlessPoor memory or concentrationThinking that life is not worth living.4. BehaviourHaving difficulty in making decisionsCan’t be bothered to do everyday tasksPutting things offNot doing things one enjoyed or did earlier
8Extending an understanding of Depression : Melancholia Freud (1918) in an interesting comparison talked about how melancholia (depression) was like mourning (death of someone)A real or imaginary loss of ‘someone’ or ‘something’ within us died and we are mourning its loss (Derrida)Knowing this ‘someone’ or ‘something’ is the key objective of a psychotherapeutic processIn Depression, it is important to know ‘who’ and ‘what’ we are mourning for!
9Aaron Beck’s Cognitive Triad Depression stems from this cycle of helplessness and hopelessness. It isour thinking patterns & emotions underlyingthat need tochangeNegative view of oneselfExplain this CBT perspective brieflyNegative view of others/worldNegative view of future
10On the same continuum..... Manic-Depressive illness (Bipolar) Cyclic vacillation between bouts of extreme happiness, euphoric (frenzy) and extremely high levels of activity and energyVarying periods of depression and mania- form subtypes of mood disorderPost partum DepressionCommon in both men and women after arrival of a new baby. Often in instances of first baby. Women more vulnerable/susceptible to it (baby blues)- Seasonal Affective Disorder
11Global Mental Health Research Facts on Depression 14% of global burden of diseases attributable to neuropsychiatric problems (Price et al. 2007, 2009, Lancet) – mostly unipolar, bipolar & substance useThe WHO deems bipolar the sixth main cause of disability for people aged In children, the diagnosis has increased by over 400%Social support is an effect modifier in case of many neuropsychiatric problems (Kleinman, Lancet, 2012)
12Battling it out!: Treatment Options Psychotherapy (medium intensity)Drug intervention/ pharmacological –SSRI, Tricyclics, SNRI, MAOI’sCombined drug and therapy or counsellingSupport or self help groupsActive participation in other socio-cultural forums or in creative artsSelf-study and careExplain all four briefly. In red are treatment that have shown to be efficacious
13Psychotherapy Different types: -Focus on different zones of experience and different management stylesIntensity/more vs. less behavioural/group vs. Individual-Evidence based finding says that it is the quality of the therapeutic relationship that matters more than orientation of the therapist- Mild to moderate depression minimum 25 sessions (upto 50) of psychotherapy helps – UK govt. NICE report , endorsed by APA & BPS
14Some creative resources.... 5 filmsThe Hour (based on Virginia Woolf’s life)Sylvia (based on Sylvia Plath’s The bell jar)HelenProzac NationIt’s all about my mother (Almodavar)Short film viewing for minsDirected by Shane Abbess, Director of Photography Peter Holland, and Edited by Enzo Tedeschi. Starring Emily Stewart and Dwaine Stevenson Sutherland country awareness programme.
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