Depressive disorders• Considered mood disorders• A mood is a sustained emotion that, when extreme, affects the persons view of the world• Mood disorders are characterized by disturbances in feelings, thinking, and behavior.
• These disorders may occur on a continuum ranging from severe depression to severe mania (hyperactivity)• A depressive illness is painful and can be psychophysiologically debilitating• Depression is much more than just sadness
– it affects the way one feels about the future and can alter basic attitudes about the self• A depressed person can become so despairing as to express hopelessness• When moods become severe or prolonged or interfere with a persons interpersonal or occupational functioning – this may signal a mood disorder.
• Patients may receive treatment in acute inpatient psychiatric hospitals or in the community in an outpatient program – Decision about treatment setting is made according to the severity of patients illness, with primary concern being the risk of self-harm (suicide) as well as the presence of symptoms that are severely disabling
• Inpatient treatment is directed toward drug management and supportive psychotherapy using milieu management
Somatic therapies• Psychopharmacologic: drugs used to treat depression are those that will increase serotonin and norepinephrine.• ECT may be used to treat severe depression that is unresponsive to antidepressant drugs.
Somatic therapies• Ultraviolet light therapy may be recommended for depression that occurs during fall and winter months (seasonal affective disorder).
• Patient may select complementary and alternative treatments – The use of herbal supplements, especially St. Johns wort, is a popular alternative for antidepressant drugs – However, use of nutritional or herbal supplements should be discussed with the health care provider because of the potential for drug interactions.
Psychodynamic therapy• helps patient to become aware of unconscious anger directed toward object loss and “work through” these feelings to alleviate depression.
Cognitive therapy• The recommended psychotherapeutic approach for depression• This approach includes identifying and challenging the accuracy of patients negative thought patterns and encouraging behaviors designed to counteract depressive symptoms.
Family therapy• Assists patient and family members in developing a sense of self that is separate from that of the family as a whole• Patient is then encouraged to take responsibility for his own actions.