This document provides an agenda for a weekly meeting on co-occurring disorders. The agenda includes checking in, reviewing last week's material, presenting on depressive disorders and suicide prevention, assigning a learning activity, and taking questions. Details are given on different types of depressive disorders like major depression, persistent depressive disorder, postpartum depression, psychotic depression, seasonal affective disorder, and bipolar disorder. Resources on depression from SAMHSA, NIMH, and screening tools are also referenced.

1. Christina Boyd, LSCSW, LCAC
Co-Occurring Disorders EPL

2. Week #2
Depressive Disorders

3. • Check in
• Review the Learning Activity from last week-
Article and questions
Welcome
• Suicide Risks and Prevention
• Depressive Disorders OverviewPresentation
• Preview of next week
• Assign Learning Activity
• Questions
Summary
Agenda

4. • What did you find
surprising about the
information that you
read in the article?
• Did you find anything
that was familiar to
what you have seen in
your own direct
practice?
• Is there anything that
you think may need
more research as we
move forward based
on what you read?
• What is the most
important thing that
you took away from
reading the article?Learning Activity #1…

5. National Suicide Prevention Lifeline
We can all help prevent suicide. The Lifeline provides
24/7, free and confidential support for people in distress,
prevention and crisis resources for you or your loved
ones, and best practices for professionals
• Some of this information may be of a sensitive nature. If you or
someone you know is having thoughts of suicide, there is help.
Please contact someone near you, or you can reach out to us via
private chat or phone. You can also call the National Suicide
Prevention Hotline.
DISCLAIMER:

6. Why we need to talk
about this…

7. Suicide Rates
have increased
in some states
as much as
58%

8. • https://suicidepreventionlif
eline.org/how-we-can-all-
prevent-suicide/
Risk Factors and Signs
of Suicide

9. https://www.youtube.com
/watch?v=3BByqa7bhto Teen Suicide Prevention

10. Great
Information on
having these
conversations

11. Talking About Mental Illness

12. Post in
Lobbies,
Treatment
Rooms,
Bathrooms

13. Depression (major
depressive disorder or
clinical depression) is a
common but serious mood
disorder. It causes severe
symptoms that affect how
you feel, think, and handle
daily activities, such as
sleeping, eating, or working.
To be diagnosed with
depression, the symptoms
must be present for at least
two weeks.
-National Institute of Mental
Health
Depressive Disorders

14. People may not
tell you that they
are depressed…
Screens such as
the PHQ-9 can be
helpful

15. • Persistent depressive
disorder (also called
dysthymia) is a depressed
mood that lasts for at least
two years. A person
diagnosed with persistent
depressive disorder may
have episodes of major
depression along with
periods of less severe
symptoms, but symptoms
must last for two years to
be considered persistent
depressive disorder.
Dysthymia

16. • Postpartum depression is
much more serious than the
“baby blues” (relatively mild
depressive and anxiety
symptoms that typically clear
within two weeks after delivery)
that many women experience
after giving birth. Women with
postpartum depression
experience full-blown major
depression during pregnancy
or after delivery (postpartum
depression). The feelings of
extreme sadness, anxiety, and
exhaustion that accompany
postpartum depression may
make it difficult for these new
mothers to complete daily care
activities for themselves and/or
for their babies
Postpartum Depression

17. https://www.postpartum.net/

18. Edinburgh Screen for
Postpartum Depression
http://www.fresno.ucsf.edu/pediatric
s/downloads/edinburghscale.pdf

19. A striking characteristic of
postpartum depression is
how covertly it is suffered.
~Cheryl Tatano Beck, 2002
You can’t tell
by looking

20. Psychotic
depression occurs when a
person has severe
depression plus some form
of psychosis, such as having
disturbing false fixed beliefs
(delusions) or hearing or
seeing upsetting things that
others cannot hear or see
(hallucinations). The
psychotic symptoms
typically have a depressive
“theme,” such as delusions
of guilt, poverty, or illness
Psychotic Depression

21. • Seasonal affective
disorder is characterized
by the onset of depression
during the winter months,
when there is less natural
sunlight. This depression
generally lifts during
spring and summer.
Winter depression,
typically accompanied by
social withdrawal,
increased sleep, and
weight gain, predictably
returns every year in
seasonal affective
disorder.
Seasonal Affective
Disorder (SAD)

22. • Bipolar disorder is
different from depression,
but it is included in this list
because someone with
bipolar disorder
experiences episodes of
extremely low moods that
meet the criteria for major
depression (called “bipolar
depression”). But a person
with bipolar disorder also
experiences extreme high
– euphoric or irritable –
moods called “mania” or a
less severe form called
“hypomania.”Bipolar Disorder

23. • TIP 48
• https://store.samhsa.gov/system/file
s/sma13-4353.pdf
• Other RESOURCES on Depression
• https://store.samhsa.gov/tags/depre
ssion
SAMHSA
Resources
on
Depression

24. • “Findings from a 2001–2002
national survey indicate that
substance abuse counselors
will encounter significant
numbers of individuals with co-
occurring substance abuse and
depressive symptoms.”
TIP 48-

25. • https://www.nimh.nih.gov/health/publications
/depression-listing.shtml
National Institute of
Mental Health Resources on
Depression

26. • Are they severe enough to warrant specific
mental health treatment, even if symptoms are
caused by substance use?
• Is the patient able to manage the activities of
daily living?
• Can he or she cope with any emotional,
behavioral or cognitive problems?-(ASAM 2013)
Consider how depressive
disorders or suicidal ideation
can affect this dimension.
ASAM-Dimension 3 Continued

27. Sneak Peek at
next week ….
Anxiety and
Trauma

28. https://www.youtube.com/watch?v=I6402QJp52M
Learning Activity-Week #2

29. Questions

30. • Center for Substance Abuse Treatment.
Managing Depressive Symptoms in Substance
Abuse Clients During Early Recovery.
Treatment Improvement Protocol (TIP) Series,
No. 48. HHS Publication No. (SMA) 13-4353.
Rockville, MD: Substance Abuse and Mental
Health Services Administration, 2008.
• https://suicidepreventionlifeline.org/how-we-
can-all-prevent-suicide/
• NIH-
https://www.nimh.nih.gov/health/topics/depressi
on/index.shtml
• The ASAM Criteria, Treatment Criteria for
Addictive, Substance-Related, and Co-
Occurring Conditions, Third Edition, 2013.
References: