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Treatment and Management of Depression (B I O C H E M I C A L (M A O I s…
Treatment and Management of Depression
B I O C H E M I C A L
commonly known as antidepressant drugs that each work in their own unique way, however have a similar effect on particular neurotransmitters.
M A O I s
Monamine Oxidase Inhibitors
W H A T
Inhibit the work of the enzyme known as monoamine oxidase. This enzyme breaks down and removes neurotransmitters such as ..
Norepinephrine, serotonin and dopamine.
As MAOIs prevents the neurotransmitters from breaking down, there are higher levels of them in the brain.
The effectiveness of MAOIs has been evidenced as early as the 1950s
S I D E - E F F E C T S
Headaches
Drowsiness/insomnia
nausea
diarrhoea
constipation
This specific antidepressant can also cause issues with withdrawal and may interact with other medications
For these reasons, current MAOIs use tends to be a course of action reserved for only
atypical depression
, when other antidepressants or treatments have been unsuccessful.
S S R I s
Selective Serotonin Reuptake Inhibitors
e.g Prozac
W H A T
SSRIs act on the neurotransmitter serotonin to stop it being reabsorbed and broken down once it has crossed a synapse in the brain
They are the most commonly prescribed antidepressant in most countries and tend to have less severe side effects than MAOIs, however may respond differently to different medications
Both MAOIs and SSRIs are agreed to be
more effective
treatment for depression than placebos, as evidenced by a multitude of large clinical studies
However, there is growing evidence to suggest that the impact of these drugs on individuals is
far more noticeable in patients with moderate to severe symptoms
and less so in patients diagnosed with mild depression.
C O G N I T I V E - R E S T R U C T U R I N G
W H A T
Cognitive restructuring therapy aims to gain
´entry to the patients cognitive organisation´
. It is essentially a
talking therapy, based on one-to-one interactions between the patient with depression and their therapist
. It involves techniques such as questioning and
identifying illogical thinking
to determine and change the patients way of thinking.
It begins by explaining the
theory of depression
to the patient.
Explaining how the
cognitive triad works
is intended to help the patient
understand their way of thinking about themselves and the world contributes to their depression
A further stage, is to train the patient to
observe and record their thoughts
; critical for helping them to
recognise irrational or inaccurate beliefs and statements.
Once the individual is able to recognise their own cognitions , the therapist helps them
understand the link between their thoughts, affect and behaviour and how each other effects the other.
The p is directed to try to
´catch´ automatic, dysfunctional thoughts as they occur in a real-life context
. Such thoughts are challenged and discussed in therapy, to explore with the patient whether they really are an accurate reflection of reality.
The purpose of
´reality testing´
for patients is to investigate and begin to notice negative distortions in thinking for themselves.
Beck 1979
ECT
Electro-Convulsive Therapy
W H A T
It is another biological treatment for depression. Using ECT to manage symptoms of depression tends to be a
last resort
, if the patient has not responded well to biochemical or other forms of therapy such as CBT
In a study which included over 2000 p´s with neither unipolar or bipolar disorder
(Dierckx et al. 2012)
found that ECT had similar levels f effectiveness,
both resulting in around 50% remission rate.
However, unlike antidepressants, ECT is administered in
short sessions
, so the benefits of treatment can be quite short term,
in contrast to a ´ maintenance ´ effect created by on-going drug therapy.
Meaning,
relapse rates are just as high as in individuals who cease antidepressant use;
it is likely that an individual will experience a reoccurrence of symptoms which necessitate further treatment.
(Jelovac et al. 2013)
Rational