Ch. 9: Treatment for Depression and Bipolar Disorders Flashcards
What percentage of the population will meet criteria for depression?
15-17%
What percentage of people seeking treatment for unipolar depression will show improvement?
80%
What is the premise, goal and strategy of psychodynamic treatment?
Premise: Depression is caused by unconscious grief over real/imagined loss
Goal: Gain awareness of loss, increase coping mechanisms
Strategy: Free association, dream analysis, interpret resistance and transference.
What are some strengths of psychodynamic treatment?
Patients develop better insight into conflicts and can change behavior over time
What are some limitation of psychodynamic treatment?
Long term therapy is inconvenient if immediate relief is needed
What is the premise, goal and strategy of behavioral treatment?
Premise: Depression is linked to reward and punishment
Goal: Reintroduce patient to pleasurable activity
Strategy: Behavioral activation, reward system, social training
What are some strengths of behavioral treatment?
Short term therapy, quick results, patients like active role in therapy.
What are some limitation of behavioral treatment?
Behavioral strategies are more effective when combined.
What is the premise, goal and strategy of cognitive treatment?
Premise: Depression caused by negative thinking and upsetting situations
Goals: Help patient recognize and change negativity and improve mood.
Strategy: Beck’s 4 phase treatment
What are the steps of Beck’s 4 phase treatment?
1) Increase activity and mood
2) Challenging automatic thoughts
3) Identify negative thoughts
4) Changing primary attitude
What are the strengths of cognitive treatment?
Heavily researched-based. Shows significant improvement in decreasing symptoms of depression.
What are limitations to cognitive treatment?
Many do not believe you have to discard negative cognitions in order to decrease symptoms of depression.
What is the premise, goal and strategy of sociocultural treatment?
Premise: Depression can be traced to our socio-cultural environment.
Goals: To address cultural issues that are impacting depression
Strategies: Special cultural training of clinicians, awareness of culture stressors
What are the strengths of sociocultural treatments?
Often uses a combined approach to enhance therapy (i.e., cognitive and socio-cultural therapy); helps patients achieve a bi-cultural balance
What are some limitation of sociocultural treatments?
Many minority groups are still underserved (cultural bias against psychological services); traditional methods that have been proven effective may be overlooked
Describe Interpersonal Psychotherpay
explores interpersonal loss of a loved one; interpersonal role dispute; interpersonal role transition; interpersonal deficits
What are some biological treatments for depression?
ECT, used for severe depression
60-80 percent of patients improve
Describe MAOIs.
a MAO inhibitor was used to treat TB and it decreased depression. Enzyme that breaks down (decreases) norepinephrine. MAO inhibitor stops that action and result is an increase in norepinephrine.
What are limitations of MAOIs?
dangerous rise in blood pressure when patient eats common foods such as bananas, cheeses, and certain wines.
Food interactions with MAOIs are decreased using what?
skin patch
What are tricyclics?
Act on neurotransmitter reuptake mechanisms
10 day lag period
The longer a person is on tricyclics, the lower the relapse rate.
SSRIs target what?
Serotonin using reuptake mechanism
SNRIs target what?
Target norepinephrine and serotonin using reuptake mechanism
What is vagus nerve stimulation?
Pulse generator implanted in skin of chest. Wire is guided by surgeon up into the neck and is attached to vagus nerve. Electrical signals are delivered to brain on a programmed schedule.
40% of patients who were non-responsive to other methods have good results
Describe transcranial magnetic stimulation
Coil placed on head and electromagnetic current is discharged into frontal lobe
Administered daily for 2 to 4 weeks
Describe deep brain stimulation?
Implanted electrodes in Broadmann Area 25 and “pacemaker” implanted in chest
Steady stream of low-voltage electricity sent from pacemaker to Broadmann Area 25
What are some treatments for Bipolar disorders?
Lithium, considered a mood stabilizer. Good results when taken properly.
What are some dosing issues with lithium?
lithium intoxication, nausea, vomiting, dizziness, tremors, slurred speech, seizures, kidney dysfunction, death
–Death is a dosing issue?!
