Ch. 9: Treatment for Depression and Bipolar Disorders

Question 1

What percentage of the population will meet criteria for depression?

Answer 1

15-17%

Question 2

What percentage of people seeking treatment for unipolar depression will show improvement?

Answer 2

80%

Question 3

What is the premise, goal and strategy of psychodynamic treatment?

Answer 3

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.

Question 4

What are some strengths of psychodynamic treatment?

Answer 4

Patients develop better insight into conflicts and can change behavior over time

Question 5

What are some limitation of psychodynamic treatment?

Answer 5

Long term therapy is inconvenient if immediate relief is needed

Question 6

What is the premise, goal and strategy of behavioral treatment?

Answer 6

Premise: Depression is linked to reward and punishment
Goal: Reintroduce patient to pleasurable activity
Strategy: Behavioral activation, reward system, social training

Question 7

What are some strengths of behavioral treatment?

Answer 7

Short term therapy, quick results, patients like active role in therapy.

Question 8

What are some limitation of behavioral treatment?

Answer 8

Behavioral strategies are more effective when combined.

Question 9

What is the premise, goal and strategy of cognitive treatment?

Answer 9

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

Question 10

What are the steps of Beck’s 4 phase treatment?

Answer 10

1) Increase activity and mood
2) Challenging automatic thoughts
3) Identify negative thoughts
4) Changing primary attitude

Question 11

What are the strengths of cognitive treatment?

Answer 11

Heavily researched-based. Shows significant improvement in decreasing symptoms of depression.

Question 12

What are limitations to cognitive treatment?

Answer 12

Many do not believe you have to discard negative cognitions in order to decrease symptoms of depression.

Question 13

What is the premise, goal and strategy of sociocultural treatment?

Answer 13

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

Question 14

What are the strengths of sociocultural treatments?

Answer 14

Often uses a combined approach to enhance therapy (i.e., cognitive and socio-cultural therapy); helps patients achieve a bi-cultural balance

Question 15

What are some limitation of sociocultural treatments?

Answer 15

Many minority groups are still underserved (cultural bias against psychological services); traditional methods that have been proven effective may be overlooked

Question 16

Describe Interpersonal Psychotherpay

Answer 16

explores interpersonal loss of a loved one; interpersonal role dispute; interpersonal role transition; interpersonal deficits

Question 17

What are some biological treatments for depression?

Answer 17

ECT, used for severe depression

60-80 percent of patients improve

Question 18

Describe MAOIs.

Answer 18

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.

Question 19

What are limitations of MAOIs?

Answer 19

dangerous rise in blood pressure when patient eats common foods such as bananas, cheeses, and certain wines.

Question 20

Food interactions with MAOIs are decreased using what?

Answer 20

skin patch

Question 21

What are tricyclics?

Answer 21

Act on neurotransmitter reuptake mechanisms
10 day lag period
The longer a person is on tricyclics, the lower the relapse rate.

Question 22

SSRIs target what?

Answer 22

Serotonin using reuptake mechanism

Question 23

SNRIs target what?

Answer 23

Target norepinephrine and serotonin using reuptake mechanism

Question 24

What is vagus nerve stimulation?

Answer 24

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

Question 25

Describe transcranial magnetic stimulation

Answer 25

Coil placed on head and electromagnetic current is discharged into frontal lobe
Administered daily for 2 to 4 weeks

Question 26

Describe deep brain stimulation?

Answer 26

Implanted electrodes in Broadmann Area 25 and “pacemaker” implanted in chest
Steady stream of low-voltage electricity sent from pacemaker to Broadmann Area 25

Question 27

What are some treatments for Bipolar disorders?

Answer 27

Lithium, considered a mood stabilizer. Good results when taken properly.

Question 28

What are some dosing issues with lithium?

Answer 28

lithium intoxication, nausea, vomiting, dizziness, tremors, slurred speech, seizures, kidney dysfunction, death
–Death is a dosing issue?!