EA Psychotherapy Final Exam - Depression Flashcards
What picture does the phenomenological observation of the depressive person give - what dominates in their expression and appearance?
Expression- flat speaking voice, “heaviness”, “weighed down”
Appearance -Reduced muscle tone, poor eye contact, lack of animation, less physical color
What is the physiology of depression dominated by?
Vegetativum: dominated by the parasympathetic nervous system: low blood pressure, appetite disturbance, sleep disturbances.
Reduced gland activity, dry mouth, Sebaceous glands, poor digestion, constipation, less Noradrenaline and less Serotonin, sexual listlessness.
The body is on low flame “physiological hibernation.”
What is the difference between depression and melancholy in experience?
See chart
What is the difference between mourning and depression?
See chart
What are the main elements in the diagnosis of classical endogenous depression?
4 axes that are affected together when talking about classic endogenous depression.
Disturbance of drive: Lack of drive, lack of strength, lack of spirit/vitality, great fatigue, not motivated.
Disturbance of temper: Depressed mood, melancholy, “sad”, moody. As if the day is overshadowed by a black cloud, it is darkened. Low mood lasting minimum 2 weeks for severe depression. Daily fluctuations: the morning is heavier than the evening = morning Pessimum.
Disturbance of one’s affectability: Mood only addresses the negative and remains untouched by the positive. Loss of interest, cheerlessness. Resonates with negative things (war, death, autumn,…). Thinking parallels the feeling (brooding negative content). Powerlessness (brood compulsion further exhausts and confirms negativity).
Disturbance of one’s own biorhythm: The internal clock is disturbed:
Sleep disorders ( untimely awakening) = often the first symptom: Characteristic: sleep is never refreshing, never restorative. Other sleep disorders - too much sleep, more than the usual 7-8 hours without being properly recovered.
Appetite disorder, Digestions: constipation, stool regularity is lost, Menstruation stops, in men impotence, General: the glands produce less, Motor inhibition, sometimes motor restlessness, lowering of blood pressure, Duration: at least 2 weeks, max 2 years.
Give the main symptoms of mania?
Overactivity and urge of talking, loss of usual social inhibitions, libido, little need for sleep; or irritability, boorishness, overconfidence. Grand ideas, excessive optimism; excessive spending; aggressive, in love or joking on inappropriate occasions. Disorders of perception occur in mania. May also be associated with psychotic symptoms; overconfidence and grand ideas go into delusion, from irritability and distrust leads to paranoia, etc.
What is hypomania?
Conspicuous sense of well being and efficiency, concentration and attention may be impaired, conspicuous merriment to uncontrollable excitement and severe distractibility (mania); increased sociability, talkativeness
Give the main characteristics of a depressive personality.
Attitude to the world: sense of caring, take on responsibility
Tendency to take everything heavy (strong in the sympathy of the heavy) and to a bad conscience
Negative is more likely to be attributed internally -
Positive external (i.e., attributed to others)
Tendency to pessimism (anticipates the negative, calculates with the negative)
Strength and value experience (energy): fatigued faster, needs a lot of sleep, muscle tone and blood pressure flaccid
Tends to feel depressed, easily exhaustible
Attitude to oneself (self-image):
take oneself as not so important, resetting oneself (“selfless” out of feeling, that one’s own life is not so much of value as others because it’s weak and powerless), secretive, introverted, daydreams, ideas → normative-comparative
Tendency to exhaustion, because the priority is always given to others
Summary:
Withdrawn life predisposition, which is comfortable in itself (“Innerworld architects” - is not so at home in the outside world as in the inner world) and likes less being in the burdening transmission of the world. Keeps within one’s limits, therefore, can be alone well. Compassionate, strives to make it so good for others as well.
Compared to others, they experience their deficits:
Dissatisfaction when looking out the window
Standard, compassions increase the tension
Aim of personal development: peace between the inner and outer world; to integrate the depressed person in a world relation.
The depressed person struggles for a world reference: How do I bring myself in this world? Am I a burden to others, am I a loser…?
Page. 11 - Characteristics of the depressive personality (continuum from healthy to sick):
Basis = reduced sense of value → the feeling of one’s own value is low, and the value of life is barely felt ® series of uncertainties, which represents a background dynamic and involves a series of processes:
[≈ FM1] Uncertainty about the sustaining capacity of life.
→ worried-pessimistic
→ or behavior-aggressive
[≈ FM2] Uncertainty in feeling power and value (of the “good”) ® no confidence in one’s own power; fatigability + → (cognitive) search of the “normal.” Life is normatively thought rather than emotionally felt. The “normal” becomes rigid and lifeless through the normative. This uncertainty also leads to a comparison with others.
→ Restrained, quiet-serving, to feel less useless and not as unlovable.
[≈ FM3] Uncertainty in sensing and feeling one’s self-worth and that of others and
because they do not feel their own value
→ they compare themselves with others
→ Blocked to the outside. Introvert, selfless
→ many wishes, assumptions and ideas. Have pretty strong ideal worlds, which are
sort of the “cognitive replacement” for their reduced feeling capacity.
→ on this basis of the unattainable goals, frustration arises, which generates
aggression towards themselves
→ Dominance of the negative in encounters
Summary:
Basic movement = withdrawal from the world.
Life feeling = “heaviness,” life is laborious, difficult.
→ cannot believe that they are able to stand up to life (“manage it”), that life becomes
good and that they are loved.
Give the main characteristics of a depressive personality disorder.
Pessimism, always worried, dejected, insecure ® unfree, normative (rigid)
[= Protection against pessimism+ remorse, overtaxing]. Resigned and disappointed, insecure,
because not all actions have the desired effect Fade out the unplanned / desirable depends on the planned ® difficulty with changes (compulsive neatness) Inability to separate (unfree)
Cannot cling to their opinion, always gives in to the other one, believes that they become impatient → gets a bad conscience because others lose time because of them. - Also has
pessim. anxiety of not being understood.
Low level of arousal, constantly - or in phases - tired, sluggish, powerless. Retreat Life:
secretive, Inaccessible. Can e.g.sit next to others for hours and remain silent.- “I always have to overcome myself so to speak - and if others have a different opinion and contradict me
or even want to convince me I may not go on talking, feel powerless,give in, and then I’m not feeling well again…“® Live in ideas/fantasies/wishes sense of uselessness[= pathological] ,
Sense of worthlessness, constant feelings of guilt, to be a burden® inferiority feeling
® Coping reaction:achieve, to be good and correct.Need to help.
Problematic way of life, which fails with itself, the world and life over and over again and in different situation and often (basically) would like to be dead.
What causes neurotic depression in general?
Unprocessed living conditions or life- dampening attitudes, orientation, convictions:
Not grieved losses, rampant strains which leads to exhaustion.
Guilt: real guilt, which burdens, but often also illusory guilt (feelings of guilt)
Blocked or suppressed aggression. To be too passive, to let too much happen without protecting or defending oneself. Out of that, tensions result + reduced values experience.
What existential reference does the experience of depression contain?
“Summary: It becomes lifeless, because, amidst this numbness, I cannot relate anymore to values, to others, to myself, to the “living water,” to liveliness. Depression points out our lack of relationship, which is connected to being distant from life.”
Or
“Depression draws our attention to a way of living, that is moving away from life or has been forced away from life. In short: Depression means: “It isn’t good to live this way!” – “This is no life!”
