Biopsychological Roots of Depression, Essay Example

A mixture of social, psychological, and biological factors causes Major Depressive Disorder and treatment responses should address all three. A personalized approach to therapy that addresses the complexity of the disorder will look at personal, societal, biological, genetic, and environmental issues that contribute to the patient’s problems. (Grohol, 2006)

In the biological realm, the brain utilizes neurons that carry electrical impulses called synapses (Huddersfield, 2012). These synapses control the brain’s electrical activity and the ability to function. In normal cognition, an impulse crosses from one neuron across the synapse to another via enzymes called neurotransmitters. Six different groups of neurotransmitters must operate effectively because each different type corresponds to a given type of brain cell. In the biological causes of depression, patients have low levels of serotonin, a certain neurotransmitter also called FHT or 5 hydroxytryptamine that works in conjunction with noradrenalin (Seligman & Reichenberg, 2011). Low levels of these neurotransmitters are thought to cause or exacerbate blue moods, lack of energy, depressed attitude, sleep problems, and low sex drive. While depression is thought to be a psychological disorder, there are real biological abnormalities that contribute to distinct physiological changes in the way the brain operates. (Huddersfield, 2012)

The occurrence of this disorder is often characterized by relentless psychosocial stressors. Stressors play a significant role in the initial onset of depression. Treatment options for this short-term depression (hopefully) will include psychotherapy and medication, a serotonin uptake inhibitor such as Elavil or Zoloft. Other considerations may include Celexa, Lexapro, Prozac, Paxil, or Luvox. (HealthyPlace.com, 2000) If the patient shows no signs of improvement or poor improvement after six weeks, the drug should be changed. Once a suitable medication has been found showing significant patient improvement, it should be continued for four months beyond the period when the patient feels better. A common problem with recurrences involves patients leaving their medication too soon. (HealthyPlace.com, 2000)

Therapy options include cognitive, behavioral therapy, rational emotive therapy to family and group therapy, depending on individual needs and available resources (Grohol, 2006). In order to start a cognitive behavioral therapy, a discussion must take place over the thoughts and behaviors that exacerbate the patient’s depressed state. This therapy seeks to concentrate on the thinking and actions that cause the depression rather than trying to analyze why the patient feels depressed. This means that cognitive-behavior therapy is short term and works best for patients dealing with distress and temporary depression (Haykal & Akiskal, 1999).

Dysthymia or a mild, low-grade, but persistent form of anxiety disorder is also a form of depression. Research shows that approximately 62% of patients with dysthymic disorder will benefit from antidepressant medication. (Long, 1997) Medication might include tricyclic antidepressants, MAOI antidepressants (classical and reversible), and SSRI antidepressants, like fluoxetine, which seems to provide the best results. (Haykal & Akiskal, 1999)

Dysthymia patients usually tend to experience a gloomy life, and at times, they may not remember their past happy moments and instances of inspiration. There is always a feeling of a lifetime depression. The disorder is in most cases by withdrawal, frequent worries, and agonizing thoughts of failure, which lead to an irritable, guilt-filled, and sluggish life in which one, may be deprived of sleep (Seligman & Reichenberg, 2011).

This disorder is a rather mild form of depression, which, unfortunately, is unceasing in nature (Grohol, 2006). Women are more prone to dysthymia as compared (about three in every one). In the event that one has a continued depression for a period of over two years, it is always necessary for such an individual to be diagnosed for the disease. In children, such needs to be just about a year and they tend to experience more of irritable moods, as opposed to depressed or sad moods. The depression associated with dysthymia may at times appear like part of the personality of the individuals involved. It may take a considerable period before one realizes that he has dysthymia (Grohol, 2006). In the event that it develops during the early stages of an individual’s life, it is common to assume that depression is a normal state of the individual, which may not be the case after all. Because of this reason, failure to notice the disease in an individual may let it go without being treated (Parker & Manicavasagar, 2005).

The condition, in most cases, develops during the early stages of an individual’s life. However, quite a number of people should be tolerant for close to a decade before seeking medical attention (Haykal & Akiskal, 1999). This, however, poses a disadvantage since the earlier the treatment of the disorder, the better. As a result, one obtains relief and prevents further distress. Children with dysthymia are supposed to obtain an evaluation from either a medical doctor or a mental health expert (Huddersfield, 2012). Through early treatment of the disorder, the children are able to avoid graver mood disorders, which may affect both their social life and schooling. It is also worth noting that such children are more prone to drug and substance abuse during their youthful days.

From past study findings, about three percent of any given population may have dysthymia. During a lifetime, the disorder may affect about six percent of the population. Individuals with relatives that have at one time had a serious depressive disorder are more likely to be affected by dysthymia (Long, 1997). When an individual develops dysthymia, it occurs during the early stages of life, that is, all the way from childhood to early adulthood. The symptoms are usually chronic, but then, it is the tendency of most people not to seek treatment until they experience considerable depressions. It is also worth noting that possessing dysthymia increases the likelihood of an individual contracting a serious depressive disorder, and accounts for about 10 percent of such individuals (Grohol, 2006). When an individual has both dysthymia and a considerable depression, the condition is referred to as “double depression”.

Personality disorders may also be a characteristic of dysthymia, and such include narcissistic, histrionic, dependent, avoidant and borderline (Huddersfield, 2012). Nevertheless, at times it becomes exceedingly tricky determining the level of a particular personal disorder because the long-term problems associated with dysthymia at times have a significant impact on the interpersonal relationships and the perception of one about oneself. Dysthymia is also linked to substance use in some cases since individuals with the condition are at times tempted to abuse drugs and alcohol in efforts to remedy their heartsickness and other awful symptoms (Huddersfield, 2012). In children, dysthymia may result in anxiety disorders, hyperactivity disorder (commonly known as attention deficit disorder), conduct disorder, learning disorders, and mental retardation. Other physical illnesses are closely linked to dysthymia, and these are the likes of AIDS, multiple sclerosis and hypothyroidism (Haykal & Akiskal, 1999).

Quite a number of approaches are available when it comes to the effective treatment of dysthymia. Most people with this condition seek treatment because of heightened stress and other personal struggles that may be related to a given situation. The chronic nature of this condition can only be established using a careful diagnostic interview (Huddersfield, 2012). The state of the condition may also be determined using a number of therapy sessions.

Perhaps the best approach of treating individuals with dysthymia is the combination approach whereby psychotherapy is done in combination with antidepressant medication. The combination of the two is more rewarding as compared to each working individually. The greatest advantage is the fact that the method addresses issues of depressive symptoms as well as social functioning (Seligman & Reichenberg, 2011).

Psychotherapy encompasses several types, which are all options for a patient suffering from dysthymia. Psychotherapy only starts after mental health professionals have conducted exhaustive evaluations in order to determine the present and functioning state of the person (Huddersfield, 2012). This usually assists in gauging the mood type and the degree to which is affecting the patient. The patient is also checked for suicidal plan and idealization. Regardless of the psychotherapeutic method used, there is always needed to establish a change oriented, supportive and excellent rapport with the patient (Grohol, 2006).

A cognitive-behavioral therapy that is usually client-centered in nature may also be used since it provides an environment of therapy, which is customized for the need of the patient for unconditional backing and acceptance. There are also other non-specific factors, which play a significant role in the therapy (Long, 1997). The therapy conducted should be done putting in mind the pace and level of functioning of the client. Trying to identify changes quite early in therapy may result in a premature termination of therapy. The major cause of this is the patients feeling of the disrespect and uncaring attitude of the therapist for not moving at their rate (Parker & Manicavasagar, 2005).

The variations in the methods of psychotherapy for this disorder are varied largely. In most cases, people prefer short-term approaches since they put more emphasis on the realistic and attainable objectives in the life of individuals, hence bringing them back to their normal functioning level. This, however, in most cases, is way below the level of functioning of an average person (Huddersfield, 2012). People having dysthymia have a tendency of possessing a considerable level of chronic unhappiness during their lifetime (Grohol, 2006). Therefore, it is essential that the realistic goals be established early enough so that the center of attention for the treatment is not the mood state of the individual.

Group therapy has in the past proved quite an effective modality, for individuals suffering from dysthymia. This is because a group tends to offer more support than an individual does and in the end, the patient’s inconsistencies can be easily pointed out (Huddersfield, 2012). This approach should always be considered, either at the beginning or the later stages of treatment when the patient has regained self-confidence, which helps him, interact in a social context. Such issues as self-esteem may be a characteristic of individuals having the disorder. Therefore, there should always be caution as to when the person should be put in a group situation. Family therapy is also significant for some people (Haykal & Akiskal, 1999). Sometimes, couple therapy can be used to draw an individual into a therapeutic relationship in order to enhance a more powerful therapeutic triad.

The goals of different forms of therapy are different depending on the depression encountered. When it comes to cognitive therapy, emphasis is more on an individual’s defective way of thinking and the general worldview. On the other hand, interpersonal therapy emphasizes the relationship of the individual with other people and the best way of strengthening and improving current relationships while subsequently identifying new ones (Huddersfield, 2012). There is also solution-focused therapy, which points at certain problems that provoke the life of an individual presently. It also seeks out the best approach relating to changing the behavior of a patient to develop a clarification for such difficulties (Long, 1997). When it comes to social skills training, emphasis is more on teaching the client skills related to the effectiveness in social and work relationships. In most cases, psychoanalytic and other insight-based methods are less effective due to the emphasis on the past and rather lengthy therapy. Although incorporating therapy into an individual’s chronic condition may seem profitable for the therapist, it does not offer a timely and the change-effective way for the patient to overcome the difficulties.

Although personal psychotherapy is the most common psychosocial treatment option, many patients with dysthymic disorder will benefit from group therapy and dynamic analysis and reorganization of maladaptive social performance. Fortunately, non-severe depression patients usually spontaneously recover from their symptoms (Long, 1997).

Individuals suffering from dysthymia in most cases use antidepressant medication, which assists in keeping up their energy levels while subsequently preventing them from reaching the least depressive moods. Selective serotonin re-uptake inhibitors (SSRIs) are mostly used for the treatment of chronic depression presently. The most renowned brand names in this regard include Prozac, Paxil, Zoloft, and Luvox (Long, 1997). It is recommended that SSRI medications be not prescribed together with older MAOIs.

Research findings indicate that most people with medication are supposed to try a variety of brands before eventually getting one that works for them. It is my endeavor to know more about this disorder because it is so prevalent and widespread (Long, 1997). People continuously experience distressing news from deaths in the family to loss of jobs or break-up of relationships and depression plays a significant role in human activity (Huddersfield, 2012). Understanding when simply “getting the blues” is a serious problem involving both physiological and psychological factors is paramount toward recognizing a serious depressive disorder and treating it early. Depression is very valuable to learn because when people suffer from it, it significantly ruins their productivity and is a drag on society. In addition, people suffering need help regardless of their effect on larger society (Parker & Manicavasagar, 2005).

References

Grohol, John, M., PsyD, (2006) “Depression Treatment,”Psyche Central, March 8, 2006, Accessed online on March 13, 2012 at: http://psychcentral.com/disorders/sx22t.htm

Haykal, R.F., and Akiskal, H.S., (1999) “The Long-Term Outcome of Dysthymia in Private

Practice: Clinical Features, Temperament, and the Art of Management,” Journal of Clinical Psychology, August, Volume 60, Issue 8, pp 508-18.

HealthyPlace.com, (2000) “Pharmacologic Treatment of Acute Major Depression and Dysthymia,”National Guidelines Clearinghouse, October 26, 2000, accessed online on March 13, 2012 at: http://www.healthyplace.com/communities/depression/treatment/antidepressants/treatment_guidelines.asp

Huddersfield, Alan Priest, (2012) “Depression,” accessed online on March 14, 2012 at: http://www.alanpriest.f2s.com/Depression%20Mild%20p2.htm

Long, Phillip W., MD, (1997) “Dysthymic Disorder: Treatment,” Online Diagnosis, August 19, 1997, accessed online on march 14, 2012 at: http://www.mentalhealth.com/rx/p23-md04.html

Seligman, L. & Reichenberg, L.W. (2011). Selecting Effective Treatments: A Comprehensive, Systematic Guide to Treating Mental Disorders. New York, NY: John Wiley & Sons

Parker, G. & Manicavasagar, V. (2005). Modeling and Managing the Depressive Disorders: A Clinical Guide. Cambridge: Cambridge University Press