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Different Psychological Approaches To Understanding And Treatment Of Major Depressive Disorder

Introduction- Different Psychological Approaches To Understanding And Treatment Of Major Depressive Disorder

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Mental illness is a serious condition and its treatments are equally important as physical disorders. Moreover, if it remains untreated it can lead to some serious behavioural and emotional issues in individuals. The conditions of mental illness have been increasing rapidly worldwide and in support of that statement the data of WHO will be used in the following sections. In addition, a discussion will be done on the types of depression and among all types of depression, the severity of depression will be analysed. Following that, a description will be provided of the concept of Major Depressive Disorder (MDD) along with its causes and symptoms of this mental illness. In the end, an overview will be given on some common approaches for treating this condition and some psychotherapy effective for MDD treatment. However, the justification will be provided on the best psychotherapy and its underlying approach for effectively curing MDD.

Overview of Major depressive disorder and its treatment

Concept on MDD

Depression is a serious mental condition that affects one’s emotions, thinking abilities and feelings. There are various types of depression and these are "MDD", "Dysthymia", "Bipolar depression", "Psychotic Depression", "Seasonal Affective Disorder", and "Dysthymic disorder", "Cyclothymic disorder" and “Postpartum Depression”. MDD is also known as “clinical depression” or “Unipolar depression” (Kennis et al. 2020). In this type of depression the thinking ability, feelings and behaviours of the individual change and that in turn affects the physical health. The person who suffers from this condition does not get pleasure or satisfaction in unusual activities and these symptoms stay for long. According to WHO, suicide is considered to be the fourth leading cause of death among adolescents and early adulthood phase which is 15 to 29 years old (Who, 2022). WHO states that depression even causes disability and that is a major concern. In order to support those who have developed disabilities, WHO even have taken an initiative called “MiNDbank'' which is an online platform that takes substance abuse, mental health, general health and other resources of national and international countries in order to protect those who have a mental disability. This campaign aims to protest against mentally disabled people (Who, 2022). Hence, with this approach WHO is not only trying to help people but also using resources to develop strategies for curing this MDD.

Causes of MDD

Hormonal changes are considered one of the important causes of MDD, which triggers this condition. However, hormonal changes during pregnancy or even postpartum period hormonal changes are significant. In addition, in menopause women experience some sudden changes in the reproduction hormones such as oestrogen and progesterone and that triggers major depression in women (Talaulikar, 2022). According to the findings of Thériault and Perreault, (2019), people who have problems with the thyroid due to changes in thyroxine levels cause depression in both males and females. Sudden changes in the neurotransmitters such as “Dopamine”, “Serotonin”, “GABA”, and ACH or “Acetylcholine” have been found to have an association with MDD. As per the findings of Hernández-Hernández et al. (2019), the way these neurotransmitters interact with the neural circuits of the brain, spinal cord, as well as peripheral nerves, play a crucial role in maintaining a stable mood and if this stability gets disrupted people suffer from depression. Moreover, as people with depression suffer from low motivation it has been found that dysfunction in the dopamine system is the major cause of this condition (Cénatet al. 2021). Serotonin is directly involved in processing emotions and thus regulates the overall mood and if the serotonin levels decrease that triggers depression among individuals. Other than these causes, some research also reveals that inherited traits are also responsible for MDD and various studies prove this fact.

Symptoms of MDD

There are some common symptoms of MDD and these are sudden outbursts of anger or frustration even if the cause is insignificant. Individuals who suffer from MDD feel low due to hopelessness and emptiness all the time and this slows down their abilities to think. They always feel tired due to a lack of sleep and in many cases, it has been seen that they suffer from insomnia. A guilt feeling makes them think they are worthless and that de-motivate them to do any work (Øverland et al. 2020). In addition, loss of appetite and for that sudden weight loss is seen. However, some experience a sudden surge in their cravings for food, which instigates gaining of weight rapidly. Other than the loss of interest or pleasure in games, sex or any other normal activities, some experience restlessness, anxiety and mood swings (Cénat et al. 2021). Due to depression, teens score poorly in school due to poor performances. Self-harm is also very common and many teens avoid social interaction as well. It has been found that depression causes some physical disorders like headaches, stomachaches, and back pain and so on.

Approaches for treating MDD

Some common approaches are used in psychotherapy in order to treat mental illnesses such as MDD. These approaches include “psychodynamic (psychoanalytical)”, “cognitive-behavioural”, “Medical model”, “Supportive psychotherapy”, “Behavioural therapies” and even “interpersonal therapies”. However, there are some other types of psychotherapies as well that are found to be effective in treating MDD (Cuijpers et al. 2020). “Psychodynamic theory” by Freud is very significant in depression, as he has stated that the presence of severe superego is the major cause of depression. In a Psychodynamic approach, where the anxiety or depression is treated, the childhood trauma, or the conflicts of interests and other incidents shape the personality of a person (Khademi et al. 2019). This approach considers all these elements and by considering the nature vs. nurture debate, it highlights one's childhood experiences that could cause MDD among individuals. In this regard, the psychoanalysts consider using “Talk therapy” in order to explore the thought patterns of the patients and try to understand their feelings (Maddox et al. 2018). Using the opportunity of unconscious mental health, these psychoanalysts try to discover the actual sources of depression. According to Luo et al. (2020), “Behavioural Therapy” helps in changing the maladaptive behaviours of the patients. “Exposure therapy” is used to expose the patient to those objects or situations in which they have phobias and in this way, depressed people develop the strength to face their fears.

Commonly used psychotherapies and drug therapies for MDD

Moreover, in the medical model, the patients with depression are treated extensively with the help of medications and for that, the actual cause of MDD is identified. Commonly it is known as drug therapy where the psychologist or the doctor prescribes “Antidepressant” medications for treating this MDD. SSRIs or “Selective serotonin reuptake inhibitors” such as “escitalopram”, “vortioxetine”, “paroxetine”, “fluoxetine”, “fluvoxamine” etc. are prescribed in order to ensure the serotonin is attached to the receptors and works properly as low levels or low utilisation of serotonin is one of the major causes of depression (Suresh et al. 2020). Other than that “Electroconvulsive Therapy” has been also used where electrodes are positioned while the patient is in anaesthesia on the head and the patient is consistently given a mild electrical shock that causes a temporary loss of memory (Hermida et al. 2018). This treatment does not have any major side effects and consistent use of this shock therapy is very effective for treating depression. Moreover, “vagus nerve stimulation” helps to stimulate the vague nerve and that in turn releases some chemical messengers or neurotransmitters such as Ach, dopamine, and serotonin for effective regulation of mood and relieving depression symptoms (Bottomley et al. 2020). Some patients experience chronic pain and that prevents them from actively performing everyday chores for that doctors prescribe “Tricyclic Antidepressants” such as “nortriptyline” and “amitriptyline” and these drugs are found to be very effective in relieving physical pain in depressed people (Castillo-Zacarías et al. 2021). Moreover, as mood swings are a common symptom of depression, mood stabilisers drugs like “lithium”, “divalproex sodium”, “lamotrigine” etc. are prescribed.

Analysing the effectiveness of the treatments

According to the findings of Clevenger et al. (2018), a treatment that helps in utilising the neurotransmitter levels is considered the most potent treatment for depression. Moreover, as per the statement of Luo et al. (2020), cognitive therapy is also very beneficial for treating people with depression and if cognitive therapy, as well as behavioural therapy, are combined that works most effectively in reducing the negative thoughts in major depressive disorder.

Conclusion

The focus of this essay was to discuss one of the common mental disorders, which were MDD, and it has been found that changes in the functionality of some common neurotransmitters are the major cause of depression. This is the main reason why many psychologists focus on treatments that either stimulate the secretion of those neurotransmitters or ensure attachment to the receptors. In addition, a discussion has been done on other types of psychotherapies like “Electroconvulsive Therapy” which helps in erasing memory temporarily so that over time the patients can deal with their depression. A discussion has been done on some other types of treatment such as drug therapy that acts as anti-depressants and efficiently treats major symptoms like mood swings in patients. Therefore, it can be conclusively stated that although MDD is a major problem it can be managed or treated and even cured completely.

References

Website

Who, 2022.Overview. Available at: https://www.who.int/health-topics/mental-health#tab=tab_1 [On 31st May 2022]

Journals

Bottomley, J.M., LeReun, C., Diamantopoulos, A., Mitchell, S. and Gaynes, B.N., 2020.Vagus nerve stimulation (VNS) therapy in patients with treatment resistant depression: A systematic review and meta-analysis. Comprehensive Psychiatry98, p.152156.

Castillo-Zacarías, C., Barocio, M.E., Hidalgo-Vázquez, E., Sosa-Hernández, J.E., Parra-Arroyo, L., López-Pacheco, I.Y., Barceló, D., Iqbal, H.N. and Parra-Saldívar, R., 2021. Antidepressant drugs as emerging contaminants: Occurrence in urban and non-urban waters and analytical methods for their detection. Science of the Total Environment757, p.143722.

Cénat, J.M., Blais-Rochette, C., Kokou-Kpolou, C.K., Noorishad, P.G., Mukunzi, J.N., McIntee, S.E., Dalexis, R.D., Goulet, M.A. and Labelle, P.R., 2021. Prevalence of symptoms of depression, anxiety, insomnia, posttraumatic stress disorder, and psychological distress among populations affected by the COVID-19 pandemic: A systematic review and meta-analysis. Psychiatry research295, p.113599.

Clevenger, S.S., Malhotra, D., Dang, J., Vanle, B. and IsHak, W.W., 2018. The role of selective serotonin reuptake inhibitors in preventing relapse of major depressive disorder. Therapeutic advances in psychopharmacology8(1), pp.49-58.

Cuijpers, P., Karyotaki, E., Eckshtain, D., Ng, M.Y., Corteselli, K.A., Noma, H., Quero, S. and Weisz, J.R., 2020. Psychotherapy for depression across different age groups: a systematic review and meta-analysis. JAMA psychiatry77(7), pp.694-702.

Hermida, A.P., Glass, O.M., Shafi, H. and McDonald, W.M., 2018. Electroconvulsive therapy in depression: current practice and future direction. Psychiatric Clinics41(3), pp.341-353.

Hernández-Hernández, O.T., Martínez-Mota, L., Herrera-Pérez, J.J. and Jiménez-Rubio, G., 2019. Role of estradiol in the expression of genes involved in serotonin neurotransmission: implications for female depression. Current neuropharmacology17(5), pp.459-471.

Kennis, M., Gerritsen, L., van Dalen, M., Williams, A., Cuijpers, P. and Bockting, C., 2020. Prospective biomarkers of major depressive disorder: a systematic review and meta-analysis. Molecular psychiatry25(2), pp.321-338.

Khademi, M., Hajiahmadi, M. and Faramarzi, M., 2019.The role of long-term psychodynamic psychotherapy in improving attachment patterns, defense styles, and alexithymia in patients with depressive/anxiety disorders. Trends in psychiatry and psychotherapy41, pp.43-50.

Luo, C., Sanger, N., Singhal, N., Pattrick, K., Shams, I., Shahid, H., Hoang, P., Schmidt, J., Lee, J., Haber, S. and Puckering, M., 2020. A comparison of electronically-delivered and face to face cognitive behavioural therapies in depressive disorders: A systematic review and meta-analysis. EClinicalMedicine24, p.100442.

Maddox, B.B., Kang-Yi, C.D., Brodkin, E.S. and Mandell, D.S., 2018.Treatment utilization by adults with autism and co-occurring anxiety or depression. Research in Autism Spectrum Disorders51, pp.32-37.

Øverland, S., Woicik, W., Sikora, L., Whittaker, K., Heli, H., Skjelkvåle, F.S., Sivertsen, B. and Colman, I., 2020. Seasonality and symptoms of depression: A systematic review of the literature. Epidemiology and psychiatric sciences29.

Suresh, V., Mills, J.A., Croarkin, P.E. and Strawn, J.R., 2020. What next? A Bayesian hierarchical modeling re?examination of treatments for adolescents with selective serotonin reuptake inhibitor?resistant depression. Depression and anxiety37(9), pp.926-934.

Talaulikar, V., 2022. Menopause transition: Physiology and symptoms. Best practice & research Clinical obstetrics & gynaecology.

Thériault, R.K. and Perreault, M.L., 2019. Hormonal regulation of circuit function: sex, systems and depression. Biology of sex differences10(1), pp.1-14.

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