CPS: Understanding outcomes, Depression and anxiety

why is depression called a syndrome

numerous symptoms that may occur together in many diff combinations. differs in manifestation between other ppl

to what extent can we rely on genetic explanations of depression

genetic explanations suggest ppl can inherit susceptibility to depression. other factors must trigger depression. no specific genes. inheritence of a gene does not necessarily predict the development of depression. may be environment or imitation of parents with depression. genetic and environmental

diathesis-stress model

a diagnostic model that proposes that a disorder may develop when an underlying vulnerability is coupled with a precipitating event

how do neural mechanisms contribute towards development of depression

neurotransmitters eg dopamine, serotonin, norepinephrine regulate stress, eating and sleep. dynapses unable to reuptake these neurotransmitters to continue regulation leading to decreased regulation of mood and other functions resulting in symptoms of depression

what happens to the brain in cases of depression

secondary changes arising from chronic stress, low mood; reductions in size of prefrontal cortex and hippocampus (emotion and memory). fewer synapses less of the relevant neurotransmitters

how does psychology explain depression

focus on cognitive interpretations of stimuli. negative cognitive triad. repeated negative thinking serves to reinforce negative perceptions and maladaptive coping responses (reinforce negative perceptions)

negative cognitive triad

negative thoughts about the self, the world, and the future

How do social factors influence the experience of depression?

adverse effects on social functioning, ability to react and deal with stressful situations. responses of others exacerbate the condition via reinforcement of -ve thinking styles. responses such as rejection, lack of belief such as hopelessness ad perceptions of the self as not good enough.

Why is it important to accurately diagnose and manage depression?

high prevalence and associations with morbidity and mortality

What are the potential consequences of depression, if left undiagnosed/untreated?

risk of morbidity, mortality, suicidal ideation. social work and psychological disability. risk of future illness such as CVD, diabetes, stroke, substance misuse

When diagnosing a patient with depression, what difficulties might arise?

other physical conditions. other conditions must be ruled out first which is time consuming. anger or frustration and make clinical interview difficult to complete in order to make diagnosis

List three situations in which symptoms of depression may be confused with another condition.

fibromyalgia, dementia, chronic fatigue syndrome, cancer, menopause

Antidepressants such as Selective Serotonin Reuptake Inhibitors are often prescribed to those with depression. How do these medications work to treat depression?

selective serotonin reuptake inhibitors and SNRI work at synapses in the brain to prevent presynaptic reuptake of serotonin and norepinephrine. increases their level in the synapse

effectiveness of SSRI and SNRI and how long they take to work

4 weeks to take effect. 50% effectiveness. increased risk of suicidal thoughts and suicide in children and adolescents.

How do surgical interventions work to treat depression?

electroconvulsive therapy. placing electrodes on the brain in order to induce seizures which alter specific networks in the brain. Deep brain stimulation pair of electrodes surgically implanted in the brain and controlled by a generator implanted in the chest. stimulation is continuous and frequency level is customised

List the benefits and drawbacks of pharmacological and surgical interventions for depression.

benefits:

-efficacy of antidepresents 50-65%

-reduction in depressive symptoms

-faster than psychological techniques

Drawbacks:

-limited evidence

-invasive

-side effects are common eg memory loss and speech problems

-risk of bleeding or infections

Explain the cognitive behavioural approach to managing depression.

concepts, thoughts, feelings, physical sensations and actions are interconnected and negative thoughts and feelings can trap you in a viscous cycle. break down overwhelming problems change these -ve thinking patterns to improve the way you feel. deals with current, not past, problems. practical ways to improve state of mind by practicing different responses to stressors that induce depressive symptoms, teaching pts distraction techniques and encouraging keeping a diary to track thoughts and behaviours so maladaptive ones can be altered

Explain the "third-wave CBT" approach to managing depression.

mindfulness based CT focuses less on changing contents of thoughts and encourages a willingness to experience thoughts as transient events without interpreting them; becoming more aware in the present moment ie noticing signs of stress, depression, anxiety thoughts and feelings from one moment to the next.

mindfulness

aware of the stream of thoughts and feelings experienced and how one can become entangled in the stream that is not helpful. allows one to stand back from one's thoughts and to see their patterns. allow us to recognise these thoughts are mental events do not have to control us.