For example Elizabeth L. Angeli, Department of Psychology, State University.
This research was supported in part by a grant from the Sample Grant
Program.
Angeli, Department of English, Purdue University, West Lafayette, IN 55555
Major Depressive Disorder (MDD)
Major Depressive Disorder is marked by recursive episodes of low feelings in mood, shallow mindedness and persistent felling deep chasm in oneself. This can be accompanied by low self-esteem and loss of interest in pleasurable activities such as listening to music, playing games, watching movies, etc. The subject continuously displays a sad attitude and lack of interest in life. The victim of Major Depressive Disorder may be haunted by continuous thoughts of suicide. The subject is also prone to devastate his professional, personal and social life. Another significant sign of Major Depressive Disorder is that the balance in life may be severely distorted such as the subject may start to eat too much or too less. He may start having a higher severity level of insomnia or hypersomnia which will further aggravate the condition of the subject.
Summary of Major Depressive Disorder
Major depressive disorder is defined as a mood disorder in which a depressive episode remains with the subject for at least two weeks. A depression that spans for less than two weeks generally, is not considered as a Major Depressive Disorder. With Major Depressive Disorder the subject loses interest in all the pleasurable activities.
The clinical diagnosis is only made when the subject shows significant impairment of work, social or personal life.
The diagnosis of a Major depression Disorder cannot be made if the subject is displaying elations and depressions that is the subject shows high and low moods (In this case the Major Depression Disorder is not present rather it indicates another mental illness known as Bipolar disorder).
The Major Depression Disorder may not be accounted for if the subject has suffered a loss of some kind as the death of a loved one, property or money. If the depressive feelings continue to exist two months beyond the loss. The symptoms of impaired functionality from others, suicidal thoughts, thoughts of worthlessness and other psychotic symptoms as mentioned before are prevalent. Only than the subject might be considered for Major Depressive Disorder (Barlow, 2008).
The Theory behind the Psychological Intervention for MDD
The Psychological interventions are steps that are taken to intervene to alter a (usually troubled) life an individual or a group of individuals. It is believed that emotions, behavior and feelings are somehow connected to each other. Psychologists have a broad range of applications. One of these applications is improving a quality of life by incorporating positive emotions, habits and attitude. The most outstanding applications of psychological interventions is in the treatment of mental disorders.
In the following the psychotherapies and related theories are described which are useful to treat MDD.
- Cognitive Behavioral Therapy (CBT)
- Interpersonal Therapy (IPT)
- Problem solving therapy (PST)
Cognitive Behavioral Therapy (CBT): The theory behind CBT is that psychological problems like “Major Depressive Disorder” is caused by certain thinking and behavior patterns. The therapists identifies unhealthy and negative thinking patterns and help the subject to alleviate him of those thought in a structured manner. The subject may also be taught to do relaxation exercises that may provide additional wellness.
Interpersonal Therapy (IPT): Interpersonal therapy relies on the fact that psychological problems occur because of problematic relationships. The therapist helps the subject to improve his relations with people close to him.
Problem Solving Therapy (PST): Problem Solving Therapy (PST) is also used to treat MDD. This Psychological therapy is based on the theory that the subject stacks up past problems in his mind over time and this leads to mental disorders. The therapist identifies the problems that the subject has stored in his mind and helps him to step by step remove them. This leads to lower the depression or stress from the mind of the subject (Department of Veterans Affairs & Department of Defense (2010), 2010).
Major Depressive Disorder is highly manageable. Psychological intervention like Psychotherapy or medications are effective for 80 percent of the subjects (Medscape.com, 2004). Two of the well-known psychotherapies are Cognitive Behavioral Therapy (CBT) and Interpersonal Psychotherapy (IPT)
- The subject eats too much or eats too less. There is a sudden increase in appetite or severe loss of hunger.
- There is a lack of sleep (Insomnia) or the subjects starts sleeping too much (hypersomnia)
- “Psychomotor agitation” can sprout in which the suffering person exhibits anxiety and perform repeated actions, such as biting fingernails, agitatedly move around in the room. On the contrary, the subject’s movement may slow down with a slow thinking process and slow reaction time, this is known as “Psychomotor retardation”.
- There can be “Fatigue” in which case there is a feeling of tiredness. There is also a notable lack of energy
- There can be a feeling of worthlessness or feelings of guilt. These feelings with no apparent cause are directly attributed to depression.
- There can be hurdles and inability to think or concentrate on work or study. There can also be a lack of decision making ability.
- There can be recurrent and persistent thoughts of committing suicide.
Literature Review (MDD)
Major Depressive Disorder is one of the most common psychotic problems. If someone feels sad and gloomy at certain times, it is considered normal. If the sad mood remains for more than two weeks than the person having such a condition becomes a candidate for the MDD. It is known that this ailment is caused by the imbalance of chemicals in the brain. The sufferer of the MDD also loses balance in life. He may sleep too much or too less and he may eat too much or too less. The subject also loses interest in pleasurable activities like games, watching movies, television and listening to music, etc. The patient will become more and more reclusive. In such a condition the psychologists can help in many different ways.
It is known that the patient with such an illness can have many negative thoughts and feeling that pile up in the patient’s mind. The psychologist identifies all such negative feeling and thoughts and with the help of therapies that are designed to help the psychotic patients, such as the sufferers of MDD can relieve the patient. Although these therapies help but they cannot replace medications to restore the chemical balance in the brain. The psychological treatment is combined with psychiatric aid to create a solution for all such problems.
Critical Review
Major Depression Disorder (MDD) like many other psychotic illnesses are known for centuries and scientists are working on them for decades but very little is known about them. It is known that these problems are genetic i.e. these problems are known to run in families. They can be inherited by children from their parents and forefathers. There is also a lot of scientific evidence that these problems can be produced in certain situational circumstances. Most of these illnesses have no cure, but they can be treated and once the treatment is done they need to be managed.
Many modern people as well as people from ancient times believe that these illnesses are caused by evil spirits. These beliefs are not supported by scientific observations because of the lack of evidence.
The modern psychological consultancy does lead to the improvement of the patient in his overall condition. The psychologists assess and diagnose the patient and treat the patient with therapies and convince the patient to use the medicines that are prescribed by psychiatrists until they return to normal social functioning.
Post-Traumatic Stress Disorder (PTSD)
After a traumatic experience if one feels frightened, anxious, and sad or disconnected than it is normal, but if one have continuously been haunted by these feelings then you may have Post Traumatic Stress Disorder (Helpguide.org, n.d.).
Summary of Post-Traumatic Stress Disorder
Post-Traumatic Stress Disorder can be caused by an unpleasant event in life that could be a few seconds long such as an accident, a rap, abuse, etc. This memory of the event can have lifelong consequences. The victim of PTSD may suffer from an intense shock, horror, helplessness and fear. This also damages confidence and the self-esteem of the person.
Psychological Intervention for PTSD (Theory)
As stated before PTSD is caused by a memory of witnessing or experiencing a disturbing or traumatic event in the past. The therapies employed in PTSD are as follows.
- Trauma-focused cognitive-behavioral therapy. Cognitive-behavioral therapy for PTSD and trauma involves carefully and gradually taking back the subject to the events, thoughts, feelings, and situations that remind him the trauma he faced in the past. Therapy also involves identifying upsetting thoughts about the traumatic events in the past, particularly, corrupt and irrational thoughts and replacing them with a more balanced picture.
- Family therapy. Since PTSD affects both the subject and his close friends, relatives and loved ones, family therapy can be very fruitful. Family therapy can help your loved ones understand the situation of the subject. It can also help everyone in the family communicate better and work through relationship problems caused by PTSD symptoms.
- Medication. It is sometimes prescribed to people with PTSD to relieve secondary symptoms of depression or anxiety. While, antidepressants may help you to get better emotionally, they do not treat the causes of PTSD.
- EMDR (Eye Movement Desensitization and Reprocessing). Incorporates elements of cognitive-behavioral therapy with eye movements or other forms of repetitive movements of the eyes, feet, hands, or sounds. Eye movements and other forms of stimulation are thought to work by “unfreezing” the brain’s information processing system, which gets disturbed in a condition of extreme stress (Helpguide.org, n.d.).
The assessment of the subject to subject is a structured interview of a person suffering from a PTSD. The information is gathered helps to assess the mental health of the subject.
The assessment of PTSD may be challenging for the psychologist because if the subject’s problem is caused by a traumatic event such as rape, child abuse or assault etc. The subject may be hesitant because of the embarrassment that is caused by the incident.
Therefore, it is absolutely necessary to make the client comfortable and questions about the following topics are carefully sought after for the assessment of PTSD.
Re-experiencing the traumatic event
- Persistent traumatic memories
- Flashbacks (acting or feeling like the event is happening again)
- Nightmares (either of the event or of other frightening things)
- Feelings of misery when reminded of the trauma
- Intense subconscious physical reactions to reminders of the event such as Pounding of the heart, fast breathing, muscular stress and sweating, etc.
Symptoms of PTSD: Avoidance and numbing
- Avoiding activities, thoughts, feelings or locations that recall the subject of the trauma in his past
- Amnesia
- Anhedonia
- Feeling disconnected from others and emotionally numb
- The Sense of a limited future
Symptoms of PTSD: Increased anxiety and emotional arousal
- Insomnia
- Disrupted mood
- Concentration difficulties
- Hyper vigilance
- Anxiety (Helpguide.org, n.d.)
Cultural Considerations for Cognitive Behavioral Therapy
One of the main aspects of Cognitive Behavioral Therapy, is taking into consideration, the uniqueness of the individual. The cognitive behavioral therapy is essentially required to be adapted to the needs of the individual. In the case of an individual belonging to a multicultural minority the emphasis becomes the culture (not the individual). This increases the effectiveness and the appropriateness of the CBT for each client. A large number of Cognitive Behavior techniques are available which serves as a tool for people belonging to diverse cultures. There is another application of CBT is the self-empowerment of the subject. The client is viewed as being in control of his thoughts and emotions (Hays, 2012).
Cultural Considerations for Cognitive Behavioral Therapy
One of the main aspects of Cognitive Behavioral Therapy, is taking into consideration, the uniqueness of the individual. The cognitive behavioral therapy is essentially required to be adapted to the needs of the individual. In the case of an individual belonging to a multicultural minority the emphasis becomes the culture (not the individual). This increases the effectiveness and the appropriateness of the CBT for each client. A large number of Cognitive Behavior techniques are available which serves as a tool for people belonging to diverse cultures. There is another application of CBT is the self-empowerment of the subject. The client is viewed as being in control of his thoughts and emotions (Hays, 2012).
Literature Review (PTSD)
The most intriguing thing about PTSD is that there are many emotional events in a person’s life, but not all become a painful memory. The subject that is destined or prone to PTSD a single tragic incidence lapsed over a few seconds or a couple of minutes can become a misery for a lifetime. The job of an experienced psychologist is to dig out that single painful incidence and identify it. The professional psychologist through his assessment and careful and polite conversation can bring out that that memory from one’s subconscious mind and bring it to the conscious. It is one of the most important stages of the PTSD healing process when the subject suddenly gets emotional and may start to cry or his emotions flow out. His facial expressions may become gloomy or he might get angry and agitated. In any such cases the psychologists have to keep the whole situation under control. A successful psychologist is always able to influence the subject on an emotional basis and let the emotions and suppressed feelings to clear out. In the case of PTSD, emotional relief helps to a significant degree. All the assessment, Diagnosis and therapies are extremely fruitful once the psychologist is able to tap into the emotional side of the PTSD subject.
Critical Review
The biggest Mistry behind PTSD is that a single piece of memory few seconds long can devastate or even destroy the whole life of an individual. The human lifetime experiences are known to be stored in the human brain. Scientists call the human brain as the most complex known structure in the universe. The information that a human brain picks up in one day and puts into the memory is more than the largest man made computer cannot absorb in its functional life. Those human memories can be good or bad or can be even worse, but how does a single or more pieces of memory become so dominant that can overpower and jeopardize the human social existence and lead him to a suicide in certain cases? Many questions like these are unanswered.
In spite all the advancements in psychology in the past with the formulation of many therapies, many people seek hypnosis to treat PTSD which not a proper science like psychology. This pseudoscience is said to be very effective in the healing or even forgetting the past painful memories which are known to be stored in the subconscious mind of an individual.
References
Barlow, D. H. (2008). Clinical handbook of psychological disorders. New York: Guilford Press.
Helpguide.org. (n.d.). Post-Traumatic Stress Disorder (PTSD): Symptoms, Treatment and Self-Help. [online] Retrieved from: http://www.helpguide.org/mental/post_traumatic_stress_disorder_symptoms_treatment.htm [Accessed: 10 Apr 2014].
Medscape.com. (2004). Treatment Strategies for Major Depressive Disorder: Overview of Treatment of MDD. [online] Retrieved from: http://www.medscape.com/viewarticle/467185_4 [Accessed: 9 Apr 2014].
Hays, P. A. (2012). Cover of Culturally Responsive Cognitive–Behavioral Therapy in Practice (medium) See larger image Culturally Responsive Cognitive–Behavioral Therapy in Practice. American Psychological Association.
