Term
| What is the DSM-5 Criteria for Major Depressive Disorder? |
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Definition
FIVE (OR MORE) of the following symptoms have been present during the SAME 2-WEEK period and represent a change from previous functioning:
• Marked diminished interest or pleasure in all, or almost all, activities
• Depressed mood
• Significant weight loss/gain or decrease/increase in appetite
• Insomnia or hypersomnia
• Psychomotor agitation or retardation
• Fatigue or loss of energy
• Feelings of worthlessness or excessive or inappropriate guilt
• Diminished ability to think or concentrate, or indecisiveness
• Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
- The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
- The episode is not attributable to the physiological effects of a substance or to another medical condition and not better explained by another mental health problem (e.g., Bipolar Disorder) |
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Term
| What is the Link between IncomeInequality and Depression? |
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Definition
As countries become more unequal, depression increases.
- Over the past few years NZ has become a lot more unequal, and the increase in wealth has gone to the top 10%.
- People in the 90% are much more susceptible to depression |
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Term
| What happened with Depression awareness in Japan? |
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Definition
- Utsu was not known in Japan
- The Pharmaceutical companies noticed that in a huge country people were not getting depressed
- So they went in and did pharmaceutical “awareness” campaigns and started selling antidepressants, in which depression rates increased immensely
- Mental health is not like a broken arm, it is a place where politics, social, psychological, and financial institutions have a large invested interest to create a profit from |
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Term
| What is the Biological Explanation to Depression? |
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Definition
- Neuro-chemical hypotheses related to serotonin have become dominant
- However, there is very little evidence of this
- Brain structure seem to be different in depressed people
- Stressful life events alone predict the likelihood of depression (Thigs that happen to us change our brains. Its not depression, it is these events that causes depression)
- Nonetheless anti-depressants prescribed to nearly 10% of NZ public |
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Term
| What is the Psychoanalysis explanation for depression? |
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Definition
| An early life experience of loss is evoked by later loss. |
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Term
| What is the Behaviourism explanation for depression? |
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Definition
| Learned helplessness – repeated experience of lack of control over aversive stimulus produces helpless response. |
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Term
| What is the Humanism explanation for depression? |
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Definition
Incongruence – discrepancy between actual and ideal self.
- Self-esteem is the problem. We all have an image of ideal self, and if it does not match where we are our self-esteem can suffer and can have a catastrophic effect. |
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Term
| What is the Socio-Cultural explanation for depression? |
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Definition
| Poverty is strongly associated with depression. |
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Term
| What is Beck's Cognitive Theory for depression? |
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Definition
People become depressed because they think in negative ways .
- When we become depresses our core beliefs, that were unarticulated get activated again
- Core beliefs = developed when young, regarded as truths, unarticulated, not always activated
- Depression arises from activation of negative core beliefs
1. Self (“I’m useless”)
2. World (including other people)(“The world is a horrible place”)
3. Future (“I have no hope for the future”)
- Activated by negative life events – E.g., relationship break-up “Nobody wants me, I am unlovable” |
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Term
| Explain the Bio-Psycho-Social Model |
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Definition
[image]
An approach to describing and explaining how biological, psychological and social factors combine and interact to influence physical and mental health.
Psychological vulnerability and/or genetic vulnerability + psychosocial stress = mental health problems
e.g. family history of depression/negative outlook on the world + recent relationship breakup = depression |
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Term
| What is the NICE Guidelines of Stepped Care for Depression |
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Definition
- The stepped-care model provides a framework in which to organise the provision of services, and supports patients, carers and practitioners in identifying and accessing the most effective interventions.
- In stepped care the least intrusive, most effective intervention is provided first; if a person does not benefit from the intervention initially offered, or declines an intervention, they should be offered an appropriate intervention from the next step.
[image] |
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Term
| What is the NICE Guidelines for Mild to Moderate Depression |
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Definition
| Psychosocial interventions (6-10 sessions over two months) . ALL evidence suggests that first treatment should be talking therapists. There is not enough people to accomplish this so people are given drugs. |
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Term
| What is the NICE Guidelines for Moderate to Severe Depression |
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Definition
| Medication and therapy (16-20 sessions over 3-4 months). Here people should receive drugs AND talking therapy. |
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Term
| What is Electroconvulsive Therapy (ECT)? |
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Definition
| A brain stimulation technique - used to treat major/life-threatening depression that hasn't responded to standard treatments. Developed in the late 1930s, when noticed that by putting people into epileptic seizures it alleviated. |
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Term
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Definition
| Electrodes are placed on the patient's scalp and a finely controlled electric current is applied while the patient is under general anaesthesia. Main side effects are short term memory issues. |
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Term
| What are the results of ECT? |
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Definition
- 50 – 70% of medication non-responders will benefit
- Relapse rate 60%. |
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Term
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Definition
| Very popular in 40s and 50s. When a patient has pieces of the brain cut out between lobes in order to treat depression emotions. Still done on people who have OCD but no longer used in NZ. Popular in China, particularly around gambling, |
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Term
| NZ Consumer Study - Percentage of Positive results from taking depression medication and their comments on it: |
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Definition
Positive 55%
- "Necessary treatment for depression"
- "Life saver"
- "Way of coping with stressful events"
- "Means to becoming a better person"
- "Stepping stone to other interventions" |
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Term
| NZ Consumer Study - Percentage of Negative results from taking depression medication and their comments on it: |
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Definition
Negative 16%
- "Ineffective"
- "Masking 'real' problems"
- "Unbearable side effects"
- "Making me feel 'not like myself'"
- "Feeling out of control" |
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Term
| NZ Consumer Study - Percentage of Mixed results from taking depression medication and their comments on it: |
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Definition
Mixed 29%
- "Weighting up unpleasant side effects against benefits"
- "Felt calmer but less like myself"
- "Struggling to find the 'right one'"
- Feel 'stuck' taking antidepressants despite want to stop |
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Term
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Definition
Combines the goals and techniques of both behaviour and cognitive therapies. The two sets of techniques can work together to promote therapeutic change: cognitive techniques change thoughts which then affect feelings and behaviours, behavioural techniques change behaviours, which in turn, lead to new experiences, feelings and ways of relating, which then change how people think about themselves and the world. Helps client to establish a sense of control (not to challenge delusional beliefs).
Basic principle: to feel better you must change the way you think |
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Term
| What are the Basic Techniques of Cognitive therapy/CBT? |
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Definition
Psychoeducation (incl. explanation of cognitive model)
– Identify negative/irrational thoughts or cognitive distortions (keep diary)
– Challenge those thoughts
– Replace them with more accurate/reasonable thoughts
– Behavioural activation |
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Term
| What are some contributing factors and warning signs of suicide? |
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Definition
1. Mental disorders, particularly mood disorders, schizophrenia, anxiety disorders and certain personality disorders
2. Alcohol and other substance use disorders. Increase level of impulsivity
3. Hopelessness. More correlated with suicide that depression
4. Impulsive and/or aggressive tendencies
5. History of trauma or abuse
6. Major physical illnesses
7. Previous suicide attempt
8. Family history of suicide (A lot of psychosocial reasons)
9. Job or financial loss
10. Loss of relationship
11. Easy access to lethal means
12. Local clusters of suicide
13. Lack of social support and sense of isolation
14. Stigma associated with asking for help
15. Lack of health care, especially mental health and substance abuse treatment
16. Cultural and religious beliefs, such as the belief that suicide is a noble resolution of a personal dilemma
17. Exposure to others who have died by suicide (in real life or via the media and Internet) |
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Term
| Statistics of suicide in NZ |
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Definition
| - Study of 384 young adults most commonly cited reasons for the high suicide rate in New Zealand: pressure to conform and perform, followed by financial worries, abuse and neglect, problems with alcohol or drugs, and boredom (Heled & Read, 2005) |
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Term
| What are warning signs that someone might want to commit suicide? |
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Definition
• They are depressed
• Verbal threats and hints “Maybe I won’t be around anymore”
• Expressions of hopelessness and or helplessness
• Daring and risk taking behaviour that is not typical
• Personality changes (withdrawal, moodiness, aggression)
• Giving away prized possessions
• Lack of interest in future |
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Term
| Statistics of suicide in Gender |
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Definition
- Gender paradox: Women are more likely to attempt suicide than men, men are more likely to complete
- New Zealand has the highest rate of male youth suicide and third highest rate of female youth suicide amongst 27 high income countries (Patton, 2012) |
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Term
| Statistics of suicide in Age |
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Definition
- Suicide is one of the leading causes of death for young people under the age of 25 in NZ
- Older men have very successful ways of killing themesemlves
- Suicide rate peaks at 40-44 in males
- Suicide rate spikes at 85+ for both genders |
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Term
| Statistics of suicide in Maori |
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Definition
- High within Maori men and Maori women
- May think about work opportunities, property, colonisation |
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