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Managing Depression. Monday 20 th January 2014 14.00 – 15.00 NAB 2.04 Michael Bryant LSE Student Counselling Service. Depression: Living with the Black Dog. What is depression?. Depression is common. Symptoms can affect day-to-day life and can become very distressing . - PowerPoint PPT Presentation
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Managing Depression
Monday 20th January 201414.00 – 15.00
NAB 2.04
Michael BryantLSE Student Counselling Service
Depression: Living with the Black Dog
What is depression?Depression is common. Symptoms can affect day-to-day life and can
become very distressing. Treatments include psychological (talking) treatments and
antidepressant medicines. Treatment takes time to work but has a good chance of success.
Some people have recurring episodes of depression and require long-term treatment to keep symptoms away.
Who gets depression? Cont.About 2 in 3 adults have depression at some time in their life.
Sometimes it is mild or lasts just a few weeks. An episode of depression serious enough to require treatment occurs in
about 1 in 4 women and 1 in 10 men at some point in their lives. Some people have two or more episodes of depression at various times
in their life
Exhaustion Funnel
How is depression medically diagnosed?There are no physical tests for depression
your GP may examine you and do some urine or blood tests to rule out other conditions that have similar symptoms, such as an underactive
thyroid.The main way in which your GP will tell if you have depression is by
asking you lots of questions about your general health and how the way you are feeling is affecting you mentally and physically.
What causes depression?Life events
LossAnger
Childhood experiencesPhysical conditions
What causes depression? Cont.Side effects of medication
DietStreet drugs and alcohol
GeneticsChemical changes in the brain
What is the difference between low mood and depression?
Low Mood can include:• sadness
• an anxious feeling• worry• tiredness
• low self-esteem• frustration• anger
Low mood will tend to improve after a short time.
What is the difference between low mood and depression? Cont.
DEPRESSION SYMPTOMS ALSO INCLUDE:
feeling irritable and intolerant of others having no motivation or interest in things
finding it difficult to make decisionsnot getting any enjoyment out of life
having suicidal thoughts or thoughts of harming yourselffeeling anxious or worried
What is the difference between low mood and depression?
DEPRESSION SYMPTOMS ALSO INCLUDE:
continuous low mood or sadnessfeeling hopeless and helpless
having low self-esteem feeling tearful
feeling guilt-ridden
Symptoms of depression: psychological
continuous low mood or sadnessfeeling hopeless and helpless
having low self-esteem feeling tearful
feeling guilt-ridden
Symptoms of depression: psychological cont.
feeling irritable and intolerant of others having no motivation or interest in things
finding it difficult to make decisionsnot getting any enjoyment out of life
Feeling anxious or worriedHaving suicidal thoughts or thoughts of harming yourself
Symptoms of depression: physicalmoving or speaking more slowly than usual
change in appetite or weight (usually decreased, but sometimes increased) constipation
unexplained aches and painslack of energy or lack of interest in sex (loss of libido)
changes to your menstrual cycle disturbed sleep (for example, finding it hard to fall asleep at night or waking up
very early in the morning)
Symptoms of depression: socialnot doing well at work
taking part in fewer social activities and avoiding contact with friends
neglecting your hobbies and interestshaving difficulties in your home and family life
Specific forms of Depression: SAD
Seasonal affective disorder (SAD) :this is seasonal depression which is related to day
length. It usually comes on in the autumn and winter, when days are short and the sun is low in the sky, and
gets better as the days get longer and brighter.
Specific forms of Depression: BPD
Bipolar disorder (manic depression):Some people have major mood swings, when periods of
depression alternate with periods of mania. When manic, they are in a state of high excitement, and may
plan and may try to carry out over-ambitious schemes and ideas. They often then have periods of severe depression.
Specific forms of Depression: Clinical
Clinical depression: Depression ranges in seriousness from mild, temporary episodes of
sadness to severe, persistent depression. Doctors use the term "clinical depression" to describe the more severe form of depression also
known as "major depression" or "major depressive disorder."
For a diagnosis of clinical depression, you must meet the symptom criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders
(DSM). The DSM is a guidebook used to diagnose mental illness in the United States.
Specific forms of Depression: Clinical
Five DSM Criteria for Clinical depression – • Depressed mood most of the day, nearly every day• Loss of interest or pleasure in most activities
• Significant weight loss or gain• Sleeping too much or not being able to sleep nearly every day
Specific forms of Depression: Clinical – cont.
FIVE DSM CRITERIA FOR CLINICAL DEPRESSION: • Slowed thinking or movement that others can see
• Fatigue or low energy nearly every day• Feelings of worthlessness or inappropriate guilt
• Loss of concentration or indecisiveness• Recurring thoughts of death or suicide
What can you do about Depression?
Develop emotional intelligenceUnderstand the concept of learned helplessness
Talking therapiesDevelop a mindfulness practice
Developing emotional intelligence
Understanding emotionsALEXITHYMIA : inability to identify / describe one’s emotions.
Mad Bad Sad Glad
Learned helplessnessLearned helplessness was discovered when researchers immobilized a dog and exposed it to electric shocks that
could neither be avoided nor escaped. Twenty-four hours later, the dog was placed in a situation in
which electric shock could be terminated by a simple response.
The dog did not make this response; instead, it just sat passively. This behavior was in marked contrast to dogs in a
control group that reacted vigorously to the shock and learned to turn it off.
Book: ‘The MindfulWay Through Depression’
Mark Williams
8 week mindfulness programme
Talking Therapies: CBT
(CBT) helps you understand your thoughts and behaviour and how they affect you.
CBT recognises that events in your past may have shaped you, but it concentrates mostly on how you can change the way you think, feel
and behave in the present.It teaches you how to overcome negative thoughts, for example being
able to challenge hopeless feelingsComputerised CBT is a form of CBT that works through a computer
screen, rather than face to face with a therapist
Talking Therapies:Counselling
Counselling is a form of therapy that helps you think about the problems you are experiencing in your life to find new
ways of dealing with them. Counsellors support you in finding solutions to problems, but do not tell you what to
do.Counselling is available at LSE from the Student Counselling
Service.See our website:
It is also available on the NHS usually consists of six to 12 hour-long sessions. You talk in confidence to a counsellor. The counsellor supports you and offers practical advice.
Talking Therapies:Interpersonal Therapies (IPT)
IPT focuses on your relationships with other people and on problems you may be having in your relationships, such as
difficulties with communication or coping with bereavement.
There's some evidence that IPT can be as effective as antidepressants or CBT, but more research is needed.
NHS Care pathways for depression
NHS CARE FOR ADULTS WITH DEPRESSION
NHS TREATMENT FOR MILD TO MODERATE DEPRESSION TREATMENT
NHS TREATMENT FOR SEVERE ADULT DEPRESSION TREATMENT
Diagnostics TestsPHQ-9: Patient Health Questionnaire:
Quick Depression Assessment
GAD 7: Generalised Anxiety Disorder AssessmentQuick Anxiety Assessment
Pleasantness Calendar
Unpleasantness Calendar
Resources /ReferecnesLSE Student Counselling Service:
NICE Guidelines for Treatment of Depression:http://www.nice.org.uk/CG090
I had a Black Dog Blogspot:http://ihadablackdog.blogspot.co.uk/
Depression: the Black Dog