Thursday, May 30, 2013

An Integrated Approach to Treat Depression


Depression, anxiety, phobias and mental health feature almost daily in the media and it appears that depression is fast becoming one of the biggest problems experienced within society. These conditions increasingly affect people living in the modern world and research has led to estimates that at least 17% of the adult population have had, or will have, an episode of depression of sufficient clinical severity to warrant treatment. A special national Institute of Mental Health report on Depressive Disorders in 1973 stated that depression accounts for 75% of all psychiatric hospitalisations and that during any given year 15% of all adults between 18 and 74 may suffer significant depressive symptoms. Current studies indicate that the lifetime risk of depression in an adult population could be as high as 30%.

Along with the increased incidence of depression has been an explosion in the use of prescription drugs to treat the condition, but recent reports have questioned whether these are effective or indeed simply create more problems for the patient. Accordingly there is a growing interest in finding a fresh approach to the treatment of these conditions. Having trained in clinical psychology and psychotherapy I am able to incorporate a lot of the accepted practices. However, the more I worked with individuals and with groups I found that by integrating the eastern inspired approaches that I learnt in India, I was able to achieve far more effective and lasting results within a shorter period of time.

Understanding Depression

In Psychiatry depression is referred to as a mood disorder. Mood disorders have been known to man since antiquity; the old Testament describes King Saul as suffering from severe depressive episodes. However, the term encompasses a wide spectrum of emotions ranging from deep depression to unbounded elation and mania and so understanding the behaviour of individuals suffering from depression can be very challenging.

All people experience a range of emotions and in general they are a healthy part of life and feeling appropriate emotions contributes positively to our well being. However, emotions are of two main types; firstly affective emotions, in other words a short lived emotional response to an event, and secondly mood, which is a lasting and dominant emotional response which colours the whole psychic life.

More than 90% of depressed people experience prolonged moods of sadness, discouragement or a sense of not caring any more. However, to classify someone with a major depressive episode clinicians look for five or more of the following symptoms to have been present during the preceding two weeks. There should also be a noticeable change in previous functioning with at least one of the symptoms being either a depressed mood or loss of interest or pleasure.

Symptoms:
1. Depressed mood most of the day.
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day.
3. Significant weight loss when not dieting, or weight gain eg. A change of more than 5% of body weight in a month. Or a decrease or increase in appetite nearly every day.
4. Insomnia (sleeplessness) or hypersomnia (excessive sleep) nearly everyday.
5. Psychomotor agitation or retardation nearly every day.
6. Fatigue or loss of energy nearly every day
7. Feeling of worthlessness or excessive or inappropriate guilt
8. Diminished ability to think or concentrate or indecisiveness
9. Recurrent thoughts of death

No single casual factor as to why people get depressed has been identified. Research points to many factors that seem to contribute to its development, including genetics, biochemical changes and personality theories. Several research papers have reported findings which suggest that relatives of patients with major depressive disorders have a higher prevalence of depression than people in the general population. Other research has focussed on biochemical correlates of depression and studied the role of chemicals that transmit nerve impulses from one neuron to another in the brain. Whilst several theories related to depression have been developed regarding personality types.

My experience as a Doctor has led me to view each client as an individual whose requirements need personalised attention. Human beings are a complex creation whose health and wellbeing depends on a balance in all dimensions of their lives, from physical health to behavioural, energy and even environmental aspects.

Treating Depression

Conventional western medicine generally treats depression using medication eg. Tricyclic, heterocyclic anti-depressants and the new SSRT drugs. The commonly used psychological therapies for the treatment of depression are individual psychotherapy, group psychotherapy and cognitive behaviour therapy. Eastern Psychotherapy integrates eastern methods, such as meditation, yoga, pranic, or energy, healing, mantra and sound healing, with elements of the traditional psychotherapy developed in the West. When treating depression and other mental health conditions it is vital to look for the causative factors and explore the issues using ayurvedic principles as well as acknowledging the spiritual component. It may sometimes also be appropriate to study the astrological chart of the person being treated to seek a better understanding of the influences affecting the individual and gem therapy, which is a commonly accepted practice in many parts of Asia, may be recommended.

The treatment of conditions such as depression, addiction and anxiety is undoubtedly enhanced by the use of complementary techniques. The value of seeking help from professionals who have worked with both approaches is they can select the right choice of treatment for each individual. Orthodox techniques often deal effectively with the symptoms, however eastern practices can be more helpful with the underlying causes. A therapist who understands the personal needs of each individual is more able to provide them with an empowering approach to their illness. For some the focus may be on the traditional Western methods, but for others accelerated and positive results can be achieved by blending the best of East and West in an integrated treatment programme.

With an integrated approach to depression most individuals are able to benefit within 3 or 4 sessions, sometimes even less, depending on the nature of their condition. It is important with any therapeutic approach to ensure clients do not develop a dependency on the treatment or only enjoy a temporary respite because the underlying causes have not been addressed.

CASE STUDY

Miss K, a 35 year old female failed to respond to conventional treatment. An holistic approach included energy and environmental assessments as well as her medical background. She had a five year history of depression which had been particularly severe in the preceding six months. She was using anti-depressants and had undergone several sessions of counseling which she did not like.

The assessment on the energetic level revealed some blockages in the heart and solar plexus chakras. The environment at home was dark and sombre with black and grey being her main choice of colours; there was no flow of energy.

She was recommended to try a combination of energy therapies including Reiki and music/mantra treatment along with some suggestions of changes to the home environment. She also used a herbal remedy (St John's Wort), massage and acupuncture and embarked on six sessions of cognitive behavioural therapy. Her programme lasted six months, but she responded very well and has been free of depression for more than a year reporting that she feels generally well, is taking an active interest in her life and in her personal development.

TEXT ENDS

November 2008

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