Mar 05, 2018
Depression is a disease, a state of low mood in a person, in which there is constant sadness, melancholy, apathy, fear, a sense of loss, irritability and loss of interest in daily activities. Disease is twice as common in women and is usually episodic. Unlike usual sadness or grief, most depression attacks of last for weeks, months or even years. Some people with depression have a chronic mild form of the disease, called dysthymia. A smaller number of patients suffer from manic-depressive psychosis, in which bouts of depression alternate with periods of high spirits.
Although depression is usually not considered life-threatening, it can lead to thoughts of suicide and attempts to commit suicide. Up to 70 percent of suicides are associated with depression, and up to 15 percent of people in a highly depressed state commit suicide. Fortunately, the vast majority of people with depression can be helped by using psychotherapy, antidepressants or other means that reduce the risk of suicide.
Numerous studies have shown that the combination of psychopharmacotherapy and psychotherapy is most effective in case of depression. These two types of treatment can be used separately or simultaneously. In the treatment of patients with severe depression, first of all, the use of drug therapy is necessary, and then psychotherapy can be used. After medical treatment leads to a decrease in the severity of depression, psychosocial impact in the form of psychotherapy becomes the main one.
The key to psychotherapy is the patient's contact with the physician, who must be emotional, based on relevant knowledge about the disease and medical information about the patient and his family.
Practical application of psychotherapy involves a certain stage.
At the beginning of psychotherapy, the patient receives the necessary explanations of the doctor about the upcoming treatment( even if he, due to the severity of his condition, talks indifferently with the doctor).
The goal of the initial phase of is to establish a therapeutic partnership with the patient and support him in the process of further treatment. The physician thus performs the following tasks.
If necessary, the patient's family should be involved in the therapeutic process.
Immediate objectives of the main stage of psychotherapy:
Known foreign therapeutic options that are considered to be most effective in depression:
Used in the treatment of ambulatory "soft" depressions. Terms of therapy are 12-16 weeks.
Primary goals: to reduce the severity of painful symptoms by using methods of teaching patients how to maintain their own well-being and solving interpersonal problems.
Techniques that are implemented in the IPT process:
1. Collect information about the patient, his existing disorders and problems( direct and indirect).
2. Help the patient to recognize the painful affect, in his overcoming with the use of positive interpersonal influences.
3. Clarification of circumstances( links) in which the patient feels constrained and untenable.
4. Helping the patient to overcome the maladaptive behaviors.
5. Use of therapeutic interaction between the doctor and the patient as a model for other interactions( relationships).
6. Changing the behavior of the patient, who should with the help of the doctor solve relatively simple problems( role games, etc.).
Based on the notion that depression consists of a cognitive triad involving a negative assessment of oneself, the world around and the future. This kind of negative type of cognitive activity is designated by the term "scheme".The patient with depression makes systematic mistakes in thinking, which feed the negative "schemes".
The following approaches are proposed:
It is assumed that depression develops due to the loss of ability to restore mental equilibrium after all sorts of severe events( death of loved ones, sudden changes in the environment).
The purpose of is to reduce the recorded negative reactions in the process of specially created experimental therapeutic situations and under the influence of the relevant circumstances of life.
Rules for the psychotherapy of Kilgolz Depression
Basic medical errors allowed during psychotherapy
The initial period of psychotherapy is aimed at trying to "alienate" the disease in the patient's relationship system. In the mind of the patient, a conviction must be formed that this diseased condition is not inherently inherent in it, that this is a foreign pathological phenomenon that requires treatment and in addition to this everyday volitional effort.
In the initial psychotherapeutic contact, it is necessary to let the patients speak out( especially if there is anxiety), sympathetically listen to them.
Further psychotherapy has the character of suggestion in a waking state and is conducted imperatively, at high emotional intensity.
Directions of suggestion:
In the following period, patients are offered( initially, when their condition is satisfactory, for example, in the evening hours) to try to get as much as possible into various natural phenomena. When you visit a doctor, they are asked to tell what they saw, how they try to escape from the vicious circle of their experiences, which impressed them( they achieve the maximum possible extroverting of behavior).
For each of the patients, an individual occupation, hobby or emotionally more highly significant "strategy" of vital interests is selected for a more distant future.
A special place is given to teaching patients to withstand a possible exacerbation in the future, including:
Incorrectly conducted psychotherapy can exacerbate emotional and cognitive disorders, increasing anxiety and depression by actualizing suicidal thoughts.
• Although the first episode of depression can not be prevented, subsequent seizures can be controlled or avoided by constant psychotherapy and / or medication. The longer a person is treated, the less likely the recurrence of an attack.