Posts Tagged psychotherapy

Clinical Depression is in a Class by Itself When it Comes to Depression

When you hear the term Clinical Depression, what comes to mind?  Clinical Depression is a serious illness.  This illness can affect the way you feel, the way you act and the way you think.  Like other conditions it is a disease and doesn’t make you a loser.  It is a condition that must be addressed.  Functioning like you did in the past will not be easy.  Activities that you once used to find entertaining may fail to interest you anymore.  Clinical Depression results in long term hopelessness and feelings of remorse.  Unlike a cold this isn’t a short term condition.  You won’t feel sad for a few days and then just get over it.  Clinical Depression is long term.  Clinical Depression is a mental disorder characterized by a pervasive low mood and loss of interest or pleasure in usual activities. The general term depression is better used to describe a temporary depressed or sad mood. By contrast, major depression is a serious and often disabling condition that can significantly affect a person’s work, family and school life, sleeping and eating habits, and general health. In Western countries, around 3.4% of people with major depression eventually commit suicide, and up to 60% of all people who commit suicide have depression or another mood disorder. Depressed individuals have a shorter life expectancy than those without depression, being more susceptible to medical conditions such as heart disease. However, depression may be overdiagnosed, and current diagnostic trends arguably have the effect of medicalizing sadness.

Every part of your normal life can be impacted by Clinical Depression.  A change in thought patterns and confusion are common.  Your will is no longer your own as this condition affects your very behaviors and moods.  It will affect your sleep patterns and eating habits, turning your life onto its head.  It’s possible that instead of being able to do your work or to focus on a task like school, you’ll wonder how it was ever possible.  Clinical Depression will target the way you deal with people.  You’ll become a stranger even to yourself.

The understanding of the nature and causes of depression has evolved over the centuries; nevertheless, many aspects of depression are still not fully understood, and are the subject of debate and research. Both psychological and biological causes have been proposed; the neurotransmitters serotonin and norepinephrine have been implicated, and most antidepressants work to increase their active levels in the brain. The question of whether there are two separate conditions, or a continuum of a single disorder has been researched since the 1920s. These two sub-groups have shown identical clinical courses, and in 1980 the term major depressive disorder was coined for the combined continuum, and has become widely used.

Common Symptoms of Clinical Depression

There are different forms of clinical depression with different combinations of the following symptoms:

Physical:

* Sleep disturbances-insomnia, oversleeping, waking much earlier than usual
* Changes in appetite or eating: much more or much less
* Decreased energy, fatigue
* Headaches, stomachaches, digestive problems or other physical symptoms that are not explained by other physical conditions or do not respond to treatment

Behavioral/Attitude:

* Loss of interest or pleasure in activities that were once enjoyed, such as going out with friends, hobbies, sports, sex, etc.
* Difficulty concentrating, remembering, or making decisions
* Neglecting responsibilities or personal appearance

Emotional:

* Persistent sad or “empty” mood, lasting two or more weeks
* Crying “for no reason”
* Feeling hopeless, helpless, guilty or worthless
* Feeling irritable, agitated or anxious
* Thoughts of death or suicide

Treatment for depression depends on many factors, including the severity of the condition, the persistence of the symptoms, and the person’s personal history with the illness. For many forms of depression, a combination of psychotherapy and antidepressant medications can be an effective treatment. Antidepressant medications can relieve symptoms of depression, while psychotherapy may help you cope with ongoing problems that may trigger or contribute to depression. Most patients are treated in the community with antidepressant medication and supportive counselling, including various forms of psychotherapy; admission to hospital may be necessary in cases associated with self-neglect or a significant risk of harm to self or others. A minority with severe illness may be treated with electroconvulsive therapy (ECT), under a short-acting general anaesthetic.

For the more serious cases of clinical depression, electroconvulsive therapy can be helpful for people who haven’t responded to other treatments or who can’t tolerate antidepressants for other reasons. During electroconvulsive therapy, an electric current is passed through the brain to induce controlled seizures. Experts aren’t sure how electroconvulsive therapy relieves the symptoms of depression. However, it’s believed the procedure may affect levels of neurotransmitters in your brain.

Depression may also be caused in part by an overactive hypothalamic-pituitary-adrenal axis (HPA axis) that is similar to the neuro-endocrine response to stress. These HPA axis abnormalities participate in the development of depressive symptoms, and antidepressants serve to regulate HPA axis function.

Depression may be connected to sleep abnormalities, or variations in the circadian rhythm. The REM stage of sleep, in which dreaming occurs, tends to be especially quick to arrive, and especially intense, in depressed people. Although the precise relationship between sleep and depression is mysterious, the relationship appears to be particularly strong among those whose depressive episodes are not precipitated by stress. In such cases, patients may be especially unaffected by therapeutic intervention.

As mentioned earlier Clinical Depression is not a personal defect.  It is not an illness that you can wish gone out of your life.  This is not an illness that will be cured through self- control or self-treatment.  It will take a long-term effort – weeks, months or even years of treatment – to control this problem.  People have been known to attempt suicide if this condition isn’t treated. The reasons for the depression may seem known to you.  However many different factors might contribute to this illness.  Typically, it is a group of factors that lead to Clinical Depression.  Your psyche, genetic factors, or even the environment might contribute.

Biological issues such as chemical imbalances can lead to Clinical Depression. Feeling sad and depressed is often a normal reaction to a stressful life situation. For example, it is normal to feel down after a major disappointment, or to have trouble sleeping or eating after a difficult relationship break-up. Usually, within a few days, perhaps after talking to a friend, we start to feel like ourselves again.

Clinical depression is very different. It involves a noticeable change in functioning that persists for two weeks or longer. Imagine that for the last three months you’ve slept more than 10 hours a day and still feel tired, you have stomach problems, you’re unable to cope with life, and you wonder if dying would solve all your problems. Or, imagine not being able to sleep more than four hours a night, not wanting to spend time with family or friends, and constantly feeling irritable. And when friends try to reach out to you, you get even more upset and bothered. You lose perspective, and you don’t realize that what you’re experiencing is abnormal. You want to just “wait it out,” and you don’t get help because you think it’s weak to ask for help or you don’t want to burden your friends.  Stress might also cause this illness.  Many areas of your life can be causing stress that affects your psychological make up .  Our lives are filled with all sorts of potential pressures that can wreak havoc with your system.  It’s well known that alcoholics and drug addicts often contract Clinical Depression. Don’t hesitate to consult a medical professional if you or anyone you know shows signs of this disease.

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Winnebago Mental Health Institute – Its History and Development

If we speak of a primary center for treatment of mental illness in Wisconsin, Winnebago Mental Health Institute or WMHI is the first facility that comes to mind. Located at Lake Winnebago’s west shore, this state facility has about 1300 admissions every year and an average of 250 patients.

The facility was constructed in 1871. Originally named Northern Asylum for the Insane, its name was later changed to Winnebago State Hospital before the name was again changed to Winnebago Mental Health Institute.

Basically, WMHI’s services can be grouped into three areas. The first one is called Adult Service 1, consisting of forensic units. The second area is called Adult Service 2, for adults that are multiply impaired, and those requiring treatment for behavior modification, substance abuse and mental illnesses. The third unit, Youth Services, is for children and adolescents that are multiply impaired and those who are mentally ill and have substance abuse disorder.

The Therapeutic Services Department is responsible in evaluating and assessing the patients. There are 4 divisions of service: occupational therapy, recreational therapy, speech therapy and physical therapy. These divisions are responsible in the holistic approach to treatment.

There are various treatment activities in WMHI. One of them is individual psychotherapy. A treatment plan is outlined for each patient to determine the frequency of sessions that he must undergo. A clinical staff writes notes for each visit. The attending psychiatrist meets the treatment team on a regular basis to review the treatment plan.

Another treatment activity is through psychopharmacology. The attending psychiatrist determines and orders the medication according to the individual patient’s treatment plan. Psychotropic medication is used in order to achieve treatment goals and reduce risk of injury and violence.

Group therapy is another kind of treatment, where problems of each patient are shared and solutions are discussed. Other treatment activities include self-help groups, family therapy and community groups.

However, the facility is faced with controversy lately. City inspectors found violations of the hospital. Infractions include failure to protect patient’s rights such as the right to be protected from violent and sexual behaviors of other patients, to have privacy and to be in a safe environment. Other violations include medication errors and failure to correct environmental hazards and infection control in the facility.

Within a period of two years, three deaths and one rape case were reported. These, among other problems, have caused authorities to cite the facility for neglect and lack of attention. Reports indicate that poor supervision and staffing as well as bad judgment in medication caused these problems. Because of this, the government ordered the facility to correct the problems by 2008. Otherwise, it shall lose its federal funding for both Medicaid and Medicare.

With this development, lawmakers have introduced a bipartisan bill requiring all patient deaths in the facility be investigated. This is to create more transparency and accountability to the taxpayers.

More problems are at hand for WMHI. Hospital officials cite financial loss as the reason why there is not enough staff in the facility. Because of such financial losses, there are not enough employees to maintain hospital safety and provide better service to patients.

Despite these problems that the Winnebago Mental Health Institute has, hospital officials continue to work hard to give quality treatment to their patients.

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