MANAGEMENT OF DEPRESSION IN A RECESSED ECONOMY: NIGERIA AS A CASE STUDY by Professor Ajibade B. L.
MANAGEMENT OF DEPRESSION IN A RECESSED ECONOMY: NIGERIA AS A CASE STUDY
A PAPER PRESENTED AT AMORIT HOUSE ESTATE, EDE ROAD, OSOGBO
TO MARK AFRICAN CIVIL SERVICE DAY BY THE FORUM OF FEDERAL CIVIL SERVICE HEADS
ON
THURSDAY, 22ND JUNE, 2017
PROF. AJIBADE, Bayo Lawal
ABSTRACT: A recession is a general downturn in any economy and it is associated with high unemployment, slowing gross domestic product, and high inflation. The unemployment and loss of job will lead to mental agony leading to ranges of depression from mild to severe. Maslow’s hierarchy of needs was adapted as the basis for the write-up. The causes, types of depression; factors that can trigger depression, clinical manifestation general management and management during recession with specific reference to Nigeria were discussed. It was concluded that apart from medical management, individual, group, family and cognitive therapies should be carried out at primary, secondary and tertiary health institutions
INTRODUCTION: Depression is likely the oldest and one of the most frequently diagnosed psychiatric illnesses. An occasional bout with the ‘blues;’ i.e a feeling of sadness or downheartedness is common among healthy people and considered to be a normal response to everyday disappointments in life. These episodes are short-lived as the individual adapts to the loss, change or failure (real or perceived) that has been experienced. Pathological depression occurs when adaptation is ineffective. Economic recession is a period of general economic decline and is typically accompanied by a drop in the stock market, an increase in unemployment, and a decline in the housing market.2
THEORETICAL FRAMEWORK: I am adapting Maslow’s hierarchy of needs to serve as the basis for this write-up.
Maslow emphasized an individual’s motivation in the continuous guest for self – actualization. He identified a hierarchy of needs, the lower ones requiring fulfillment before those at higher levels can be achieved, with self actualization being fulfillment of one’s highest potential. An individual’s position in the hierarchy may change from a higher level to a lower level based on life circumstances. For examples, an individual facing premature retirement who has been working on tasks to achieve self actualization may become preoccupied, with the need for safety and security. This may cause distortion in maintaining optimum level of functioning leading to mental agony which consequently may lead to depression, depending on the pre-morbid personality. Maslow described self actualization as being psychologically healthy, fully human, highly evolved, and fully matured. He believed that healthy, or self-actualized individual possessed the following characteristics:-
An appropriate perception of reality
The ability to accept oneself, others and human nature
The ability to manifest spontaneity
The ability / capacity for focusing concentration on problem solving
A need for detachment and desire for privacy
Independence, autonomy, and a resistance to enculturation
An intensity of emotional reaction
A frequency of ‘peak’ experiences that validate the worthwhileness, richness and beauty of life
An identification with humankind
The ability to achieve satisfactory interpersonal relationship
A democratic character structure and strong sense of ethics
Creativeness
A degree of non conformance
Considering the example of a worker that was retired prematurely and could not reach the peak of the triangle could make the individual be disposed to mental agony. We will all agree from this example that economic recession could serve as a factor that could trigger depression.
CONCEPT OF ECONOMIC RECESSION: The national bureau of Economic Research (NBER)5 defined a recession as ‘a significant decline in economic activity spread across the economy, lasting more than a few moths, normally visible in a real gross domestic product (GDP), real income, employment, industrial production and wholesale-retail sales. Economic recession can also be defined as a negative real DGP growth rate for two consecutive quarters (say first and second quarters).
I have brought in this definition in order to drive home the relationship between the economic recession and mental illness. It could be observed from the first definition of recession in the above, that socio-economic status of some individuals are bounds to be affected in terms of employments and business outcomes. This could result in mental illness if it happens to people with weak personality
CONCEPT OF DEPRESSION: This the bane of the topical discourse, the concept will centre on causes, types, levels and management of depression
HISTORICAL PERSPECTIVE: May ancient cultures (e.g Babylonian, Egyptian, Hebrew) believed in the supernatural or divine origin of depression and mania6. The Old Testament states in the book of Samuel that king Saul’s depression was inflicted by an ‘evil spirit’ sent from God to ‘torment’ Saul.
A clearly non-divine point of view regarding depressive and manic states was held by the Greek medical community from the 5th century BC through the 3rd century AD. This represented the thinking of Hippocrates, Casus and Galen among others. They strongly rejected the idea of divine origin and considered the brain to be the seat of all emotional states6. Hippocrates believed that melancholia was caused by an excess of black bile, a heavily toxic substance produced in the spleen or intestine which affected the brain.
During the Renaissance, several new theories evolved. Depression was viewed by some as being the result of obstruction of vital air circulation, excessive brooding, or helpless situations beyond the client’s control. Contemporary thinking has been shaped a great deal by the works of Sigmund Freud, Emil Kraeplin and Adolf Meyer. Having evolved from these early disorders generally encompasses the intrapsychic, behavioural and biological perspectives. These various perspectives support the notion of multiple causation in the development of mood disorders
CAUSES OF DEPRESSION
Genetic influence
Biochemical influences
Biogenic amines – deficiency of neuron transmitters, none epinephrine, serotonin and dopamine
Neuro endocrine disturbances: thyrotropin releasing factor from the hypothalamus
Medication side effects – e.g cortisone, cimetidene estrogen, progressive
Neurological disorders: An individuals who has suffered a CVA (Cerebrovasular accident)
Electrolyte imbalance: Excessive levels of sodium bicarbonate or calcium can procure symptoms of depression
Hormonal disturbances: Depression is associated with dysfunction of the adrenal cortex
Nutritional deficiencies: Vitamin B1 (thiamine)
Psychosocial causes: It was reveled that melancholia occurs after the loss of a loved object, either actually by death or emotionally by rejection, or the loss of some other abstraction of value to the individual 8. Having experienced numerous factures (either real or perceived)
WHAT ARE THE TYPES OF DEPRESSION?: Mood disorders can be classified as:- Mood disorders can be classified as:
MAJOR DEPRESSIVE DISORDER: This disorder is characterized by depressed mood or loss of interest or pleasure in usual activities. Evidence of impaired social and occupational functioning has existed for atleast 2 weeks. There is no history of manic behavior and the symptoms cannot be attributed to use of substance or a general medical condition. It may be further classified (on the basis of features) as follows9.
Single episode or recurrent: A single episode specifier is used for an individual’s first diagnosis of depression, Recurrent is specified when the history reveals two or more episodes of depression
Mild, moderate or severe: These categories are identified by the number and severity of symptoms
With psychotic features: The impairments of testing is evident. The individual experience delusions or hallucination
With catatonic features: This category identifies the presence co psychomotor disturbances, such as severe psychomotor retardation, with or without the presence of waxy flexibility or stupor or excessive motor activity
Wild melancholic features: temporary reactivity to usually pleasurable stimuli is absent
Chronic: This classification applies when the current episode of depressed mood has been evident continuously for atleast the past 2year
With seasonal pattern: The depressive disorder occur only during a seasonal period of the year
With post partum onset: This specifier is used when symptoms of major depression occur within 4 weeks postpartum
Dysthymic disorder: Individuals with dysthymic disorder describe their mood as sad or ‘down in the dumb’10. There is no evidence of psychotic symptoms. The essential feature is a chronically depressed mood for most of the day, more days than not, for atleast 2 years
Bipolar disorders: A bipolar disorder is characterized by mood swings from profound depression to extreme euphoria (mania), with intervening periods of normalcy. Delusions or hallucinations may or may not be a part of the clinical picture. It is in two forms
Bipolar 1 Disorder: The client may have experienced episodes of depression. Usually there is an evidence of mania, hypomania, mixed or depressed mood)
Bipolar II disorder: this diagnostic category is characterized by recurrent bouts of major depression with the episodic occurrence of hypomania
Cyclothymic disorder: The essential feature of cyclothymic disorder is a chronic mood disturbance of at least. 2 years duration, involving numerous episodes of hypomania and depressed mood of insufficient severity or duration o meet the criteria for either bipolar I or II disorder. The individual is never without pomania or depressive symptoms for more than 2 months
WHAT ARE THE LEVELS OF DEPRESSION?: Having enunciated on the types of depression let us elucidate on the levels of depression. The levels of depression can be described as alterations in four (4) spheres of human functioning – (i) affective, (2) behavioral, (3) cognitive and (4) physiological
Level 1 – Transient depression
Affective – sadness, dejection, feeling down heart
Behavioural – some crying possible
Cognitive – difficulty in getting mind off the disappointment
Physiological – feeling tired and listless
Level 2- Mild depression: The mild level of depression is identified by symptoms associated with normal grieving
Affective: Denials of reality, anger, anxiety, guilt, helplessness, hopelessness, sadness and despondency
Behavioural: tearfulness, regression restlessness agitation, withdrawal
Cognitive: Pre-occupation with the loss, self blame, ambivalence, blaming others
Physiological: anorexia or over reacting, insomnia or hypersomina, headache, body aches
Level 3: Moderate Depression: This level of depression represents a more problematic disturbance
Affective: Feelings of sadness, dejection, helplessness, powerlessness, hopelessness, gloomy and pessimistic outlook, low self esteem, difficulty experiencing pleasure in activities
Behavioural: Psychomotor retardation (slowed physical movements, slumped posture, slowed speech, limited verbalizations, possibly consisting of ruminations about life’s’ activities, social isolation with a focus on the self increased use of substances possible, self destructive behavior possible, decreased interest in personal hygiene and grooming
Cognitive: retarded thinking processes, difficulty concentrate and directing attention, obsessive and repetitive thoughts generally portraying pessimism and negativism verbalization and behaviour reflecting suicidal ideation
Physiological: Anorexia or overreacting, insomnia or hypersomnia, amenorrhea, loss of libido, body ache and abdominal discomfort, feeling best early in the morning and continually worse as day progresses
Level 4: severe Depression: All the symptoms in the moderate level are over exaggerated here.
Affective: Feeling of total despair, hopelessness, worthlessness, appearance devoid of emotional tone, feeling of nothingness and emptiness, apathy, loneliness, sadness and inability to feel pleasure
Behavioural: Severe psycho-motor retardation or psychomotor behavour manifested by rapid; agitated, purposeless movement, slumped posture, sitting in a curled-up position, non-existence communication
Cognitive: delusion of persecution, and somatic delusions, confusion, hallucinations, self-blame and thoughts of suicide
Physiological: A general slowdown of the entire body, reflected ins sluggish digestion, constipation and urinary retention
Having elucidated on the levels of depression and their manifestation, let us deliberate or factors that can trigger depression
The underlisted factors can trigger the occurrence of depression:
Loss of a loved one through death , divorce or separation
Social isolation or feelings of being deprived
Major life changes – moving, gravitation, job change loss of jobs, premature retirement, economic down torn
Physical, sexual or emotional abuse
Community instability – violence
Considering the above highlighted points, it is evident that depression is both genotypic and phenotypic in outcome. World-health organization defines health as a state of complete physical, mental, social and spiritual well – being and not merely the absence of disease or infirmity. Considering this definition, I wonder if all of us in this hall can say we are healthy because of the situation the country has been plunged into. Therefore, majority of Nigerians are within the armpit of depression
How then can will manage depression in Nigeria?
As it has been discussed earlier in this discourse that the causes of depression are multifactorial so the treatment will equally be eclectic
PREVENTION OF DEPRESSION
Government at all levels should design a programme for employment
There must be a periodic health information on health challenges in all our government agencies and parastatals.
All the primary health care units should have mental health / psychiatric units
There must be adequate preparation of staffers before retirement and they must be paid their allowances as at when due
There must be an adequate distribution of social amenities
MANAGEMENT OF DEPRESSION
Medical management: anti depressants
Electroconvulsive therapy
Psychological treatments
Individuals psychotherapy
Group therapy
Family therapy
CONCLUSION: In conclusion, it has been observed depression is one oldest recognized psychiatric illnesses that is still prevalent today. It is so common in fact, that if has been referred to as the ‘common cold of psychiatric disorders’. The causes of depressive disorders is not entirely known. A number of factors including genetics, biochemical influences, and psychosocial experiences likely enter into the development of the disorder. No single theory can explains the etiology of depressive disorder, and it is likely that the illness is caused by a combination of factors. The patient with depression should be monitored seriously because of suicidal ideation that is prevalent in the moderate and sever levels of the illness. The treatment of mood disorder include individual, group, family and cognitive therapies in child psychopharmacology and ECT.
Thanks so much for listening.
REFERENCES
Mary .C Townsend (2014. Essential of Psychiatric mental health nursing 2nd
, Philadelphia F.A Davis Company
Wanda K. Mohr (2009) Psychiatric – mental health nursing. Evidence Based Concepts, Skill and Practices 7th ed. Philadelphia, Lippincott, Williams & Wilkins
Balzer, D. (1994). Geriatric Psychiatric burke, K.C burke J.D & Rangier, D.A (1990). Age at the onset of selected mental health
Economic recession in Nigeria: Causes and solution http://education.com/economic-reseassion-nigeriaassessed 26 may, 2017
Maslow hierarchy of Needs: Counseling Tutor htt://counseling tutor.co/counseling-approacks.assessed 25th May, 2017
An overview of clinical depression: httpl://www.webmd.com.assessed 26th may, 2017
Depression: A Global Public health concern
Andrew. G. Cuijpers, P, Crake, M.G (2010). Computer therapy for the anxiety and depressive disorder is effective, acceptable and practical health care a metal analysis, plos one 13, 5 (10)
A PAPER PRESENTED AT AMORIT HOUSE ESTATE, EDE ROAD, OSOGBO
TO MARK AFRICAN CIVIL SERVICE DAY BY THE FORUM OF FEDERAL CIVIL SERVICE HEADS
ON
THURSDAY, 22ND JUNE, 2017
PROF. AJIBADE, Bayo Lawal
ABSTRACT: A recession is a general downturn in any economy and it is associated with high unemployment, slowing gross domestic product, and high inflation. The unemployment and loss of job will lead to mental agony leading to ranges of depression from mild to severe. Maslow’s hierarchy of needs was adapted as the basis for the write-up. The causes, types of depression; factors that can trigger depression, clinical manifestation general management and management during recession with specific reference to Nigeria were discussed. It was concluded that apart from medical management, individual, group, family and cognitive therapies should be carried out at primary, secondary and tertiary health institutions
INTRODUCTION: Depression is likely the oldest and one of the most frequently diagnosed psychiatric illnesses. An occasional bout with the ‘blues;’ i.e a feeling of sadness or downheartedness is common among healthy people and considered to be a normal response to everyday disappointments in life. These episodes are short-lived as the individual adapts to the loss, change or failure (real or perceived) that has been experienced. Pathological depression occurs when adaptation is ineffective. Economic recession is a period of general economic decline and is typically accompanied by a drop in the stock market, an increase in unemployment, and a decline in the housing market.2
THEORETICAL FRAMEWORK: I am adapting Maslow’s hierarchy of needs to serve as the basis for this write-up.
Maslow emphasized an individual’s motivation in the continuous guest for self – actualization. He identified a hierarchy of needs, the lower ones requiring fulfillment before those at higher levels can be achieved, with self actualization being fulfillment of one’s highest potential. An individual’s position in the hierarchy may change from a higher level to a lower level based on life circumstances. For examples, an individual facing premature retirement who has been working on tasks to achieve self actualization may become preoccupied, with the need for safety and security. This may cause distortion in maintaining optimum level of functioning leading to mental agony which consequently may lead to depression, depending on the pre-morbid personality. Maslow described self actualization as being psychologically healthy, fully human, highly evolved, and fully matured. He believed that healthy, or self-actualized individual possessed the following characteristics:-
An appropriate perception of reality
The ability to accept oneself, others and human nature
The ability to manifest spontaneity
The ability / capacity for focusing concentration on problem solving
A need for detachment and desire for privacy
Independence, autonomy, and a resistance to enculturation
An intensity of emotional reaction
A frequency of ‘peak’ experiences that validate the worthwhileness, richness and beauty of life
An identification with humankind
The ability to achieve satisfactory interpersonal relationship
A democratic character structure and strong sense of ethics
Creativeness
A degree of non conformance
Considering the example of a worker that was retired prematurely and could not reach the peak of the triangle could make the individual be disposed to mental agony. We will all agree from this example that economic recession could serve as a factor that could trigger depression.
CONCEPT OF ECONOMIC RECESSION: The national bureau of Economic Research (NBER)5 defined a recession as ‘a significant decline in economic activity spread across the economy, lasting more than a few moths, normally visible in a real gross domestic product (GDP), real income, employment, industrial production and wholesale-retail sales. Economic recession can also be defined as a negative real DGP growth rate for two consecutive quarters (say first and second quarters).
I have brought in this definition in order to drive home the relationship between the economic recession and mental illness. It could be observed from the first definition of recession in the above, that socio-economic status of some individuals are bounds to be affected in terms of employments and business outcomes. This could result in mental illness if it happens to people with weak personality
CONCEPT OF DEPRESSION: This the bane of the topical discourse, the concept will centre on causes, types, levels and management of depression
HISTORICAL PERSPECTIVE: May ancient cultures (e.g Babylonian, Egyptian, Hebrew) believed in the supernatural or divine origin of depression and mania6. The Old Testament states in the book of Samuel that king Saul’s depression was inflicted by an ‘evil spirit’ sent from God to ‘torment’ Saul.
A clearly non-divine point of view regarding depressive and manic states was held by the Greek medical community from the 5th century BC through the 3rd century AD. This represented the thinking of Hippocrates, Casus and Galen among others. They strongly rejected the idea of divine origin and considered the brain to be the seat of all emotional states6. Hippocrates believed that melancholia was caused by an excess of black bile, a heavily toxic substance produced in the spleen or intestine which affected the brain.
During the Renaissance, several new theories evolved. Depression was viewed by some as being the result of obstruction of vital air circulation, excessive brooding, or helpless situations beyond the client’s control. Contemporary thinking has been shaped a great deal by the works of Sigmund Freud, Emil Kraeplin and Adolf Meyer. Having evolved from these early disorders generally encompasses the intrapsychic, behavioural and biological perspectives. These various perspectives support the notion of multiple causation in the development of mood disorders
CAUSES OF DEPRESSION
Genetic influence
Biochemical influences
Biogenic amines – deficiency of neuron transmitters, none epinephrine, serotonin and dopamine
Neuro endocrine disturbances: thyrotropin releasing factor from the hypothalamus
Medication side effects – e.g cortisone, cimetidene estrogen, progressive
Neurological disorders: An individuals who has suffered a CVA (Cerebrovasular accident)
Electrolyte imbalance: Excessive levels of sodium bicarbonate or calcium can procure symptoms of depression
Hormonal disturbances: Depression is associated with dysfunction of the adrenal cortex
Nutritional deficiencies: Vitamin B1 (thiamine)
Psychosocial causes: It was reveled that melancholia occurs after the loss of a loved object, either actually by death or emotionally by rejection, or the loss of some other abstraction of value to the individual 8. Having experienced numerous factures (either real or perceived)
WHAT ARE THE TYPES OF DEPRESSION?: Mood disorders can be classified as:- Mood disorders can be classified as:
MAJOR DEPRESSIVE DISORDER: This disorder is characterized by depressed mood or loss of interest or pleasure in usual activities. Evidence of impaired social and occupational functioning has existed for atleast 2 weeks. There is no history of manic behavior and the symptoms cannot be attributed to use of substance or a general medical condition. It may be further classified (on the basis of features) as follows9.
Single episode or recurrent: A single episode specifier is used for an individual’s first diagnosis of depression, Recurrent is specified when the history reveals two or more episodes of depression
Mild, moderate or severe: These categories are identified by the number and severity of symptoms
With psychotic features: The impairments of testing is evident. The individual experience delusions or hallucination
With catatonic features: This category identifies the presence co psychomotor disturbances, such as severe psychomotor retardation, with or without the presence of waxy flexibility or stupor or excessive motor activity
Wild melancholic features: temporary reactivity to usually pleasurable stimuli is absent
Chronic: This classification applies when the current episode of depressed mood has been evident continuously for atleast the past 2year
With seasonal pattern: The depressive disorder occur only during a seasonal period of the year
With post partum onset: This specifier is used when symptoms of major depression occur within 4 weeks postpartum
Dysthymic disorder: Individuals with dysthymic disorder describe their mood as sad or ‘down in the dumb’10. There is no evidence of psychotic symptoms. The essential feature is a chronically depressed mood for most of the day, more days than not, for atleast 2 years
Bipolar disorders: A bipolar disorder is characterized by mood swings from profound depression to extreme euphoria (mania), with intervening periods of normalcy. Delusions or hallucinations may or may not be a part of the clinical picture. It is in two forms
Bipolar 1 Disorder: The client may have experienced episodes of depression. Usually there is an evidence of mania, hypomania, mixed or depressed mood)
Bipolar II disorder: this diagnostic category is characterized by recurrent bouts of major depression with the episodic occurrence of hypomania
Cyclothymic disorder: The essential feature of cyclothymic disorder is a chronic mood disturbance of at least. 2 years duration, involving numerous episodes of hypomania and depressed mood of insufficient severity or duration o meet the criteria for either bipolar I or II disorder. The individual is never without pomania or depressive symptoms for more than 2 months
WHAT ARE THE LEVELS OF DEPRESSION?: Having enunciated on the types of depression let us elucidate on the levels of depression. The levels of depression can be described as alterations in four (4) spheres of human functioning – (i) affective, (2) behavioral, (3) cognitive and (4) physiological
Level 1 – Transient depression
Affective – sadness, dejection, feeling down heart
Behavioural – some crying possible
Cognitive – difficulty in getting mind off the disappointment
Physiological – feeling tired and listless
Level 2- Mild depression: The mild level of depression is identified by symptoms associated with normal grieving
Affective: Denials of reality, anger, anxiety, guilt, helplessness, hopelessness, sadness and despondency
Behavioural: tearfulness, regression restlessness agitation, withdrawal
Cognitive: Pre-occupation with the loss, self blame, ambivalence, blaming others
Physiological: anorexia or over reacting, insomnia or hypersomina, headache, body aches
Level 3: Moderate Depression: This level of depression represents a more problematic disturbance
Affective: Feelings of sadness, dejection, helplessness, powerlessness, hopelessness, gloomy and pessimistic outlook, low self esteem, difficulty experiencing pleasure in activities
Behavioural: Psychomotor retardation (slowed physical movements, slumped posture, slowed speech, limited verbalizations, possibly consisting of ruminations about life’s’ activities, social isolation with a focus on the self increased use of substances possible, self destructive behavior possible, decreased interest in personal hygiene and grooming
Cognitive: retarded thinking processes, difficulty concentrate and directing attention, obsessive and repetitive thoughts generally portraying pessimism and negativism verbalization and behaviour reflecting suicidal ideation
Physiological: Anorexia or overreacting, insomnia or hypersomnia, amenorrhea, loss of libido, body ache and abdominal discomfort, feeling best early in the morning and continually worse as day progresses
Level 4: severe Depression: All the symptoms in the moderate level are over exaggerated here.
Affective: Feeling of total despair, hopelessness, worthlessness, appearance devoid of emotional tone, feeling of nothingness and emptiness, apathy, loneliness, sadness and inability to feel pleasure
Behavioural: Severe psycho-motor retardation or psychomotor behavour manifested by rapid; agitated, purposeless movement, slumped posture, sitting in a curled-up position, non-existence communication
Cognitive: delusion of persecution, and somatic delusions, confusion, hallucinations, self-blame and thoughts of suicide
Physiological: A general slowdown of the entire body, reflected ins sluggish digestion, constipation and urinary retention
Having elucidated on the levels of depression and their manifestation, let us deliberate or factors that can trigger depression
The underlisted factors can trigger the occurrence of depression:
Loss of a loved one through death , divorce or separation
Social isolation or feelings of being deprived
Major life changes – moving, gravitation, job change loss of jobs, premature retirement, economic down torn
Physical, sexual or emotional abuse
Community instability – violence
Considering the above highlighted points, it is evident that depression is both genotypic and phenotypic in outcome. World-health organization defines health as a state of complete physical, mental, social and spiritual well – being and not merely the absence of disease or infirmity. Considering this definition, I wonder if all of us in this hall can say we are healthy because of the situation the country has been plunged into. Therefore, majority of Nigerians are within the armpit of depression
How then can will manage depression in Nigeria?
As it has been discussed earlier in this discourse that the causes of depression are multifactorial so the treatment will equally be eclectic
PREVENTION OF DEPRESSION
Government at all levels should design a programme for employment
There must be a periodic health information on health challenges in all our government agencies and parastatals.
All the primary health care units should have mental health / psychiatric units
There must be adequate preparation of staffers before retirement and they must be paid their allowances as at when due
There must be an adequate distribution of social amenities
MANAGEMENT OF DEPRESSION
Medical management: anti depressants
Electroconvulsive therapy
Psychological treatments
Individuals psychotherapy
Group therapy
Family therapy
CONCLUSION: In conclusion, it has been observed depression is one oldest recognized psychiatric illnesses that is still prevalent today. It is so common in fact, that if has been referred to as the ‘common cold of psychiatric disorders’. The causes of depressive disorders is not entirely known. A number of factors including genetics, biochemical influences, and psychosocial experiences likely enter into the development of the disorder. No single theory can explains the etiology of depressive disorder, and it is likely that the illness is caused by a combination of factors. The patient with depression should be monitored seriously because of suicidal ideation that is prevalent in the moderate and sever levels of the illness. The treatment of mood disorder include individual, group, family and cognitive therapies in child psychopharmacology and ECT.
Thanks so much for listening.
REFERENCES
Mary .C Townsend (2014. Essential of Psychiatric mental health nursing 2nd
, Philadelphia F.A Davis Company
Wanda K. Mohr (2009) Psychiatric – mental health nursing. Evidence Based Concepts, Skill and Practices 7th ed. Philadelphia, Lippincott, Williams & Wilkins
Balzer, D. (1994). Geriatric Psychiatric burke, K.C burke J.D & Rangier, D.A (1990). Age at the onset of selected mental health
Economic recession in Nigeria: Causes and solution http://education.com/economic-reseassion-nigeriaassessed 26 may, 2017
Maslow hierarchy of Needs: Counseling Tutor htt://counseling tutor.co/counseling-approacks.assessed 25th May, 2017
An overview of clinical depression: httpl://www.webmd.com.assessed 26th may, 2017
Depression: A Global Public health concern
Andrew. G. Cuijpers, P, Crake, M.G (2010). Computer therapy for the anxiety and depressive disorder is effective, acceptable and practical health care a metal analysis, plos one 13, 5 (10)
Comments
Post a Comment