DSM Criteria for Depression

-Usefull info on defining depression from http://oyc.yale.edu/psychology

There is a lot of nonsense talked about depression and mental ill-health, mainly by Stephen Fry. “22% of women will have an episode of serious depression and 13% of men,” things like that, which I don’t know what we’re supposed to take away from that? No matter how true it may be I don’t necessarily find it a use-full statistic, other than to perhaps say you may be more likely to suffer from depression than you expected.

Regardless of the statistics there are two potential issues, do you have/ are you in a phase of depression, and what is the best way to move through it, and out the other side.

Below is some info from the Yale introduction to psychology lectures, which are available on Youtube or there website

http://oyc.yale.edu/

http://oyc.yale.edu/psychology/psyc-110

“Diagnosis”

There needs to be a definition of abnormality for all mental illness to be defined, and it is not clear cut there is no blood test etc.

What is Abnormality?

We have an intuitive sense

• Would be nice if there was some objective criteria
• Is a subjective judgment call
• Heavily influenced by
• Social norms (woman wearing a veil in Muslim vs. non-Muslim culture)
• Characteristics of target (a man crying vs. a woman beating up on someone)
• Context (paranoia in Baghdad vs. a quiet little farm town)

Current Consensus

An Abnormality is characterized by 3 factors:

Distress: causes person or others significant distress

Dysfunction: prevents person from functioning in daily life

Deviance: behaviours or feelings highly unusual

-Specifically relating to depression-

DSM Criteria for Major Depression

A. Sadness or diminished interest or pleasure in usual activities (anhedonia)
B. At least four of the following symptoms:

1. Significant weight or appetite change (eating a lot more or a lot less)

2. Insomnia or hypersomnia (sleeping all the time or not at all)
3. Psychomotor retardation or agitation (extremely slow reaction response/ hyper active/fast)
4. Fatigue or loss of energy
5. Feelings of worthlessness or excessive guilt
6. Diminished ability to concentrate, indecisiveness
7. Suicidal ideation or behaviour

C. Duration of at least 2 weeks

So if you are undergoing 4 or more of the above for more than 2 weeks it may be worth seeking help.

Beck’s Negative Cognitive Triad

“Cure” breaking the cycle

Cognitive-Behavioural Therapy

1. Identify themes in negative thoughts and triggers for them.

2. Challenge negative thoughts.

1. What is the evidence for your interpretation? 2. Are there other ways of looking at the situation? 3. How could you cope if the worst did happen?
3. Help clients recognize negative beliefs or assumptions.
4. Change aspects of environment related to depressive symptoms.
5. Teach person mood-management skills that can be used in unpleasant situations.

Interpersonal Therapy

Less structured form of therapy than CBT.
Explore patterns of relationships and roots in childhood.

Look for four types of interpersonal problems: Grief or loss, Interpersonal role disputes, Role transitions, Interpersonal skills deficits

Help clients understand connections between interpersonal problems and upbringing, and make choices for changing relationships.

A few studies suggest it is as effective as CBT, but much less research has been done on IPT than on CBT.

General conclusions about therapy effectiveness

• People in treatment do better than those not
• Some types of therapy work better for specific problems – cognitive-behavioural for major depression – Medication for bipolar disorder • some therapists are better than others

Nonspecific factors in therapy effectiveness

• Nonspecific = unrelated to specific principles but critical to outcome
• Support – acceptance, empathy, encouragement, guidance
• Hope – sense of faith in therapy process – placebo effect = improvement from belief, rather than actual effect

A word on Medication, anti-depresents, serotonin reuptake inhibitors, are usefull but typically once they stop taking the drug, the client will return to there original state of depression. So medication is most effective in conjunction with therapy, creating a kind of stop gap so the client can begin to move out of the depression.   



So that’s the notes, below is a thing I wrote on the train whilst drunk a while back, which I guess is some of my personal interpretation. Bit weird!

Your differences, your preference, your unique-ness is your strength, not your weakness. It’s what makes you, you. It is everyone else who is wrong, who is inferior. How wrong you are to see yourself through them. Be arrogant, be proud, and be free. Define yourself happily; don’t let me tell you to do this. DIY

P.S. It is likely that had say, Freud said this to Hitler in 1927 then things may not have improved or may have got worse. This is not a damnation of the intention above. Rather a flaw in the certainty and lack of empathy in the written word and non-personal interaction in general.

And then I believe i punched this tramp that was looking at me askance, not really.

Martin E.P. Seligman is mentioned in the lectures, the tip of the ice-burg of his research is into the psychology of happiness and wellbeing what it means and attaining it...

Implications of the hedonic treadmill:

• Possessions are not the key to happiness

ALTERNATIVE 1: Endless novelty (fun)

ALTERNATIVE 2: Step off the treadmill Seek out more substantial goods Friends and family; long-term projects (wellbeing)

Also, useful books might be

Siddhartha

by Hermann Hesse

Self- esteem: proven Cognitive Techniques for assessing and Maintaining Your self-esteem

By Matthew McKay & Patrick Fanning

Your Erroneous Zones, by Wayne W. Dyer

The death of Ivan Ilyich, by L.N. Tolstoy

What We May Be  :Techniques for Psychological and spiritual growth Through Psychosynthesis.

by Piero Ferrucci

 Or maybe not they all say the same core thing.

Be well