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Essay on Unipolar Depression: Factors and Treatment!
Essay on the Factors of Unipolar Depression:
Biological Factors:
It has been reported that there is decreased Himipramine binding to blood platelets from some depressed individuals. Large numbers of studies have reported various abnormalities in bionic amine metabolites in blood, urine and cerebrospinal fluid in mood disorder patients.
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Abnormalities of the limbic-hypothalamic-pituitary-adrenal (LHPA) axis are the most consistently reported neuro endocrine-dysregularities. Findings indicate that hyper secretion of cortisol is present in some depressed patients.
The DST (Dexamethasone Suppressed Test) is abnormal in about 50 per cent of the depressed patients indicating hyperactivity of LHPA axis. Other neuroendocrine causes of depression include hypo (less) release of thyroid stimulating hormone upon administration of thyroid releasing hormone. Depressive patients usually do not have a good sleep and sleep irregularity is very often found in them.
This is perhaps the most important proof that unipolar depression has a biological cause. Frequently of early morning awakening and discontinuity of sleep increases in depressed patients. Multiple awakening during night also increases. It has also been remarked that unipolar depression is a disorder of chronobiological regulation.
It can therefore be concluded that unipolar disorder involve pathology of the limbic system, the basal ganglia and the hypothalamus. Studies further indicate that neurologic disorders of the basal ganglia and limbic system are likely to present with depressive symptoms.
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The stopped posture, motor slowness and minor motor cognitive impairment seen in unipolar depression are quite similar to disorders of the basal ganglia like Parkinson’s disease and other subcortical dimensions.
Personality Factors:
Though all persons with different type of personality pattern can have depression under appropriate circumstances, certain personality types like oral dependent type, obsessive compulsive type, hysterical may have greater risk for unipolar depression.
The antisocial, paranoid and other personality type who use projection and other externalizing defense mechanisms for channelizing their emotion etc. have relatively less depression.
Psychoanalysis Factors:
According to Freud’s structural theory, the ambivalent interjecting of the lost object into the ego leads to depressive symptoms.
Learned Helplessness:
When the organism learns that he is helpless, it leads to depressive symptoms. Unipolar depression can be reduced if the psychiatrist creates a sense of control and mastery to reduce helplessness in the patient.
Reward, positive reinforcement and a sense of success created by some sort of achievement can help in the matter. Avoidance of negative distortions of life experience, negative self evaluation, pessimism and hopelessness will obviously develop a positive attitude towards life and would help in reducing depression.
Essay on the Treatment of Unipolar Depression:
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Mild depression may be treated in the office of the physician, at home or as an out-patent provided the symptoms are at a minimum level. The support system should also be quite strong to avoid hospitalization. But in case of severe depression hospitalization is a must.
Approximately 50 per cent of the patients have their first attack of unipolar depression before 40 years of age. Acute depression can be treated through drugs.
However applying drug on the depressive patient it must be ensured that:
(1) The depression is a combination of biological and psychological factors,
(2) That the patient will not get addicted to anti-depressants since these drugs do not give immediate relief,
(3) The patient should be explained that the drug will have slow effect and also side effects,
(4) The patient must also be informed that sleep or appetite will improve first and the feeling of the unipolar depression will change.
Further taking into consideration the past history of the patient anti-depressants may be prescribed. Although controversial E.C.T. (Electro Convulsive Therapy) is perhaps the most effective treatment, antidepressant treatment so far particularly for unipolar depression has quick effect.
Psychotherapy:
Antidepressants combined with Psychotherapy bring better results than either method alone. Interpersonal behaviour, individual Psychotherapy, family therapy and cognitive therapies bring good results in the treatment of depressive patients. It is found that individual Psychotherapy helps the patients to be more aware of their moods and the results of their acts on others in the environment.