Jan 17, 2016
Depression?Depression?Depression is an illness that
affects our thoughts, feelings, behavior and overall health.
One feels sad or down for long periods of time
It can even have physical affects on one’s body
“A depressed person can feel hopeless, helpless and worst of all alone” (Ayer, 1997)
People suffering from depression always feel they’ve done something wrong when things go bad
Many times people with depression become irritable and upset at small things
Who Gets DepressedWho Gets DepressedMental health professionals used
to believe that depression was an adult’s disorder.
In fact depression can affect anyone from infants to teens to adults even older.
Symptoms of depressionSymptoms of depression
HopelessnessIncreased
irritability, anger, or hostility
Low self esteemWithdrawalLoss of appetite or
constant hungerAlcohol or drug
abuse
Self injury Discussion or
thoughts of suicide
Feelings of guiltInability to
concentrateDifficulty with
relationships
Common Types of Common Types of DepressionDepression
Major DepressionDysthymiaBipolar DisorderSeasonal Affective Disorder (SAD)
Major DepressionMajor Depression
• Begin suddenly, possibly triggered by a loss, crisis or change
• Interfere with normal functioning• Continue for months or years• It is possible for a person to have only one
episode of major depression. It is more common for episodes to be long lasting or to occur several times during a person’s life
DysthymiaDysthymia
People with this illness are mildly depressed for years. They function fairly well on a daily basis but their relationships suffer over time.
Bipolar DisorderBipolar DisorderPeople with this type of illness change back
and forth between periods of depression and periods of mania (an extreme high).
Symptoms of mania may include:◦Less need for sleep◦Overconfidence◦Racing thoughts◦Reckless behavior◦Increased energy◦Mood changes are usually gradual, but can be
sudden
Season Affective DisorderSeason Affective DisorderThis is a depression that results
from changes in the season. Most cases begin in the fall or winter, or when there is a decrease in sunlight.
Causes of DepressionCauses of DepressionThere is not one single cause of
depression, it is usually a combination of things.
Stress is however the leading cause of depression.
Other things such as genetics, traumatic events, low self esteem, stress and physical illness can also contribute to depression.
Depression StatisticsDepression Statistics10-25 percent of
women and 5-12 percent of men will likely become depressed in their life
One of eight women will develop depression but only one in three women will seek care
15 percent of those with severe depression will commit suicide
70 percent of antidepressant prescriptions are given with misdiagnosis
Major depression occurs most often in the mid to late 20’s
Depression occurs most frequently in women 25-44 years of age.
(Statistics, 2003-2007)
Cognitive Behavioural Therapy (CBT) is a psychological treatment that addresses the interactions between how we think, feel and behave. CBT is a process of teaching, coaching, and reinforcing positive behaviours. CBT helps people to identify cognitive patterns or thoughts and emotions that are linked with behaviours..Evidence now supports the effectiveness of CBT for many common mental disorders. For some disorders, carefully designed research has led international expert consensus panels to identify CBT as the current “treatment of choice”.
Cognitive Behavioural Cognitive Behavioural TherapyTherapy (CBT)(CBT)
Characteristics of Characteristics of Cognitive-Behavioral Cognitive-Behavioral Therapy:Therapy:
• Thoughts cause Feelings and Behaviors.
• Brief and Time-Limited.
• Emphasis placed on current behavior.
• CBT is a collaborative effort between the therapist and the client.
• Client role - define goals, express concerns, learn & implement learning
• Therapist role - help client define goals, listen, teach, encourage.
• Based on "rational thought." - Fact not assumptions.
• CBT is structured and directive. Based on notion that maladaptive behaviors are the result of skill deficits.
• Based on assumption that most emotional and behavioral reactions are learned. Therefore, the goal of therapy is to help clients unlearn their unwanted reactions and to learn a new way of reacting.
• Homework is a central feature of CBT.
MethodologyMethodologyTotal Sample Size- 208Pre Test & Post Test Groups- 4
(G1, G2, G3, G4)G1- Only Homoeopathic
MedicinesG2- Only CBTG3- Combined Regimen TherapyG4- Placebo Therapy
Methodology (Contd.)Methodology (Contd.)Case Taking of PatientsDetermination of Type of TherapyFollow Up of Patients &
Assessment of ProgressUse of Different InstrumentsOrganizing Sessions for CBT.
Sex wise distribution of Sex wise distribution of respondentsrespondents
Gender Frequency Locality Percentage
Urban Rural
Male 81 53 28 38.94
Female 127 94 33 61.06
Total 208 147 61 100
Family size wise distribution Family size wise distribution of the respondentsof the respondents
Family size Frequency Percentage
1-4 117 56.25
5-8 64 30.77
8 and Above 27 12.98
Family type wise distribution Family type wise distribution of the respondentsof the respondents
Type of family
Nuclear 141 67.78
Extended 67 32.22
Locality wise distribution of Locality wise distribution of the respondents the respondents
Type of locality
Urban 61 29.33
Rural 147 70.67
Financial status of Financial status of respondentsrespondents
Socio economic
status
Number of
Respondents
Percentage
HIG 39 18.75
MIG 82 39.44
LIG 64 30.76
EWS 23 11.05
Occurrence of depression on Occurrence of depression on the basis of aetiological the basis of aetiological
incidenceincidence Cause Frequency Percentage
Emotional 116 56
Financial 28 13.6
Grief 49 23.4
Miscellaneous 15 7
Total 208 100
Homoeopathic Medicines Homoeopathic Medicines UsedUsed
Name Frequency Percentage
Natrum- Mur 53 25.48
Pulsatilla 41 19.71
Nux Vomica 23 11.05
Ignatia 17 8.17
Anacardium 17 8.17
Arggentum Nitricum 15 7.21
Aurum Met 10 4.80
Scores of Pre & Post Test Scores of Pre & Post Test GroupsGroupsScore
GroupDegree of Depression
Pre Test Frequency
Score Post Test Frequency
Frequency
0-9Depression
likely5 2.40 0 0
10-17Possibly
mild9 4.33 0 0
18-21 Border line 32 15.38 10 4.80
22-35Mild to
moderate83 39.90 24 11.53
36-53Moderate
to severe49 23.56 19 9.13
54 and
above
Very
Severely
depressed
30 14.43 13 6.25
Homoeopathic Medicines on Homoeopathic Medicines on Depression in different age Depression in different age
groupsgroupsAge
group in
years
No. of
respondent
s
Good
improveme
nt
Moderate
improve
ment
Mild/No
improveme
nt
16-20 6 4 1 1
20-40 27 18 5 4
40-60 19 11 4 4
Response of CBT on Response of CBT on Depression in different age Depression in different age
groupsgroupsAge
grou
p in
year
s
No. of
respond
ents
Good
improve
ment
%
Moderat
e
improve
ment
%
Mild/No
improve
ment
%
16-20 16 10
6
2.
5
4 25 2 12.5
20-40 26 18
6
9.
2
3
519.
233 11.53
40-60 10 55
03 30 2 20
Response of Combined Response of Combined Regimen Therapy on Regimen Therapy on
Depression in different age Depression in different age groupsgroups
Age
grou
p in
year
s
No. of
respon
dents
Good
improve
ment
%
Moderat
e
improve
ment
%
Mild/No
improve
ment
%
16-20 6 35
02
33.
331 16.67
20-40 19 13
6
8.
4
2
315.
793 15.79
40-60 27 14
5
1.
8
5
933.
334 14.82
Response of PLACEBO Response of PLACEBO therapy on Depression in therapy on Depression in
different age groupsdifferent age groupsAge
gro
up
in
yea
rs
No. of
respon
dents
Good
improv
ement
%
Modera
te
improv
ement
%
Mild/
No
improv
ement
%
16-
2010 3 30 2 20 5 50
20-
4014 4
28.
572
14.2
88
57.1
5
40-
6028 5
17.
866
21.4
317
60.7
1
Response of over all Response of over all treatment on Depression in treatment on Depression in
different age groupsdifferent age groupsAge
gro
up
in
yea
rs
No. of
respon
dents
Good
improve
ment
%
Modera
te
improv
ement
%
Mild/No
improv
ement
%
16-
2038 21
55.2
713
34.2
14
10.5
2
20-
4086 62
72.0
911
12.7
913
15.1
2
40-
6084 49
58.3
325
29.7
710
11.9
0
ConclusionConclusionCombined therapy regimen of
Homoeopathic Medicines and CBT works very effectively and provides wonderful relief to the patients.
Placebo Therapy is very effective for those patients who are suffering from mild psychosomatic disorders and have vague complaints.
Conclusion (Contd.)Conclusion (Contd.)Mental symptoms in
Homoeopathy have incredible value. Any prescribing is made keeping the mental symptoms of patient in central attention. Hence they are very effective in treating psychological disorders. They bring dramatic changes in the thoughts of patient by de-rooting the culprit from the body.
Conclusion (Contd.)Conclusion (Contd.)CBT was found as psycho
educational form of psychotherapy. Its purpose is for patients to learn new skills of self-management that they will then put into practice in everyday life. It adopts a collaborative stance that encourages them towards optimistic attitude.
Recommendation Recommendation • Following points are very important to live a healthy and cheerful life free from depression:
• Healthy life style leads to lesser amount of depression.
• Development of supportive relationship.
• Practicing regular physical exercises, meditation, relaxation techniques and having sound sleep are components of training in CBT.
Nutritious diet boosts mood naturally.• Proper time management and coping
with stress is required.
Recommendation (Contd.)Recommendation (Contd.)• Balancing emotions and remaining
optimistic.• Seeking professional support, when
ever any negative thoughts are disturbing frequently.
• Life skill training is important for not losing psychological balance in adversity also as ups and downs are part of the life.
• Setting the goals as per your capacity.• As for as possible following the system
of extended family is beneficial.
• In built shock absorbers are to be developed within family support system.
• frequency of family and professional get- together are to be increased.
• Counseling for the management of depression is to be made part of medical training as behavioral medicine procedure.
THANK YOU