Major DepressiveDisorder occurs when feelings of sadness persist for a two-weekperiod. The diagnosis of Major Depressive Disorder requires a personto experience at least five of nine symptoms. Some of these symptomsinclude fatigue, indecisiveness, restlessness, significant weightgain, a loss of interest in usual activities, depression, andinsomnia (Preston, O’Neal, & Talaga, 2013).
A person is mostat risk for suicide when they manifest feelings of guilt orworthlessness. This is because feeling worthless causes a person todoubt the necessity of their existence. Excessive guilt also causes aperson to want to end it all. Unchecked, feelings of guilt andworthlessness culminate into persistent thoughts of death or suicide.Suicidal tendencies could manifest themselves in the speech andactions of a person. Certain risk factors include chronic illness,abuse, family history, and prior suicide attempts (Preston, O’Neal,& Talaga, 2013). Nevertheless, thoughts of suicide are precededby an impaired ability to concentrate and make proper judgments.
Major DepressiveDisorder and Dysthymic Disorder have some striking similarities. Forexample, both disorders are manifested through feelings of apathy orsadness. On average, both disorders affect persons in their early 30s(Thompson, 2015). The diagnosis of both disorders is made upon theoccurrence of other symptoms for a particular length of time.However, the two disorders differ regarding duration, intensity, andthe diagnostic requirement for the number of symptoms.
Major DepressiveDisorder requires a person to manifest at least five out of ninesymptoms over a period longer than two weeks. One of the fivemandatory symptoms must be either loss of interest in activities ordepressed mood. On the other hand, Dysthymic Disorder requires anindividual to experience only two additional symptoms apart from themandatory depressed mood (Thompson, 2015). A person is diagnosed withMajor Depressive Disorder when he experiences depressive symptoms ona nearly daily basis during a two-week period. On the other hand,Dysthymic Disorder requires a person to have relatively less intensedepressive symptoms for at least two years (Thompson, 2015). Thesymptoms of Dysthymic Disorder must occur within any two-month periodin the duration of the two years.
For the case of45-year old Bryan, the recommendation of electroconvulsive therapy isproper since he has suffered clinical depression for many years.Besides, he has been unresponsive to treatments and therapies.Nevertheless, ECT has several disadvantages. Memory loss has beenidentified as a major side effect. Some people may gradually recovertheir memories while others have lost fundamental knowledge andskills. Other disadvantages include confusion, loss of appetite,headaches, drowsiness, and aching muscles (Preston, O’Neal, &Talaga, 2013). Persistent nausea and fatigue may also be experiencedafter ECT treatments.
For 30-year oldMartha, the course of therapy must take into account her history ofalcohol abuse and binge-eating. Due to the high potential of relapse,the best antidepressants are those that would not adversely reactwith alcohol. In this regard, selective serotonin reuptake inhibitorssuch as Prozac and Celexa would work best. This is because personswith Major Depressive Disorder customarily have low levels ofserotonin (Preston, O’Neal, & Talaga, 2013). Therefore, thedrugs prevent the breakdown of serotonin. After Martha has beenasymptomatic for seven months, her medication treatment should becombined with psychotherapy to avoid further relapse.
I found it quiteenlightening to read about the history of ECT. I was amazed to learnthat ECT was used as a method of inducing convulsions due to itsconvenience and cost-effectiveness. However, its negative portrayalin the media progressively reduced the appeal of the technique(Mandal, 2014). I was enthused to learn how ECT has emerged as anecessary evil. On the one hand, it remains unclear how the techniqueworks. On the other hand, the method has been markedly effective incombating unresponsive cases of depression. Contrary to previous use,ECT is currently applied after the administering of muscle relaxantsand anesthetic (Leiknes, Schweder, & Hoie, 2012).
Leiknes, K. A., Schweder, L. J., & Hoie, B. (2012, May).Contemporary use and practice of electroconvulsive therapy worldwide.Brain and Behavior, 2(3), 283-344.
Mandal, A. (2014, June 23). Electroconvulsive therapy history. NewsMedical. Retrieved fromhttp://www.news-medical.net/health/Electroconvulsive-Therapy-History.aspx
Preston, D.J., O’Neal, J., & Talaga, M. (2013). Handbook ofclinical psychopharmacology for therapists, (7thEd.). Oakland,CA: New Harbinger Publications.
Thompson, K. (2015, August 10). A comparison of Major DepressiveDisorder with Dysthymia. Livestrong. Retrieved fromhttp://www.livestrong.com/article/108557-comparison-major-depressive-disorder-dysthymia/