Symptoms of Depression

An
In Service Activity
By
Christopher Skinner
 Aims of In Service

At the end of this session the learner will

have an understanding of the symptoms
and signs of Clinical Depression, together
with a basic understanding of how
Depression is treated both
pharmaceutically and behaviourally.
 Symptoms of Depression

If a person is clinically depressed they

would have at least two (2) of the
following symptoms for at least two
weeks.
An unusually sad mood that does not go away
Loss of enjoyment and interest in activities that used to
be enjoyable
Lack of energy and tiredness
 Symptoms of Depression
As well, people who are depressed have other
symptoms such as:-
Loss of confidence in themselves, or poor self esteem
Feeling guilty when they are not at fault
Wishing they were dead
Difficulty concentrating, or making decisions
Moving more slowly or, sometimes, becoming agitated
and unable to settle
Difficulty in sleeping or, sleeping too much
Loss of interest in food or, eating too much, changes in
dietary habits can lead to weight changes.
 Symptoms of Depression

Appearance of the depressed person.

The person usually looks sad and depressed,
and is often anxious, irritable and easily moved
to tears. A depressed person is usually slow in
thinking and moving, though agitation and
restlessness, as well as irritability, can occur.
The Affect is Flat. Emotions may be blunted.
Speech can be slow and monotonous. There
may be a lack of interest in one’s own grooming
and personal hygiene.
 Symptoms and Signs of
Depression
Thought content is often negative, with ideas of
helplessness, hopelessness and failure and views of
despondency.
Speech content may be limited, mono-syllabic and there
may be poverty of speech which identifies underlying
poverty of thought.
Examples of Speech content are:- “It’s all my fault, I am
a failure, life is not worth living, there is no point in going
on, things will never get better, no one cares about me,
no one loves me, I’d be better off dead.
 Treatments

There are three main ways of treating

depression

Pharmaceutical Treatment
Behavioural Change (Psycho-Social)
ECT (Electro-Convulsive Therapy)
 Pharmaceutical
Treatments
The main stay of Pharmaceuticals are the
anti depressants, these drugs are
effective in over 70% of cases. (WHO 2005)
There are two main classes of anti
depressants in use today – the Tricyclic
Antidepressants, and the Selective
Serotonin Re-uptake Inhibitors (SSRI’s)
There are also some other anti-
depressants, such as Venlafaxine.
 Tricyclic Antidepressants:

These are the most effective, but have

fallen out of favour lately as they are
known to have cardio-toxic (heart
damaging) effects when used over long
periods.
Examples are Amitriptyline and
Imipramine
 SSRI’s

These are the newer anti-depressants

Examples are Citalopram, Fluoxetine and
Paroxetine. Common trade names are
Cipramil, Zoloft and Aropax
They work by altering brain chemistry
They are generally given once a day
 Treatments

All antidepressants take between 5 and 10 days

to reach a therapeutic level in the blood stream.
During this time the patient may undergo some
adjustment experiences such as blurred vision
and a dry mouth. They need to be re-assured
that these symptoms will soon pass.
 Treatments

Drug Treatment usually carries on for 3 – 6

months depending on the severity of the
symptoms – the drug is withdrawn by gradually
reducing the dosage, to see whether or not
depression returns. Some patients will remain
drug free and symptom free, others will require
occasional intervention. Some require life long
treatment. (About a third in each case)
 Behavioural change:

Cognitive Behavioural Therapy

Takes between 3-6 months of weekly one
hour sessions
Changes the way the patient thinks about
themselves and the world around them,
teaching them to use tools of positive rather
than negative thinking
Lifestyle coaching and change

Exercise is an important tool in helping

people with depression get better, often
depressed people are unfit, obese and
feel tired due to their poor physical
stamina.
Exercise routines improve cardiac output
and general organ functioning and may
help “lift” the depression.
Lifestyle coaching and change

Diet can play a large part in people being

depressed, fast foods, fatty foods and
processed foods such as McDonalds and
Hungry Jocks, Coca Cola, Fat Burgers and
Sausages are examples of unhealthy, semi
toxic foods that de-energise the body and the
brain. These should be substituted with fresh
whole foods such as Cereals, Fruit, Vegetables,
Nuts, Fresh Fish and small portions of Red
Meat as well as Fresh Water and 100% Fruit
Juice. Tea is also good.
 Electro Convulsive Therapy
This is an empirical treatment, no one knows why or how it works,
but it is often effective in people who are resistant to drug
treatment. Generally, there are a course of 7 to 20 treatments,
usually a week apart.
After effects can include confusion, short term memory loss and
tiredness, but these effects pass after 1-2 days.
Older patients are usually convulsed with a uni-lateral placement of
electrodes, to reduce after effects of short term memory loss and
confusion.
The treatments are administered by passing an electric current
through the brain, creating a seizure in the patient – the severity of
the seizures are clinically controlled by the administration of a short
acting anaesthetic and by regulation of the current voltage.
Properly administered ECT is a safe procedure.
 Treatments

Treatments are usually integrated so that

both an anti-depressant and a
behavioural strategy are employed.
Hospitalisation may occur where the
person is so depressed that they are at
risk of Suicide.
Other recommendations revolve around
altering unhealthy habits such as drinking
too much, cigarette smoking and
sedentary habits.
 Getting Better

The patient reports better sleep, improved

mood and concentration and returning
zest for life. They become more active
and feel happier – they often can’t believe
the way they felt and are often grateful to
their therapist for the improvement.
 Questions

Not all at once please!

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