Healing takes time, but asking for help is courageous
DEPRESSION – GENERAL TYPES
TRAUMATIC EXPERIENCE
DAILY LIFE STRUGGLES- SERIES OF HEART BREAKING EVENTS
PHYSICAL DEPRESSION AND ANXIETY
PHASES OF DEPRESSION :
PHYSICAL – Tired, aches pains, weakness, disturbed sleep and less/ over eating
FEELING – sadness, irritation, losing interest in everything , guilt
THOUGHTS – Hopeless , difficulty in decision making, thinking worthless, Thoughts of dying
ACTIONS – reduced social interaction, inability to work , withdrawal from favourite activities.
SYMPTOMS TO INDENTIFY A PERSON IS UNDERGOING DEPRESSION
Depression level depends on the number of symptoms, how long they last, and how much they get in the way of daily functioning depending on the phases of depression
PROBLEM |
POSSIBLE SOLUTIONS |
FAMILY MEMBER IS A ALCOHOL ADDICT
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- Person concerned can be encouraged to seek treatment by asking the patient to share the hazardous drinking brochure
- People close to the family member can encourage and support him/her to stop drinking
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PHYSICALLY ABUSIVE SPOUSE |
- Seek the help of someone who may be able to speak to the spouse
- Discuss safety measures
- Referral to support agencies
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PATIENT DOES NOT HAVE A JOB |
- Explore options of job opportunities such as ads for vacancies
- Ask friends and family to explore their network
- Share information about government employment schemes
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ILLNESS IN THE FAMILY |
- Encourage the family to seek the right treatment
- Follow medical advice
- Refer the person to a specialist/agency/hospital
- Care for the person’s needs suitably
- Seek support for oneself to deal with the burden of care
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RELATIONSHIP DIFFICULTIES |
- Identify ways of communicating better
- Ask the person close to the patient to come for a session
- Involve a third person who can help the patient
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FINANCIAL DIFFICULTIES |
- Look for better job opportunities
- Refer to government schemes such as pension schemes
- Explore ways of saving
- Seek help from friends/family
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A PERSON IN THE FAMILY WITH SPECIAL NEEDS |
- Seek professional help to support the person
- Gather information and enhance skills to care for the person
- Seek support for oneself to deal with the burden of care
- Refer to an agency
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DIFFICULTY IN COPING WITH WORK STRESS |
- Learn useful ways to cope with stress, such as taking short breaks
- Time management
- Improve skills that will help with work performance
- Seek support from seniors/co-workers
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STRESS AND LONELINESS CAUSED BY LIVING AWAY FROM HOME AND FAMILY |
- Maintain regular communication with family
- Create a support network of friends
- Join community activities
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ELDERLY PATIENTS WITH NO FAMILY SUPPORT |
- Explore possibility of building a support network
- Provide information about government schemes
- Refer to agency
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COUNSELLING THERAPY TO BE FOLLOWED :
HAP – HEALTHY ACTIVITY PROGRAM
- Body, feeling, thought
- 8 sessions 3 phases each
- PHQ 9 – questions are asked to the person to know the level of depression he/she is under going and analyzing the suicidal risk.
EARLY PHASE (1-2 SESSION)
- Getting started
- Understanding problems
- Commitment to treatment
- Addressing barriers
MIDDLE PHASE :
From the assessment of phase one
- Judging activity targets and encouraging activities
- Identifying barriers and how to overcome them
- Helping patients solve or cope with life problems
- Ending Phase
- Gaining strength
- Preparing for situations that may trigger depression in the future and generating plans to deal with them
When u give counseling to a person
- Focus on action
- Be non-judge mental
- Acknowledge the patient’s experience
- Be encouraging
- Express warmth and be genuine
PHASE 1
3 important questions to get to know their intensity of pain
- What Happened
- How did you feel
- What did you do
Few people struggle to figure out what is the reason behind feeling low/ depressed
WHAT HAPPENED :
- Severe stress, defined as a traumatic event (e.g. death of a loved one, loss of a job, serious accident or injury)
- Long-term stress, defined as problems the patient has been dealing with for a long time (e.g. work-related or relationship problems; lack of care from family and isolated ignored; long-term financial problems; or having to care for a sick family member)
- Harmful childhood experience (e.g. abuse, neglect or trauma)
HOW DID YOU FEEL
Ex : Arugument with spouse
- Sadness and irritation
- Low interest or motivation
- Decreased energy – feeling tired and fatigued
- Lowered attention and concentration – inability to study or keep at one task for long
- Thoughts of hopelessness, worthlessness and helplessness
Tell them it’s common , these feelings are normal in the phase of life’s challenges.
WHAT DID YOU DO
- Not meeting or talking to friends and family
- Not going to work
- Doing routine activities, e.g. sleeping, eating, hygiene routines, in disorderly ways
- Stopping or reducing physical activity (staying in bed, not exercising, etc.)
- Increasing conflict with people close to them
- Thinking again and again about their problems
And we can say
The problem with this kind of behavior is that it keeps you stuck in feeling low/down/stressed as you are less engaged in things that make you happy.”
Suggest them to stop
EXAMPLES OF ACTIVITIES THAT DON’T MAKE YOU FEEL GOODS
- Watching TV for hours at a time
- Lying in bed for long periods
- Not attending work
- Not caring for personal appearance and hygiene
SUGGEST THEM THESE ACTIVITIES
- Speaking to a friend
- Spending time in hobbies
- Praying or reading religious or motivational books
- Going for a walk
- Distracting in things u love to do.
- Let the pain out by exercises and physical activity.
SIGNIFICANT OTHER (SO)
An important part of counseling involves helping family members understand what depression is and ways to treat it.
- If the SO attends the session, ask the person if he/she wants to provide more information on the patient’s problems and if he/she has questions.
BEARERS DURING SESSIONS
Uncommunicative and doesn’t open up about problems
Spend greater amount of time in engaging and explaining how treatment will help.
Assure the patient that all information will be confidential.
Speak to the patient alone if he/she has come with the SO
Suffering from personal crisis
Allow time for the patient to show sadness or emotional pain.
PHASE 2
ASSESSMENT OF IMPROVMENT / WORSENING OF MOOD SWINGS
If worsening
Problem solving is an important form of activation for many patients.
Common problems and solutions table refer
- Identify a problem and generate solutions when attempting to solve problems in the patient’s life
- Support the patient in doing the activities
Motivate them to feel better , as they are no longer alone they have support
Help them fight back difficulties and face them.
Give hope and confidence.
As sessions continues
The SO can help:
- Encourage the patient to continue engaging in activities that help them feel better
- Identify stressors that may cause tension and aid the patient in finding solution
STRATEGIES :
- OVER THINKING OF PROBLEM :
- Encourage to distract
- Make them understand overthinking will never help in sorting
Tell them if a problem has solution, try the solution and end it , if no solution and not under our control, time heals . Refer examples of people who has gone through even more worsed problems and are now happy ( either real / imaginary example to Make them feel better and worried)
- FEELING ANXIOUS AND TENSED
- Breathing exercises and mediation/ yoga for inner peace.
3, PROBLEM WITH A PERSON CLOSE TO HIM/ HER :
- Effective communication.
- Communicate and sort out at the right time.
- Put yourself in his/ her situation and talk.
- Never argue , make them understand how u feel and got hurt .
- Never bring past , talk about the present incident that hurted you..
- Give time for them to realize and understand.
- Get help of a third person who can help in this like a common friend or relative to sort out.
- SLEEPING DIFFICULTY :
- Constant sleeping and waking up hours
- Hot shower before bed
- Breathing exercises, eye exercises
- Avoid afternoon nap
- No overthinking of problems/ worrying
- No tea coffee before bed
- Book/ Audio story that makes them asleep
- No sleeping pills
- ALCOHOL/ TOBACCO ADDICTION
- Personal advices and suggest family to advice
If worsening ,
Go with Medications
No improvement/ worsening of mood swings after attending 2 phases also
The PHASE 3
MEDICATIONS – ANTI DEPRESSION PILL
- Antidepressants are widely used and have benefited many by helping to reduce symptoms and improve overall health
- They are not addictive
- They may produce side effects, but these are common, mild and short-term
- They may take up to two weeks to start showing positive effects
- It is important to take them regularly for maximum benefit
- It is important to take them as prescribed by the doctor, even if one feels an improvement. Stopping the medicines before the suggested time frame can cause the problems to return
- Taking them regularly is an important activity target. Explore possible barriers and solutions
- Report any unusual or severe side effects to the supervisor, who can discuss them with the doctor. Always encourage the patient to talk to his/her doctor about any questions about the medication or side effects
The most common ones are Fluoxetine and Amitryptilline.
Do share and care.