Monday, July 27, 2009

Psychotherapy of depression

Psychotherapy of depression. Pharmacological treatment of depression. Pharmacotherapy and antidepressants in the treatment of depression.
Depression should not be treated with psychotherapy, and patients themselves to seek this form of medical and psychological assistance. They have not solved a long time to accept drug use as starting receiving antidepressants, often quickly cease medication. Because of helplessness and constant doubt, patients usually suggestibility, and reading the annotations on these or other drugs, it is easy to find in their side effects are already in the first days of treatment. In addition, patients suffering from depression have a functional disorder of internal organs, and because of this really sensitive to side effects of drugs. Many patients have a false alarm with regard to permanent dependence on antidepressants. A significant portion of patients suffering from depression related to a placebo - the reactor, ie people responsive to receiving even "empty pill" does not contain any - or the active drug substance. All of the above determines the increasing interest of patients to psychotherapy.

A major argument against the role of psychotherapy in treating depression, are the experimental data, which speak of the importance of psychological factors in shaping the sustainability of therapeutic drugs for depression. An effective course of psychotherapy in the long term, possibly more useful than the drug because it teaches the patient. The latter acquired the skills to overcome depression, learning to recognize its approach, to prevent the development of its recurrence. The results of many studies, the normalization of endocrine indices in the treatment of depression is achieved not only during treatment with antidepressants, but also in psychotherapy. Moreover, the impact of psychotherapy on endocrine indicators observed in the case of combination therapy with psihofarmakologicheskoy, and in the case of using it as the sole method of treatment.

In some cases, psychotherapy allows patients to adjust to real life, with the continuing violations of affective sphere of thinking and attitudes. Having an independent therapeutic effect, psychotherapy promotes optimal patient and physician collaboration, improves efficiency of medical treatment, and improves family relationships and the professional status of the patient.

Frequent start of depression after acute trauma or prolonged stress leads to a persistent search for the psychological reasons for its occurrence. This fact reinforces the desire of patients to psychological care. However, excessive overestimation of its possibilities, unfortunately, can lead to a complete rejection of psychotropic substances, the formation of resistant variants and the protracted course of depression, the emergence of early exacerbations.

From the standpoint of medical psychotherapy of depression should be primarily aimed at addressing its symptoms. Some of them are more sensitive to psychotherapy and other relatively hard to its effects. Understand that in severe depression psychotherapy opportunities are more limited than in cases of lung disease.

As a target in the mental health impact of depression distinguish disorders of mood, thinking, behavior, motivation and physiological symptoms. Among the affective symptoms - sadness, guilt and shame and anxiety in particular are especially sensitive to psychotherapeutic influence.

There are a number of general principles of the psychotherapist with patients suffering from depression. It is important for the doctor's control own feelings in relation to the patient because you may experience the feeling of emptiness, anger, sympathy, and excessive fatigue. Psychotherapy not only sympathy for the patient, but also closely watched him, keeping a certain distance. In the process of therapy is necessary to strictly regulate the time to communicate with patients, to maintain the structure of the momentum of recovery. The active production of targeted issues, confidence in diagnosis, providing real hope to apply the basic rules of treatment of depression. Studies have shown that from the doctors hope retrospectively evaluated the patients as an important aid in the process of overcoming depression.

A feature of the psychotherapist with patients depression is not so much empathy, understanding how much of the state and, in particular, the possibility of adverse changes of mood episodes. Often the patient is seeking «paralyze» psychotherapist its infinite expectation of assistance, and the latter admits a mistake, putting in the search for theoretical explanations and psychological causes of depression. In fact, the psychotherapist should aim to ensure that the patient drew attention to himself and seek an adequate perception of their situation. Especially desirable conversation with the patient about the symptoms of his condition, much more important to emphasize the dependence of their expression of different situations, to talk about the features and relationships with other people. Compassion psychotherapist usually increases the patient waiting for assistance, an attempt to ease the severity of symptoms leading to their strengthening, consolation - for inconsolable. It is important to bring the patient to the appropriate self-help, not to comfort him, show him the importance of the adoption of a way it is.

For the treatment of depression have been proposed various methods of psychotherapy:

* Psychoanalysis.
* Client-centered therapy.
* Existential therapy.
* Interpersonal therapy.
* Cognitive Therapy.
* Therapy memories.
* Changing the projection in time.
* Relaxation training.
* Therapy to address the social problems and other methods of psychotherapy.
* Includes its mixed or eclectic options.

According to most researchers is most effective in the treatment of depression, cognitive therapy, focusing on correcting thinking features of patients with depression.