DEPRESSIVE DISORDERS

Depressive Disorders among the Disabled

Disability Researchers

Depressive Disorders among the Disabled

Many disabled individuals experience some level of depression that need addressing to improve their living standards. Disability in the context can refer to a mental or physical condition that limits a person’s senses, movements and abilities to carry out activities. Depression among this group of people originates from several factors relating to their conditions and problems people face in societies. Individuals can develop different types of depressive disorders that are evident in the duration of types of symptoms. Depressive disorders affect the lives of disabled individuals and can cause adverse impacts on health. Prevention of adverse outcomes requires the treatment of depressive disorders using different approaches depending on the unique needs of each patient.

Intervention to improve the mental health of disabled patients should begin with evaluation into the causes of depression. Çağan and Ünsal (2014) showed that social isolation and loneliness are some of the leading causes of depression among the population. Disabled individuals face the problems of the inability to move to some areas or carry out some activities that leave them out of the team. Besides, disability makes some of the affected individuals develop the feeling of sadness that leads to depression. Their inability to change their status and how other people view them contribute to the development of depressive disorders. In addition to these factors, other aspects such as loss of loved ones, economic problems, and abuse lead to the development of depressive disorders.

The presence of more than one of these factors increases the risk of depression among patients with disabilities. In most cases, disabled individuals face more than an issue that contributes to the development of depressive disorders. Affected individuals develop different types of depressive disorders that need addressing using evidence-based approaches. Analyses highlight different types of depressions affecting the mental health of disabled individuals. The duration of symptoms presented by the patient provides one of the ways that professionals use in classifying depressions.

Types of Depressive Disorders

Disabled individuals are at increased risk of suffering from major depressive disorders due to their condition. Major depressive disorder refers to conditions where the individual present the symptoms for two weeks or extended periods. Information used in health facilities shows that patients should show symptoms such as fatigue, hopelessness, suicidal thoughts and loss of pleasure. Patients may even show remissions of major depressive disorder that significantly affect the health of disabled people (Culpepper, Muskin & Stahl, 2015). Thus, evaluation of the mental health of disabled individuals should consider the possibility of major depressive disorder.

Disabled individuals may also develop bipolar disorder. Individuals having the condition show extreme fluctuations of moods, behavior, sleep and energy. The depression due to bipolar disorder may lead to suicidal thoughts that can further involve additional changes. Disabled individuals having manic depression show mood swings that can take place more frequently, such as every week or in sporadic nature, such as twice annually. Health professionals should evaluate the incidence of changes in moods of affected people to determine the presence of manic depressions.

The impact on the mental health of disabled individuals may also involve the development of dysthymia. The condition refers to a persistent depressive disorder that can last for many years. People who develop dysthymia can show symptoms that affect their relationships, daily activities and work. A constant feeling of sadness among people having dysthymia finds it hard to be happy on any occasion. Affected individuals may show signs of complaining most of the time that affect their relationships with other people in society.

Assessment aiming to improve the mental health of patients should analyze the type of depressive disorder. The information gained from the client help in the provision of best care using a patient-centered approach. However, there is a need to understand the health impact of depression to facilitate interventions.

Impact of Depression on Health

Suicides

One of the most noticeable health concerns due to depression is cases of suicides. Disabled individuals who have depression have suicidal thoughts as one of the symptoms. Suicidal thoughts originate from an overbearing sense of sadness with affected individuals seeing no way out. Therefore, such situations present death as one of the options to escape from existing problems. Disabled individuals face many challenges that can prompt the feeling of hopelessness that make some individuals think suicide is the only way out of problems.

Nutritional Problems

Depression among disabled individuals shows significant impacts on their appetite. Change in appetite is one of the common signs of depression. Some individuals who have depression experience loss of appetite while others increase the amount of food they eat. In any case, changes in appetite result in health problems. Individuals may adopt the habit of taking less food that limits their ability to take nutrients that meet physiological requirements. Cases of nutritional deficiencies can lead to significant health problems depending on the deficient nutrient. Malnutrition also affects the immune system that can lead to infections affecting the health of the patient. Therefore, depressed individuals are at increased risk of malnutrition health problems.

Heart Problems

Depression can cause overeating that results in other sets of health problems. Overeating due to depression increases calories provided to the body. Constant accumulation of calories contributes to weight gain resulting in health problems such as diabetes, obesity and hypertension. The development of these health problems affects disabled and depressed individuals that can lead to fatalities. The gain of weight due to overeating can further lead to low self-esteem that further affects the mental health of the patient.

The presence of depression among disabled individuals also increases the risk of heart conditions. Depression causes low energy among disabled people that is evident in their unwillingness to carry out any physical activity. The person develops a sedentary lifestyle that increases the risk of heart problems. Studies also indicate the association between heart disease and depression among affected individuals. Studies show additional factors that increase the risk of cardiovascular diseases due to depression other than sedentary lifestyles. A study by Dhar and Barton published in 2016, showing an association between major depressive disorder (MDD) and coronary heart disease (CHD), highlighted that neurochemicals released due to MDD increase the risk of CHD. Thus, despite the lack of changes in the lifestyles of individuals, depression can still lead to heart problems.

The presence of these health problems shows the need for interventions aiming to improve the mental and physical health of patients having depression. In cases of physical health, health professionals should consider the need of every patient. At the same time, the assessment of the patient should involve evaluation of the cause of depression to provide patient-centered services. Therefore, support for disabled people should focus on specific aspects affecting each patient to improve the outcome. Health professionals should use various intervention approaches to improve the health of disabled people having depression.

Interventions to Manage Depression among Disabled

Treatment of depression among depressed individuals can involve the use of many approaches depending on the needs of clients. The prescription of medications to manage the mental condition of patients is one of the methods. Professionals can also opt for therapies that focus on the cognition and behavior of the patient to improve mental health. A combination of more than one method is also useful in some cases to further improve outcomes.

Pharmacotherapy

Treatment of depression among affected individuals using medications primarily relies on antidepressant medications. The use of antidepressants aims to manage the symptoms presented by patients. Such drugs achieve the objective by changing neurochemicals in the brain to manage the feelings of individuals. Impacts of the medications restore chemical balance in the brain to relieve depression symptoms. Patients have a range of antidepressants to choose from while aiming to manage their health conditions. The choice of medication depends on symptoms, suspected side effects, possible drug interactions and costs for some patients. Thus, health professionals must consider symptoms presented and patients’ medical history of prescribing appropriate medication. However, the drugs do not provide immediate relief to patients at the beginning of using medication. Patients taking medications require about two to four weeks to start realizing the effects.

Despite the effectiveness of medication in the ability to relieve symptoms, it is not the preferable approach to treat depression. Impacts of medications only last while patients use medications. Symptoms of depression may be present after patients stop using antidepressants. Medications are ineffective due to their inabilities to address the underlying problems leading to depression. Therefore, professionals prescribe medications together with other treatment methods to improve the outcomes.

Psychotherapies

Psychotherapies show high efficacy in treating patients with depressive disorders. They involve evaluating causes of depression as part of addressing the problem. In some cases, professionals may use more than one method to enhance the outcomes. Therapists that use psychotherapies should develop strong relationships with patients to improve outcomes.

Interpersonal therapy can be crucial to disabled individuals by improving personal relationships with other people (Van Hees, Rotter, Ellermann & Evers, 2013). Disabled people face isolation as one of the factors causing depression. Improving relationships helps in keep people around through interactions to eliminate loneliness and social isolation.

Psychodynamic therapy focuses on the experience of disabled people to understand the source of depression. Most cases of depression arise from experiences of individuals that affect interactions and lives. Some of the disabled individuals may even show the impacts of experiences unconsciously leading to depression. The use of the approach focuses on such incidents to improve the recovery of patients.

Cognitive-behavioral therapy (CBT) is an effective method to treat depression (Vara et al., 2018). Psychotherapists applying the approach aim to assess negative thoughts associated with depression and make appropriate changes. Patients gain from the method by developing coping mechanisms to limit remissions.

Despite the presence of different therapies for depression, effective treatments should involve a combination of different approaches. Professionals can prescribe medications for fast improvement of depression symptoms. However, interventions that ensure there are no remissions of depressive disorders require psychotherapies that focus on the cause of depression. Besides, professionals providing the services should evaluate the need of every client to provide patient-centered services during therapies.

References

Çağan, Ö., & Ünsal, A. (2014). Depression and loneliness in disabled adults. Procedia–Social and Behavioral Sciences, 114, 754-760.

Culpepper, L., Muskin, P. R., & Stahl, S. M. (2015). Major depressive disorder: understanding the significance of residual symptoms and balancing efficacy with tolerability. The American journal of medicine, 128(9), S1-S15.

Dhar, A. K., & Barton, D. A. (2016). Depression and the link with cardiovascular disease. Frontiers in psychiatry, 7, 33.

Van Hees, M. L., Rotter, T., Ellermann, T., & Evers, S. M. (2013). The effectiveness of individual interpersonal psychotherapy as a treatment for major depressive disorder in adult outpatients: a systematic review. BMC psychiatry, 13(1), 22.

Vara, M. D., Herrero, R., Etchemendy, E., Espinoza, M., Baños, R. M., García-Palacios, A., ... & Franco-Martín, M. (2018). Efficacy and cost-effectiveness of a blended cognitive behavioral therapy for depression in Spanish primary health care: study protocol for a randomised non-inferiority trial. BMC psychiatry, 18(1), 74.