24 hour turn-around- Respond to calls paper on Major Depressive Disorder

Major Depressive Disorder

Some of the common symptoms of major depressive disorder involve being a depressed mood most of the day, anhedonia (loss of feeling pleasure in life), sleeping problems (including sleeping too much or too little), psychomotor agitation or retardation, feelings of worthlessness or guilt, general fatigue and loss of energy, problems with concentration, noticeable weight gain/loss, and recurrent thoughts of death or suicide. By definition, as a whole, major depressive disorder is diagnosed by five of more of the above over a two week period, and include the depressed mood and/or anhedonia as listed above.

While the exact cause of major depressive disorder is not known, many researchers believe it is linked to various chemical changes in the brain, genetic problems or complications, or a combination of both. It tends to run in families, but can also occur in those with no family history of the disease. Alcohol and drug abuse may play a role in major depressive disorder, as can other medical conditions such as certain types of cancer. It can also be triggered by certain such events such as death or illness of a loved one, divorce, childhood abuse or neglect, loneliness, or the breakup of a significant relationship.

Treatment Options

Medications, particularly antidepressants, and talk therapy are the two most common forms of treatment for major depressive disorder. For those diagnosed with depression, particularly major depressive disorder, antidepressants are the first line of attack. Common types of antidepressants include selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), fluoxetine (Prozac), escitalopram (Lexapro) and sertraline (Zoloft). One caution; though St. John’s Wort, an herb sold over the counter, may help some people with lower levels of depression, it generally should not be used in those with major depression, because it not only is generally ineffective, but may also interact with antidepressant medications.

Talk therapy, most notably, cognitive and cognitive behavioral therapy, has been shown to be helpful in treating various forms of depression. Cognitive behavioral therapy teaches the individual how to fight off negative thoughts and to learn how to become more aware of certain symptoms as well as how to spot triggers that may make the depression worse. This can also incorporate group counseling sessions as well, which can foster a sense of community and support for those suffering from a major depressive disorder. Most research agrees that therapy, in concert with antidepressant medications, is better in terms of overall outcomes for an individual than just either modality alone.

For those who may not respond well to the aforementioned medications and psychotherapy treatment options, electroconvulsive therapy (ECT) has proven to be a very effective (and safe) treatment for those with the most severe cases of major depressive disorder, as well as in those who experience psychotic symptoms in conjunction with their depression, and is generally safe.

Functional limitations

· Stamina During the Workday

· Concentration

· Memory Deficits

· Difficulty Staying Organized and Meeting Deadlines

· Difficulty Handling Stress and Emotions

· Attendance Issues

Psychosocial Issues

For many living with major depressive disorder, the psychosocial impact can be great. Individuals experiencing feelings of hopelessness, discouragement, and a general loss of interest and pleasure in life may find it difficult to concentrate at work or school, and even to find meaning in their vocation on a more existential level. The concomitant feelings of guilt and worthlessness may cause a decrease in self-care and hygiene, as well as an inability to concentrate and make even the simplest of decisions, and thus seriously degrade their own attempts at living an independent life.

Other manifestations such as sleep disturbances and appetite and weight changes may also have a detrimental effect on the individual, as well as family members and loved ones who may not fully understand the problems and feelings that a person suffering from major depressive disorder is going through, and distance themselves or render themselves ineffective at helping such an individual through this difficult, disabling disorder. Social connections of many types may be broken as the individual retreats into their own world of hopelessness and despair.

Accommodations

Stamina During the Workday:

· Provide flexible scheduling

· Allow longer or more frequent work breaks

· Allow employee to work from home during part of the day or week

· Provide part-time work schedules

· Move closer to frequently accessed office equipment

Concentration:

· Reduce distractions in the work area

· Provide space enclosures or a private office

· Allow for use of white noise or environmental sound machines

· Allow the employee to play music and use a headset

· Increase natural lighting or provide full spectrum lighting

· Plan for uninterrupted work time and allow for frequent breaks

· Divide large assignments into smaller tasks and goals

· Restructure job to include only essential functions

Memory Deficits:

· Allow the employee to tape record meetings and provide written checklists

· Provide type written minutes of each meeting

· Provide written instructions and allow additional training time

· Implement color coding scheme for priority projects

Difficulty Staying Organized and Meeting Deadlines:

· Make daily To-Do lists and check items off as they are completed

· Use calendar to mark meetings and deadlines

· Remind employee of important deadlines

· Use electronic organizers

· Divide large assignments into smaller tasks and goals

Difficulty Handling Stress and Emotions:

· Provide praise and positive reinforcement

· Refer to counseling and employee assistance programs

· Allow telephone calls during work hours to doctors and others for needed support

· Allow the presence of a support animal

· Allow the employee to take breaks as needed

Attendance Issues:

· Provide flexible leave

· Provide a self-paced work load and flexible hours

· Allow employee to telework

Resources Specifically for People with Depression

Mental Health Association of Erie County

Main Office Address 999 Delaware Avenue Buffalo, New York 14209

Phone: (716) 886-1242

Center for Psychiatric Rehabilitation Boston University 940 Commonwealth Avenue West Boston, MA 02215 Direct: (617)353-3549 Fax: (617)353-7700 [email protected] http://cpr.bu.edu/

Depression and Bipolar Support Alliance

Depression and Bipolar Support Alliance

730 North Franklin

Suite 501

Chicago, IL 60610-7225

Toll Free: 800-826-3632

Fax: 312-642-7243

Email: [email protected]

http://www.dbsalliance.org/

International Foundation for Research and Education on Depression (iFred)

P.O. Box 17598

Baltimore, MD 21297-1598

Fax: (443)782-0739

Email: [email protected]

http://www.ifred.org