Depression?Depression?Depression is an illness that

affects our thoughts, feelings, behavior and overall health.

One feels sad or down for long periods of time

It can even have physical affects on one’s body

“A depressed person can feel hopeless, helpless and worst of all alone” (Ayer, 1997)

People suffering from depression always feel they’ve done something wrong when things go bad

Many times people with depression become irritable and upset at small things

Who Gets DepressedWho Gets DepressedMental health professionals used

to believe that depression was an adult’s disorder.

In fact depression can affect anyone from infants to teens to adults even older.

Symptoms of depressionSymptoms of depression

HopelessnessIncreased

irritability, anger, or hostility

Low self esteemWithdrawalLoss of appetite or

constant hungerAlcohol or drug

abuse

Self injury Discussion or

thoughts of suicide

Feelings of guiltInability to

concentrateDifficulty with

relationships

Common Types of Common Types of DepressionDepression

Major DepressionDysthymiaBipolar DisorderSeasonal Affective Disorder (SAD)

Major DepressionMajor Depression

• Begin suddenly, possibly triggered by a loss, crisis or change

• Interfere with normal functioning• Continue for months or years• It is possible for a person to have only one

episode of major depression. It is more common for episodes to be long lasting or to occur several times during a person’s life

DysthymiaDysthymia

People with this illness are mildly depressed for years. They function fairly well on a daily basis but their relationships suffer over time.

Bipolar DisorderBipolar DisorderPeople with this type of illness change back

and forth between periods of depression and periods of mania (an extreme high).

Symptoms of mania may include:◦Less need for sleep◦Overconfidence◦Racing thoughts◦Reckless behavior◦Increased energy◦Mood changes are usually gradual, but can be

sudden

Season Affective DisorderSeason Affective DisorderThis is a depression that results

from changes in the season. Most cases begin in the fall or winter, or when there is a decrease in sunlight.

Causes of DepressionCauses of DepressionThere is not one single cause of

depression, it is usually a combination of things.

Stress is however the leading cause of depression.

Other things such as genetics, traumatic events, low self esteem, stress and physical illness can also contribute to depression.

Depression StatisticsDepression Statistics10-25 percent of

women and 5-12 percent of men will likely become depressed in their life

One of eight women will develop depression but only one in three women will seek care

15 percent of those with severe depression will commit suicide

70 percent of antidepressant prescriptions are given with misdiagnosis

Major depression occurs most often in the mid to late 20’s

Depression occurs most frequently in women 25-44 years of age.

(Statistics, 2003-2007)

Cognitive Behavioural Therapy (CBT) is a psychological treatment that addresses the interactions between how we think, feel and behave. CBT is a process of teaching, coaching, and reinforcing positive behaviours. CBT helps people to identify cognitive patterns or thoughts and emotions that are linked with behaviours..Evidence now supports the effectiveness of CBT for many common mental disorders. For some disorders, carefully designed research has led international expert consensus panels to identify CBT as the current “treatment of choice”.

Cognitive Behavioural Cognitive Behavioural TherapyTherapy (CBT)(CBT)

Characteristics of Characteristics of Cognitive-Behavioral Cognitive-Behavioral Therapy:Therapy:

• Thoughts cause Feelings and Behaviors.

• Brief and Time-Limited.

• Emphasis placed on current behavior.

• CBT is a collaborative effort between the therapist and the client.

• Client role - define goals, express concerns, learn & implement learning

• Therapist role - help client define goals, listen, teach, encourage.

• Based on "rational thought." - Fact not assumptions.

• CBT is structured and directive. Based on notion that maladaptive behaviors are the result of skill deficits.

• Based on assumption that most emotional and behavioral reactions are learned.  Therefore, the goal of therapy is to help clients unlearn their unwanted reactions and to learn a new way of reacting.

• Homework is a central feature of CBT.

MethodologyMethodologyTotal Sample Size- 208Pre Test & Post Test Groups- 4

(G1, G2, G3, G4)G1- Only Homoeopathic

MedicinesG2- Only CBTG3- Combined Regimen TherapyG4- Placebo Therapy

Methodology (Contd.)Methodology (Contd.)Case Taking of PatientsDetermination of Type of TherapyFollow Up of Patients &

Assessment of ProgressUse of Different InstrumentsOrganizing Sessions for CBT.

Sex wise distribution of Sex wise distribution of respondentsrespondents

Gender Frequency Locality Percentage

Urban Rural

Male 81 53 28 38.94

Female 127 94 33 61.06

Total 208 147 61 100

Family size wise distribution Family size wise distribution of the respondentsof the respondents

Family size Frequency Percentage

1-4 117 56.25

5-8 64 30.77

8 and Above 27 12.98

Family type wise distribution Family type wise distribution of the respondentsof the respondents

Type of family

Nuclear 141 67.78

Extended 67 32.22

Locality wise distribution of Locality wise distribution of the respondents the respondents

Type of locality

Urban 61 29.33

Rural 147 70.67

Financial status of Financial status of respondentsrespondents

Socio economic

status

Number of

Respondents

Percentage

HIG 39 18.75

MIG 82 39.44

LIG 64 30.76

EWS 23 11.05

Occurrence of depression on Occurrence of depression on the basis of aetiological the basis of aetiological

incidenceincidence Cause Frequency Percentage

Emotional 116 56

Financial 28 13.6

Grief 49 23.4

Miscellaneous 15 7

Total 208 100

Homoeopathic Medicines Homoeopathic Medicines UsedUsed

Name Frequency Percentage

Natrum- Mur 53 25.48

Pulsatilla 41 19.71

Nux Vomica 23 11.05

Ignatia 17 8.17

Anacardium 17 8.17

Arggentum Nitricum 15 7.21

Aurum Met 10 4.80

Scores of Pre & Post Test Scores of Pre & Post Test GroupsGroupsScore

GroupDegree of Depression

Pre Test Frequency

Score Post Test Frequency

Frequency

0-9Depression

likely5 2.40 0 0

10-17Possibly

mild9 4.33 0 0

18-21 Border line 32 15.38 10 4.80

22-35Mild to

moderate83 39.90 24 11.53

36-53Moderate

to severe49 23.56 19 9.13

54 and

above

Very

Severely

depressed

30 14.43 13 6.25

Homoeopathic Medicines on Homoeopathic Medicines on Depression in different age Depression in different age

groupsgroupsAge

group in

years

No. of

respondent

s

Good

improveme

nt

Moderate

improve

ment

Mild/No

improveme

nt

16-20 6 4 1 1

20-40 27 18 5 4

40-60 19 11 4 4

Response of CBT on Response of CBT on Depression in different age Depression in different age

groupsgroupsAge

grou

p in

year

s

No. of

respond

ents

Good

improve

ment

%

Moderat

e

improve

ment

%

Mild/No

improve

ment

%

16-20 16 10

6

2.

5

4 25 2 12.5

20-40 26 18

6

9.

2

3

519.

233 11.53

40-60 10 55

03 30 2 20

Response of Combined Response of Combined Regimen Therapy on Regimen Therapy on

Depression in different age Depression in different age groupsgroups

Age

grou

p in

year

s

No. of

respon

dents

Good

improve

ment

%

Moderat

e

improve

ment

%

Mild/No

improve

ment

%

16-20 6 35

02

33.

331 16.67

20-40 19 13

6

8.

4

2

315.

793 15.79

40-60 27 14

5

1.

8

5

933.

334 14.82

Response of PLACEBO Response of PLACEBO therapy on Depression in therapy on Depression in

different age groupsdifferent age groupsAge

gro

up

in

yea

rs

No. of

respon

dents

Good

improv

ement

%

Modera

te

improv

ement

%

Mild/

No

improv

ement

%

16-

2010 3 30 2 20 5 50

20-

4014 4

28.

572

14.2

88

57.1

5

40-

6028 5

17.

866

21.4

317

60.7

1

Response of over all Response of over all treatment on Depression in treatment on Depression in

different age groupsdifferent age groupsAge

gro

up

in

yea

rs

No. of

respon

dents

Good

improve

ment

%

Modera

te

improv

ement

%

Mild/No

improv

ement

%

16-

2038 21

55.2

713

34.2

14

10.5

2

20-

4086 62

72.0

911

12.7

913

15.1

2

40-

6084 49

58.3

325

29.7

710

11.9

0

ConclusionConclusionCombined therapy regimen of

Homoeopathic Medicines and CBT works very effectively and provides wonderful relief to the patients.

Placebo Therapy is very effective for those patients who are suffering from mild psychosomatic disorders and have vague complaints.

Conclusion (Contd.)Conclusion (Contd.)Mental symptoms in

Homoeopathy have incredible value. Any prescribing is made keeping the mental symptoms of patient in central attention. Hence they are very effective in treating psychological disorders. They bring dramatic changes in the thoughts of patient by de-rooting the culprit from the body.

Conclusion (Contd.)Conclusion (Contd.)CBT was found as psycho

educational form of psychotherapy. Its purpose is for patients to learn new skills of self-management that they will then put into practice in everyday life. It adopts a collaborative stance that encourages them towards optimistic attitude.

Recommendation Recommendation • Following points are very important to live a healthy and cheerful life free from depression:

• Healthy life style leads to lesser amount of depression.

• Development of supportive relationship.

• Practicing regular physical exercises, meditation, relaxation techniques and having sound sleep are components of training in CBT.

Nutritious diet boosts mood naturally.• Proper time management and coping

with stress is required.

Recommendation (Contd.)Recommendation (Contd.)• Balancing emotions and remaining

optimistic.• Seeking professional support, when

ever any negative thoughts are disturbing frequently.

• Life skill training is important for not losing psychological balance in adversity also as ups and downs are part of the life.

• Setting the goals as per your capacity.• As for as possible following the system

of extended family is beneficial.

• In built shock absorbers are to be developed within family support system.

• frequency of family and professional get- together are to be increased.

• Counseling for the management of depression is to be made part of medical training as behavioral medicine procedure.

THANK YOU