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Taking Charge of Your Health


– [Voiceover] When you picture
someone treating depression, and maybe when you think
about therapy more generally, you might picture something
like the scene here. Someone lying on a couch
discussing their problems while a bearded serious
therapist, who happens to look a lot like Freud, listens and takes notes and maybe occasionally gives the patient some kind of insight. But this is an overly simplistic picture of psychological therapies,
which can actually be really diverse. But before I talk about
specific ones, I want to note two things about all
psychological therapies. The first is that
therapists go through years of training to get where they are, so chances are they
have helped individuals with depression in the past. The second thing is that the
therapist doesn’t know you. They aren’t personally invested
in you or your problems. Both of these things making
talking to a therapist very different from talking
with a family member or a friend. The first type of therapy
I want to talk about here is also the oldest, and
that’s psychodynamic therapy. This is the type of therapy
that looks most like that couch picture from before. It is based on the idea
that depression is caused by a loss in a person’s life, either a real one or a symbolic one. This loss could also be
conscious or unconscious. The goal of this type of therapy
is to give a person insight into their thoughts and behaviors. In doing so they can
help them find the root of their depression, the
symbolic loss in their life that lead to their
current depressive state. They do this by talking, not necessarily about their problems, but about anything that comes to their mind at that moment. The job of the therapist is
to guide that discussion, to focus their attention
on certain details. This therapy is meant to
be continued long term, because as it turns out
it can take a long time to shift through and
identify unconscious causes. But unfortunately this type
of therapy is generally not effective in treating depression. Another thing that I want to focus on is the term “psychotherapy,”
because we have Freudian psychotherapy, that’s what we’ve been talking about here, but these days the term psychotherapy is generally used as an umbrella term for
many different therapies, some of them really effective. Although these may look different from traditional psychotherapy, they all do use it as a base. One example of a modern
form of psychotherapy is called “inter-personal
therapy,” it’s also known as IPT. The idea behind this
type of psychotherapy is that social networks and
social support can kind of act as a buffer against depression. IPT focuses on helping
people be more aware of their social networks. Specifically it’s goal is
to help people be more aware of the ways that their actions might be preventing them from maintaining close social relationships
with those around them. The goal is to help the
individual with depression improve these social
relationships as a means to decrease their depressive symptoms. Unlike traditional psychotherapy,
this type of therapy is meant to be short term. It focuses on strategies
rather than discussing the past and looking for insights. Instead of lying on a couch and talking about their relationship
with their mother, they might talk about ways to
reconnect with their mother. It’s much more action oriented. The next therapy that
I want to talk about is behavioral therapy, and
behaviorism in general does away with hidden
concepts like the unconscious. Instead it focuses on people’s behaviors. As it relates to depression,
the ideas is that depression stops a person’s
energy and makes them withdraw from their social contexts. A combination of these two
things reduces a person’s access to pleasurable activities,
so all of the things that they once enjoyed doing. Because they are no longer
going out and having fun, this reinforces their negative mood. The goal of behavioral therapy is to focus on strategies instead of
thinking about the past. But rather than focusing on
ways to fix relationships like IPT, the goal of
behavioral therapy is to get the person out
of the house and back to the activities that they once enjoyed. By increasing social contact
with friends and family and by forcing the individual
to engage in activities that they once found pleasurable, even if they don’t find
them pleasurable now, they will eventually feel better. Through repetition they
will eventually begin to enjoy them again. This therapy, which is short
term, let me write that down, this therapy is actually quite effective. It turns out that going
through the motions really does make people
feel better over time. But one problem with
this style of therapy is that people find it really hard. People with depression
might find taking part in these activities to be really stressful and really intimidating. Another problem is that people don’t start feeling better right away,
it isn’t spontaneous. In fact, it can be a few weeks
before they see improvement, before they start enjoying
these activities again. Because of this, some individuals might have a hard time sticking with it. If behavioral therapy is more focused on changing people’s
behaviors, cognitive therapy is about changing people’s thoughts. The idea behind this
theory is that how we feel is largely a factor of how
we think about the world and how we interpret the world around us. Over time people develop
automatic negative thoughts and irrational assumptions. Imagine a person going around
thinking to themselves, “I am worthless.” Think about how thinking
about that statement and repeating it over
and over might contribute to depression. Think about how it might
affect how this person acts, how they perceive the world. Both of these things,
both automatic thoughts and irrational assumptions,
drive our behavior and shape our experiences, even if we’re not consciously aware of it. In practice, cognitive
therapy has two parts. The first is to challenge
these automatic thoughts and irrational assumptions,
and the next is to change them. More specifically, to show the individual that they have the ability to change them, to show them that these
thoughts are actually under their control. Because it’s action-oriented,
this type of therapy tends to be short term. There are some problems
with this style of therapy. The main one is that depends
a lot on the individual with depression. The therapist can act as
a guide, but it is really the individual with depression
who needs to make it work. That can be somewhat
challenging for individuals who believe that their
symptoms are a part of them and who don’t believe
that they have the power to do anything about them. But that said, cognitive
therapy can be really effective for individuals who are
active participants. The last kind of therapy I want
to talk about in this video is cognitive behavioral therapy. As you can probably tell by the name, this therapy is a combination
of cognitive therapies and behavioral therapies. It’s based on the idea that there is a reciprocal relationship
between our thoughts, our feelings, and our behaviors. Notice that I have drawn
all of these arrows as being two-sided. Here we’re saying someone
has a negative thought, “I am worthless,” and this
might lead them to not study for a test since they
believe it’s hopeless anyway, and then they feel upset when they fail. Or maybe they forget when
an assignment was due and this leads them to
think, “I’m stupid,” which then leads to a depressed mood, which then leads to them
canceling plans with their friends and causes them to think,
“I am a terrible friend.” This could go on forever, and
that’s the main point here. CBT holds that all of these
things are interconnected, and you can’t really piece them apart. So if anything is really
going to help an individual with depression, it needs to address both cognitions and behaviors. The goal of this therapy
is to challenge people’s negative schemas and change them while at the same time
also encouraging them to be mindful of their
behaviors and go back to being active
participants in their life. Of the therapies that I’ve mentioned here, IPT and CBT are generally considered to be the most effective. Sometimes just as effective as medication. But I want to point out that this isn’t an either/or kind of deal. In general the best outcomes tends to come from a combination of
medicine and therapy.

8 thoughts on “Treatments for depression – Psychological therapies | Mental health | NCLEX-RN | Khan Academy

  1. I'm not sure but, if anyone else wants to learn how to overcome their depression try- "Dawtix Incredible Depression Annihilator" (just google it ) ? Ive heard some mind blowing things about it and my partner saw amazing success with it.

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  4. I refuse to take medication. So, what option is there for someone who refuses to be helped in all other ways? I'm 100% convinced that I am impossible to help, and that I have no will power to change on my own. I've spoken to a lot of [non-professional] people about this, and no one can give me an answer. It's almost like they want to tell me to end my own life, but can't because they know it's wrong to say that.

  5. Medication should only be used in the worst of the worst cases, however maybe not even then. Treating someone on medication opens up a world of difficulties, and is never recommended. Don't mix physiology and biology with psychology. Clinical psychiatry does it a lot, but that's because it's clinical. They are using patients as test subjects for their own learning. And you didn't even mention Rational Emotive Therapy, which has been shown to be the most effective in recent years for treating depression and social anxiety.

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  7. I started to think a lot of unfavorable things until the depression that I experienced became most unfortunate. But now w ith this depression treatment method “fetching kafon press” (Google it) I can fully concentrate my energy and .
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  8. Electroshock or ECT has no FDA testing for safety or even effectiveness. Devices have never had pre-market approval before the FDA. Based on electrical mechanism of trauma CA. courts have proved brain injuries at minimum. Electrical trauma can evolve years out to include CTE and ALS. National product liability suit taking place and medical malpractice firms interviewing for suit. Two suits also filed against the FDA. We have also approached for discrimination and fraud/false claims suits. ECT no longer just used for depression nor as a last resort. It is battery of patients. This is a women's rights issue as well. Women mostly impacted and secondary to TBI one becomes less effective in life. Inform yourselves. See ectjustice now owned by firms participating in national suit. Consent is fallible. Actual structural brain changes result from this and that is certainly missing from consent but not from their research. We need many more firms to hear from patients. You have a known mechanism and you have a known and anticipated outcomes in ALL populations. This is what all trauma is based on and this is purely trauma. 
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