Introduction
Depression is a disorder that hinders activities of daily living and is associated with low quality of life. Depression is a mental health disorder characterized by persistent sadness, lack of energy, and difficulty concentrating. According to the National Institute of Mental Health (2022), over 21.0 Million adults suffer from depressive disorders. This factor indicates that many people suffer from this disorder associated with low quality of life. The reason is that the symptoms cause significant distress or impairment in social, occupational, or other important areas of functioning. Allan, a 47-year-old father of two, has depicted most of these symptoms, including loss of appetite, withdrawal, and insomnia, which indicates that he suffers from clinical or major depression (American Psychiatric Association, 2013). Therefore, the best psychological treatment for clinical depression is Cognitive Behavioral Therapy and Psychodynamic Approach, which focus on altering negative thoughts and strengthening positive behaviors.
The DSM-5 Diagnostic Criteria
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the diagnostic criteria for depression include five symptoms present for at least two weeks. The symptoms include a depressed mood that hinders their everyday activities. The individual must also have diminished interest or pleasure in activities they once enjoyed (American Psychiatric Association, 2013). Weight loss or gain and persistent insomnia must also be present. They could also be experiencing agitation, which causes restlessness or lethargy. Allan qualifies to be diagnosed with major depression, considering that he has experienced disinterest in cooking and golfing, which are activities he enjoyed while experiencing weight loss and anorexia (American Psychiatric Association, 2013). The DSM-5 treatment plan includes medication by antidepressants which can consist of serotonin reuptake inhibitors and psychotherapy such as CBT and Psychodynamic model. A combination of both treatment options is viable in enhancing mental wellness.
Evaluation of Cognitive Behavioral Therapy
After a conclusive diagnosis of depression, Allan can benefit from Cognitive Behavioral Therapy (CBT). The reason is that depression is one of several mental health conditions that have shown improvement with evidence-based psychological treatment like cognitive behavioral therapy (CBT). CBT is a subset of psychotherapy, aiming to improve patients’ moods and everyday functioning by identifying and replacing maladaptive thought and behavior patterns (American Psychiatric Association, 2013). CBT strongly emphasizes the interconnected nature of one’s ideas, emotions, and behaviors (Schoenleber & Gratz, 2018). The core tenet is that thoughts directly affect emotions and behaviors and that an individual can achieve fulfillment by becoming more self-aware and modifying thinking patterns.
CBT focuses on integral aspects of self-modifying dysfunctional thoughts such as lack of motivation, hopelessness, and poor lifestyle. The strategy involves mind restructuring, behavioral activation, meditation, problem-solving, relaxation, and psychoeducation on positive behaviors (Schoenleber & Gratz, 2018). Mind restructuring can be applied to ensure that Allan identifies and challenges maladaptive and negative thoughts (American Psychiatric Association, 2013). For instance, depression is also characterized by a feeling of worthlessness or hopelessness, resulting in withdrawal from activities that were once interesting (Döpfner & Hanisch, 2020). Therefore, the therapist can use this strategy to restructure Allan’s thoughts by encouraging him to adopt a new thinking pattern by refuting assumptions that may influence pessimism.
Behavioral activation is another CBT process that encourages clients to be more active in their social lives and develop new interests that bring joy and satisfaction. For instance, the client can revive his passion for cooking by engaging in this activity to experience eating together with family and have a positive experience again. This strategy ensures positive experiences are triggered to sponsor optimistic emotions (Schoenleber & Gratz, 2018). Behavioral activation works similarly to cognitive restructuring by encouraging an individual to challenge negative beliefs by developing more realistic thoughts.
Meditation is another integral aspect used in CBT which involves mindfulness. This strategy enables an individual to pay attention to thoughts and feelings to discover how each of those thoughts influences depression (Stefan et al., 2019). This strategy helps establish new thinking patterns, which can influence new behaviors necessary to promote change. Meditation enables an individual to develop positive thinking and problem-solving, considering that through this strategy, an individual discovers solutions to maintaining a peaceful state of mind amidst adversity.
Relaxation is a method derived from the ancient strategies of calming the system, which involves taking time alone for rest. The CBT approach encourages relaxation, which promotes deep breathing and muscle relaxation to reduce stress (Stefan et al., 2019). This strategy helps provide a mechanism to ensure an individual can control negative thoughts when facing problems. Relaxation is vital for the body and mind and can be used to promote better lifestyle habits like meditation and mindfulness, which are integral for improved cognitive functioning.
Restructuring thoughts and psychoeducation are other strategies used by therapists to strengthen the targeted outcome. Changing negative thoughts is done by identifying resources that help clients deal with their problems alone (Stefan et al., 2019). For instance, the client may be introduced to an activity such as connecting positive events in life with future expectations to make them optimistic. On the other hand, psychoeducation provides information to a client about their mental health condition, the available treatment options, and how to manage distress and other symptoms and focus on healing (Richards et al., 2018). These strategies indicate that CBT is an inclusive approach that restructures the cognitive distortions that lead to depression by supporting ways to challenge negativity and explore the positive thoughts that trigger positive emotions and reactions.
Despite CBT’s efficacy in managing depression, the approach exhibits various application problems. According to Gautam et al. (2020), CBT has no medical contraindications considering that the strategy is viable in treating depression. However, the procedure requires that all parties are dedicated to the treatment for it to work. There is also no measure of progress, meaning CBT’s success can hardly be estimated. Additionally, the strategy may not address the emotional and physical components of depression since it focuses on optimism, similar to positive psychology. Therefore, the design can be used after careful consideration of its limitations to achieve a successful outcome.
Evaluation of the Psychodynamic Approach
Psychological models of treating depression focus on establishing a better thinking pattern to ensure well-being. The psychodynamic model is one of the integral talk therapies used to counter mental health issues (Hwang, 2019). The principle of the psychodynamic method of treating depression is that our present and past relationships and experiences shape our emotions and actions in the present. This multi-phased strategy involves the therapist examining the client’s past experiences and mental state and focusing on restructuring thoughts. This goal is accomplished by establishing a fantasy experience, identifying defense mechanisms, and building resources for recovery.
Depression, according to the psychodynamic theory, stems from childhood trauma that was not solved. This factor indicates that underlying childhood traumatic events are responsible for his depressive symptoms. Therefore, Allan’s depressive symptoms may have been attributed to his childhood trauma which comes to influenced his current behaviors. The psychodynamic approach focuses on establishing how traumatic experiences could influence his withdrawal from activities he once loved, loss of appetite, and inactivity at the workplace (American Psychiatric Association, 2013). Therefore, a therapist using the psychodynamic approach focuses on assisting the individual in discovering and getting insight into the underlying problems that might be causing their depression. This strategy is inclusive since it involves reminiscing and realizing how they influence behavior.
The next focuses on cognitive assessment to determine the mental state of an individual. The psychodynamic method of treating depression involves examining the patient’s past experiences, current relationships, and emotional state (Hwang, 2019). The therapist can learn more about the patient’s current mental state and find out whether any unresolved issues might be the root of the depression through this investigation. This intervention may entail looking at the person’s early years, familial relationships, and previous partnerships. The therapist can assist the patient by guiding them through this exploration.
The Psychodynamic approach effectively restores mental health since it establishes the root cause of a problem and ways to cope with it in the future. Application of this intervention in Allan’s case would begin with a flashback approach whereby the root cause of his behaviors would be analyzed. The therapist would uncover why the client exhibits depressive symptoms by analyzing the client’s childhood history (American Psychiatric Association, 2013). This strategy would help establish whether the problems encountered in childhood influence behavior in adulthood. Installing a counteractive system to eradicate depressive symptoms is also valuable for analyzing depressive symptoms. However, the therapist must first examine the current state, which means they can assess Allan’s relationships with family members and friends to identify dissociative symptoms. This systematic move ensures that the client’s lifestyle is analyzed from an all-rounded scope to establish a better plan to enhance care.
Restructuring of thoughts is the last phase, whereby the client’s negative beliefs are challenged to create new patterns of thinking. The intervention helps to establish a defense mechanism to counter negative thoughts that bring sadness and loneliness so that the individual can live a fulfilled life (American Psychiatric Association, 2013). The restructuring stage may encompass learning how to cope when adversity strikes, like dismissal from work and how to start as a job seeker post-recovery. All these plans are individualized to ensure that the client recovers successfully in a better socio-economic state.
The disadvantage of using the psychodynamic approach is that it involves revisiting painful experiences, which could sometimes work against the client’s well-being. The strategy can be challenging to implement, considering it involves exploring personal hurtful and traumatic issues (Jesser et al., 2022). The approach can be less effective when the client does not desire to explore their bad feelings and experiences. Therefore, this factor indicates that the strategy can be challenging to implement when the client does not want to revisit past experiences.
Conclusion
The DSM criteria provide a viable strategy to help diagnose and treat major depression. Allan’s case is no different, considering that he can benefit from CBT, a psychodynamic model, or medication in severe cases. The CBT strategy helps to improve positive emotions and everyday functioning by identifying and replacing maladaptive thought and behavior patterns. On the other hand, the Psychodynamic method of treating depression focuses on dealing with childhood trauma that affects individual functioning. The strategies have weaknesses, such as measuring progress in CBT and difficulty revisiting the past in the psychodynamic approach. With proper tuning, these interventions effectively treat major depression since they establish positive thoughts, emotions, and behaviors.
References
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