Effective Combination Treatment for Depression with Anger, Irritability, Aggressiveness or Hostility; New Study Shown
Some people believe that depression is "normal" in people who are elderly, have other health problems, have setbacks or other tragedies, or have bad life situations.Clinical depression affects about 19 million Americans annually. It is estimated to contribute to half of all suicides. About 5-10 percent of women and 2-5 percent of men will experience at least one major depressive episode during their adult life. Depression affects people of all races, incomes, and ages, but it is 3-5 times more common in the elderly than in young people.
Depression can appear as anger and discouragement rather than feelings of hopelessness and helplessness. If depression is very severe, it may be accompanied by psychotic symptoms, such as hallucinations and delusions. These are usually consistent with the depressed mood, and may focus on themes of guilt, personal inadequacy, or disease.
There's usually an activating event for anger— something in particular that sets you off, such as a disagreement at work, being stuck in traffic or not being able to get through to an actual person on the phone. Some people may be angry about their own personal circumstances, such as financial problems.
The suicidal act itself is the communication that there is a problem that needs resolution. Death may be seen as a way out of difficult circumstances. Frequently, people who feel miserable and think of suicide will share that feeling with someone. They are often amenable to intervention and eventually find alternative means to structure their lives although this process may be interrupted by cries for help.Suicide ideation and attempted suicide are closely related to feelings of hopelessness.The belief that people who threaten to kill themselves never do so is wrong!!This might be violent and non violent method;
*Violent methods: This is when the client uses or thinks of using violent means as a way of killing
themselves, e.g. hanging, shooting, burning, planned accidents or jumping from heights.
*Non-violent: When the client uses non-violent methods such as drug overdose, poisoning, exhaust
fumes or suffocation.
A number of adverse family circumstances have been found to affect child well-being. Parental alcohol and substance abuse, for example, has consistently been associated with childhood conduct problems and with internalizing symptoms, such as depression . Importantly, the negative effects of parental alcohol and substance abuse appear to be largely due to the stressful family contexts and life events that directly arise from the caregiver’s impairment. The literature suggests similar concerns about stress and well-being among children of parents with severe physical illnesses and those experiencing parental unemployment , the death of a close family member, disaster , and child chronic illness. The above represent examples of childhood adversity that, even when considered individually, have been associated with negative mental health outcomes.
Possible reactions to crisis:
Body: Body reactions may include hypertension and tendency for heart attacks, gastric or duodenal ulcers, etc. The weakest parts of different clients’ bodies tend to be most adversely affected by stress.
Feelings: The feelings associated with excessive stress may include shock, depression, frustration, anger, anxiety, disorientation and fear of insanity or nervous breakdown.Children living in stepfamilies or (among younger children) single parents reported both more depression and more anger than those living with two biological or adoptive parents,independent of race and socioeconomic status.
Some cancers have a particular effect on emotions: some brain tumors, pancreatic cancer and lung cancer tend to be the most debilitating emotionally. Patients with those types of cancer often have more difficulty with depression and anxiety than patients with other types of cancer.
Depression can be treated in a variety of ways, particularly with medications and counseling. Most people benefit from a combination of the two. Some studies have shown that antidepressant drug therapy combined with psychotherapy appears to have better results than either therapy alone.Medications include tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin re-uptake inhibitors (SSRIs), and some newer antidepressant drugs.
With the combination of the treatments and the emotional rollercoaster that you ride when this happens to you, you get into a situation where you're very confused, you're lost, your anger is prevalent.Antidepressants usually only start to lift depressive mood symptoms after a lapse of up to two weeks or more. However, the psychomotor retardation that is often associated with depression tends to lift prior to improvement of mood.
Findings from a small study suggest that combining an antidepressant with an anticonvulsive drug, a type of drug normally used to treat epilepsy, may be an effective treatment for patients with depression plus dysphoric mood, such as anger or hostility.
A link between depression and anger was first made decades ago, but only in recent years have studies investigated this association and possible treatments, Dr. Massimo Pasquini, from University "La Sapienza" of Rome, and colleagues note in Clinical Practice and Epidemiology in Mental Health, a BioMed Central journal.
In fact, depression plus anger or aggression is almost as common as depression with anxiety, the researchers point out.
The implication of serotonergic pathways in aggressive behaviors has led some researchers to consider a selective serotonin reuptake inhibitor (SSRI) as the first-line therapy for depression complicated by dysphoric mood.
There is also some evidence that anticonvulsants affecting GABAergic and glutamatergic pathways may be useful, but to the authors' knowledge, no trials have examined this.
The present study involved 35 outpatients with a depressive disorder, along with "substantial anger, irritability, aggressiveness or hostility." The subjects were treated with an SSRI plus an anticonvulsant (usually valproate) for 12 weeks.
A variety of tests, including the Hamilton Depression Rating Scale, were used to gauge the severity of depression and dysphoric mood before, during, and after treatment. Follow-up data through week 4 and 12 of treatment were available for 32 and 23 patients, respectively.
Treatment with the two-drug regimen was associated with a significant improvement in depressive symptoms. In addition, marked improvements in anger or irritability and anxiety were noted. Eighty-two percent of patients were rated as improved or much improved on the Clinical Global Improvement scale, the authors state.
"Future studies with more robust methodology are needed to corroborate our findings," the investigators conclude. Confirmation of these findings would support the use of a "dimensional rather than a strictly categorical approach to psychopathological assessment and treatment of psychiatric conditions."