How does a psychologist work in a case of depression?

What is a depression?

Depending on the number and intensity of symptoms, depressive episodes can be classified as mild, moderate or severe.

A fundamental distinction is established between depression in people with and without a history of manic episodes. Both types of depression can be chronic and recurrent, especially when they are not treated. In this sense, a great solution to treat this disease is offered by many psychologists, specialized in providing therapy for depression.

Unipolar depression

uring typical depressive episodes there is depressed mood, loss of interest and ability to enjoy, and reduced energy that produces a decrease in activity, all for a minimum of two weeks. Many people with depression also suffer from symptoms of anxiety, sleep and appetite disturbances, feelings of guilt and low self-esteem, difficulties in concentration and even symptoms without medical explanation.

Depending on the number and intensity of symptoms, depressive episodes can be classified as mild, moderate or severe. People with mild depressive episodes will have some difficulty in continuing with their usual work and social activities, although they probably will not stop them altogether.

In contrast, during a severe depressive episode it is very unlikely that the patient can maintain their social, work or domestic activities if not with great limitations.

Bipolar disorder

This type of depression characteristically consists of manic and depressive episodes that alternate with a normal mood. Manic episodes present with elevated or irritable mood, hyperactivity, logorrhea, excessive self-esteem and decreased need for sleep.

What is cognitive-behavioral psychological therapy?

Here we will briefly explain how cognitive behavioral therapy is carried out in a patient with a unipolar depression or a major depressive disorder. The sessions are usually done face-to-face, however thanks to the advancement of new technologies, it is increasingly common to offer an online psychological consultation service .

1st Session or contact.

When a psychologist receives a patient, an interview should be conducted where information is collected such as: personal data, family and behavioral history, symptoms and situations and behaviors that make the person feel better and which make him feel worse.

An anxiety, depression and personality test is also usually administered to determine the patient’s current status. In this way, it is possible to establish a starting point, to subsequently evaluate the intervention and, in addition, to determine if the depression is comorbid to another disorder or, if on the contrary, it is presented in isolation.

2nd Session and start of the intervention.

In this new session the patient is explained the diagnostic hypothesis and also the type of therapy that the psychologist decides and begins to proceed.

Normally, we try to locate the cognitive distortions that the patient emits in his discourse and also try to find those positive and negative reinforcers that are helping to maintain the behaviors associated with depression.

With all this behavioral self-records are elaborated so that the patient fills in his day to day and so later, in a new therapeutic session, analyze them to be able to carry out a modification of his thoughts and behaviors.

3rd Session

The self-records are analyzed to be able to refute the cognitive distortions that the patient presents and to refute them with objective thoughts, so that these are replacing the typical automatic thoughts in a depressive picture.

In the last part of the session, relaxation will be introduced as a measure to diminish the psychophysiological arousal and thus avoid the anxiety that usually afflicts these patients.

4th Session and later.

In the next sessions, cognitive distortions will continue to be worked on and the patient will be trained in relaxation , in addition to recommending the usual practice of aerobic sport (walking, swimming, soft “running”, etc.)

With all this, what is intended, is to regulate the levels of serotonin, adrenaline and stabilize, in this way, your mood.

Last session

  • The anxiety and depression tests will be administered again to objectify the results.
  • The preventive factor will be emphasized, in the face of future depressive episodes, which have the practice of relaxation and sports.
  • It will be scheduled for a review in, more or less, two months.

In conclusion

The duration of the therapy usually varies, but it is usual for its duration to be from six to ten sessions, during which the evolution of the patient will be observed depending on the number and intensity of cognitive distortions, their psycho and physiological symptoms and also, his work with self-records, the practice of relaxation and sports.

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