Modelling and Managing the Depressive Disorders: A Clinical Guide

Cover......Page 1
Half-title......Page 3
Title......Page 5
Copyright......Page 6
Contents......Page 7
Acknowledgements......Page 9
Introduction......Page 11
Part I The current model for depressive disorders and its impact on clinical management......Page 15
1 A declaration of independence......Page 17
The wrong model......Page 18
The trouble with RCTs......Page 19
Consequences of non-specific findings......Page 21
Treatment effects......Page 24
2 Defining and diagnosing depression......Page 28
Clinical depression......Page 29
3 Depression sub-typing: independence and interdependence......Page 35
Part II The diagnosis and management of melancholic and psychotic depression......Page 43
Introduction......Page 45
Symptoms of melancholic depression......Page 46
Functional and structural melancholia......Page 49
Acute management of unipolar melancholic depression......Page 51
Maintenance issues for unipolar melancholic depression......Page 54
Clinical diagnosis......Page 56
Maintenance issues for unipolar psychotic depression......Page 59
6 Bipolar melancholic or psychotic depression......Page 61
Part III An introduction to non-melancholic depression......Page 65
7 Our model of non-melancholic depression......Page 67
Elements of neurotransmission......Page 68
A ‘psychotransmitter’ model for non-melancholic depression......Page 73
8 Self-esteem......Page 78
Introduction......Page 84
General model of personality......Page 86
Personality functioning......Page 93
The spectrum model......Page 96
Does personality contribution to non-melancholic depression influence treatment response?......Page 98
10 Identifying the constructs to non-melancholic depression: stress......Page 99
11 Resilience and vulnerability......Page 103
Vulnerability to depressive episodes......Page 104
Resilience to further episodes of depression......Page 105
Increasing resilience to depression......Page 106
Maintaining flexibility and adaptability......Page 107
Summary......Page 108
Psychological interventions for non-melancholic depression......Page 109
Therapy characteristics......Page 111
Cognitive and behavioural therapies......Page 112
Interpersonal psychotherapy......Page 113
Narrative therapy......Page 114
Solution-focused therapies......Page 115
Counselling......Page 116
Intervention strategies for non-melancholic depression......Page 117
Part IV Modelling and managing the non-melancholic depressive disorders......Page 119
The psychotransmitter model......Page 121
Principles of psychological intervention......Page 125
Establishing the areas for intervention......Page 126
Intervention strategies......Page 127
The role of medication......Page 129
The psychotransmitter model......Page 131
Case summary......Page 132
What sort of therapist?......Page 133
Intervention strategies......Page 134
The role of medication......Page 136
The psychotransmitter model......Page 137
Case summary......Page 140
What sort of therapist?......Page 141
Intervention strategies......Page 142
The role of medication......Page 144
16 Perfectionist personality style and non-melancholic depression......Page 145
The psychotransmitter model......Page 146
Summary of Susan’s problem areas......Page 149
Principles of psychological intervention......Page 150
Getting started......Page 151
Intervention strategies......Page 152
The role of medication......Page 155
Irritable personality style......Page 157
The psychotransmitter model......Page 158
Case summary......Page 161
Principles of psychological intervention......Page 162
Establishing the areas for intervention......Page 163
Intervention strategies......Page 164
Barriers to effective intervention......Page 166
The role of medication......Page 167
Anxious worrying style......Page 168
The psychotransmitter model......Page 169
Case summary......Page 172
Principles of psychological intervention......Page 173
Getting started......Page 174
Intervention strategies......Page 175
The role of medication......Page 177
Social avoidance personality style......Page 178
The psychotransmitter model......Page 179
Summary of Alan’s problem areas......Page 182
Principles of psychological intervention......Page 183
Getting started......Page 184
Intervention strategies......Page 185
Building resilience......Page 186
The role of medication......Page 187
Personal reserve style......Page 188
The psychotransmitter model......Page 189
Dysfunctional thoughts and attitudes......Page 192
Principles of psychological intervention......Page 193
Getting started......Page 194
Intervention strategies......Page 195
The role of medication......Page 196
Rejection sensitivity style......Page 197
The psychotransmitter model......Page 198
Summary of Claire’s problem areas......Page 201
What sort of therapist?......Page 202
Getting started......Page 203
Intervention strategies......Page 204
The role of medication......Page 206
Self-focused style......Page 207
The psychotransmitter model......Page 208
Case summary......Page 211
Principles of psychological intervention......Page 212
Establishing the areas for intervention......Page 213
Intervention strategies......Page 214
The role of medication......Page 215
Self-critical personality style......Page 216
The psychotransmitter model......Page 217
Summary of Vanessa’s problem areas......Page 220
What sort of therapist?......Page 221
Getting started......Page 222
Intervention strategies......Page 223
Barriers to effective intervention......Page 224
The role of medication......Page 225
The range of natural and alternate treatments......Page 226
Alcohol for relaxation......Page 227
Colour therapy......Page 228
LeShan distance healing......Page 229
Music......Page 230
Relaxation therapy......Page 231
Ginkgo......Page 232
Natural progesterone......Page 233
St John’s wort......Page 234
Vitamins......Page 235
Summary......Page 236
Appendix 1: The DMI-18 and the DMI-10......Page 238
Appendix 2: The CORE system of measuring psychomotor disturbance......Page 240
Appendix 3: The temperament and personality measure......Page 242
References......Page 243
Index......Page 250