Jessica Miller

Depression

1. Define depression2. Recognize different symptoms in men and women3. Identify at least 5 causes of depression4. Recognize the effects of cognitive impairment and

depressive symptoms have on motor function5. Know at least 2 way to identify and assess

depression6. Identify at least 5 symptoms of depression7. Identify the 3 most common way to treat depression8. Understand how PT/OT can help treat with

depression9. Know how depression affects therapy treatments

Objectives:

Depressiona condition of

general emotional dejection and withdrawal; sadness greater and more prolonged than that warranted by any objective reason.

a depression so severe as to be considered abnormal, either because of no obvious environmental causes, or because the reaction to unfortunate life circumstances is more intense or prolonged than would generally be expected.

What is Depression?

Clinical Depression

Study done in GermanyObjective:

Investigate gender differences of depressive symptoms of the elderly

236 subjects, 357 control subjectsUsed a questionnaire CIDI

Results: In general women suffer from more depressive

symptoms than men.Major depression in the elderly presented with a

similar number of symptoms in men and women.Women suffer more from appetite disturbances.Men suffer more frequently with agitation.

Gender Differences of Depressive Symptoms-Case Study

Previous history of depressionChemical imbalance in the brainDamage to BodyMemory LossLoneliness, isolationBeing unmarried or widowedDecreased mobility due to illnessDependency on othersFear of death or dyingDifficulty adjusting to new or changed living

situation

What Causes Depression in the Elderly

Objective:Cognitive impairment (CI) and depressive

symptoms(DS) inter-relate to effect functional decline

5697 participantsFollowed for 2 years

Results:No ADL dependence, both CI and DS effect

declineADL dependence, only CI effects decline.

Cognitive Impairment, Depressive Symptoms and How They Effect Functional Decline-Case Study

Self-report forms

Patient Health Questionnaires

Geriatric Depression Scale

Cornell Scale for Depression in Dementia

Six Item Cognitive Impairment Test

Looking for signs and symptoms

Simply asking questions

How to Detect Depression

Symptoms of DepressionChange in appetiteBowel changesGeneral appearanceSleep disturbanceSkin PickingHand WringingDiminished interestTired/SleepyWeight changeDiminished ability to think

How to Treat Depressionanti-depressants

severe side effects early withdrawal

counseling services offer little often fail

exercise therapy cost effective

MotivationGet back to regular activities

Social TimeTherapistOther patients

Physical Activity Improves mood by releasing endorphinsRegaining independence

How Can PT and OT Help

Most affects of depression can negatively affect PT and OT sessions. These things don’t allow the pt to get a full treatment time in and they don’t give full effort when these factors play a part.

No motivationFatigue/TiredIrritationIncontinenceDecrease in functional abilitiesAgitation/Yelling Out

Depressions affect on PT and OT Treatments

Demonstrating empathyLending supportHelp patient find support groupsReferring patients to appropriate resourceFocus on their progressRemind them how far they have comeBe encouragingMOTIVATE

Treatment Techniques

1. Brown C. I've got a right to sing the blues; or recognizing depression in the elderly. Tar Heel Nurse [serial online]. March 2002;64(2):16-17. Available from: CINAHL with Full Text, Ipswich, MA. Accessed June 9, 2012.

2. Cripps F. Exercise your mind: physical activity as a therapeutic technique for depression... including commentary by Craft LL and McDougall T. International Journal Of Therapy & Rehabilitation [serial online]. October 2008;15(10):460-465. Available from: CINAHL with Full Text, Ipswich, MA. Accessed June 10, 2012.

3. Dutton, Mark. Orthopaedics for the Physical Therapist Assistant. MA: Jones & Bartlett Learning; 2012: 632

4. Hardy S. Depression in the elderly: ways to offer support. Practice Nursing [serial online]. October 2011;22(10):520-525. Available from: CINAHL with Full Text, Ipswich, MA. Accessed June 9, 2012.

References:

5. Kockler ,, Heun ,. Gender differences of depressive symptoms in depressed and nondepressed elderly persons. International Journal Of Geriatric Psychiatry [serial online]. 2002;17(1):65-72. Available from: CINAHL with Full Text, Ipswich, MA. Accessed June 9, 2012.

6. Mehta K, Yaffe K, Covinsky K. Cognitive impairment, depressive symptoms, and functional decline in older people. Journal Of The American Geriatrics Society [serial online]. June 2002;50(6):1045-1050. Available from: CINAHL with Full Text, Ipswich, MA. Accessed June 9, 2012.

7. Pain, anxiety, and depression: why these conditions often occur together and how to treat them when they do. Harvard Mental Health Letter [serial online]. May 2010;26(11):1-3. Available from: CINAHL with Full Text, Ipswich, MA. Accessed June 10, 2012.

8. U.S. Department of Health and Human Services. What is Depression? National Institute of Mental Health. 2011. Available at: http://www.nimh.nih.gov/health/publications/depression/what-is-depression.shtml. Accessed June 8,2012.

References Continued: