Adlerian Therapy against Depression

Overview


Adlerian psychotherapy was founded by Alfred Adler (an ex-associate of Freud who rejected Freud's notion that sex is the root of all psychological problems.) It takes a positive view of human nature: We are all goal-oriented creatures who are striving for social connectedness, and we are in control of our destiny. Many personal difficulties, Adler believed, stem from feelings of inferiority-he in fact coined the term "inferiority complex."


An Adlerian therapist will identify, explore, and challenge a client's current beliefs about their life goals. He or she will gather family history and will use information about a client's behavior patterns to help the client set new, socially satisfying, and attainable goals. These could relate to any realm of life and could include developing parenting or marital skills, or ending substance abuse. Once these healthier objectives are set, the therapist may also assign homework, set up contracts with the client, and make suggestions on how the client can reach his or her new goals.


Image and video hosting by TinyPic


Probably, the most influential contribution Adler has made was his emphasis on birth order and sibling relationships. This emphasis propelled him to focus his therapeutic approach in family relationships. This approach was labeled “family constellation”, which gathers information on the client’s immediate family member, such as parents, brothers and/or sisters, and others living in their house. A summary and interpretation of this information portrays how the client interacts with the social world.


The Adlerian therapy focuses on spotting concerns or issues revolving around unrealistic ambitions or lack of confidence. The therapist also discovers the successes and failures the client has gone through and how these experiences have affected him or her. The diagnostic tool of early recollections is also practiced. With this method, the client narrates early childhood incidents that keep on happening again and again. According to Adler, these recollections describe how an individual sees himself or herself and what he or she envisions for the future. After gathering this information, the therapist then develops a lifestyle assessment, or the main targets of therapy.


Image and video hosting by TinyPic


It is a guideline for Adlerian therapists to guide the client in exploring his or her strength, rather than revealing his or her weaknesses. Therapists use an objective interview that inquires about the beginning of the client’s problems, the client’s medical history, the client’s purpose for engaging in therapy, and the person’s coping mechanisms. Indeed, based on this approach, therapists or counsellors are “lifestyle investigators”.


Questions about family environment have likewise been included in the techniques. The family issues include the client’s similarity or dissimilarity with the parents and other siblings, parents’ treatment of the children and discipline in the home. Early recollections are also practiced, commonly starting with the line, “Tell me something that happened one time.” This narration is further interpreted by the therapist, according to the client’s perception of the event. Personality priorities are also interpreted based on the four behavioral patterns of superiority, control, comfort, and aim to please.


Adlerian Therapy Focus for Depression Treatment
- Emphasis is placed on the importance of the feelings of self that arise from conflicts and interactions
- The sense of self being the central core of personality is also stressed
- The relationship of ego being the core personality of a person is another focus of the therapy
- It starts from psychoanalysis
- Great emphasis is placed on motivation and social interaction 


How Adlerian Therapy works?
The goal of Adlerian Therapy is to challenge and encourage the clients' premises and goals, to encourage goals that are useful socially and to help them feel equal. These goals may be from any component of life including, parenting skills, marital skills, ending substance abuse, and most anything else.


The Adlerian therapist provides a supportive, accepting environment that can help you build trust, hope and confidence. This can be achieved in a non-judgmental, non-labeling context where the client is stimulated (or irritated) into thoughts and actions which strive for a positive, balanced, connected, competent and creative approach to self and others. The therapists may also assign homework, setup contracts between them and the client, and make suggestions on how the client can reach their goals.


Adlerian Play Therapy
Adlerian Play Therapy is a component of the complete program of Adlerian Therapy. Although Adlerian Play Therapy may work a little different because it is geared to appeal to children, the concept is the same. In Adlerian Therapy sessions, the therapist will focus on and examine the lifestyle of the client and try to form a mutual respect and trust with the client. They will then mutually set goals as the therapist provides encouragement and makes suggestions on how the client can reach those goals. The therapist will also provide the encouragement for the client to make the changes that will assist him or her in attaining the goals that have been set.  


In the case of children, they are not always perceptive to opening up and talking about their feelings, and without this very important part of lives being revealed, it’s difficult for a therapist to help solve the problem that may be plaguing the child. As a result, a systematic approach to therapy was developed called Adlerian Play Therapy and is used in combination with the Adlerian Therapy. Children, being as they are, do not like the idea of anyone trying to find out why they act a certain way, or what happened to make them the way they are. They are very timid little creatures when it comes to the way they feel inside and why they feel that way. I am sure many parents have heard their children say, “I’m not saying anything. I don’t like talking to strangers.” It becomes difficult for a parent who is trying to get to the root a problem with her child’s behavior or the way her child thinks. 


Image and video hosting by TinyPic


What is the solution and how do you help a child who refuses to open up? That’s where the concept of Adlerian Play Therapy steps in. Your child doesn’t want to talk to a stranger, and no matter what you do, he or she just won’t open up and talk. With the Adlerian Play Therapy concept, the child is “fooled” into opening up because the session is conducted during a course of playtime with the therapist. By playing together and developing a sense of being on the child’s level, he or she opens up without even realizing it.


Methodology


Adler taught that a client’s life-style can be viewed as a personal mythology. These mythologies are true for the individual and so the individual acts accordingly. These mythologies are “truths” and “partial truths,” but they can also be myths that one confuses for truths. Adler calls these basic mistakes. Look at common overgeneralizations, such as “people are hostile”, “life is dangerous” as well as misperceptions of life, “life doesn’t give me any breaks”, are all myths that one confuses for truth. These mythologies or life-styles are expressed in the client’s physical behavior, language, dreams, interpretations, etc. The intervention in Adlerian therapy is reeducation and reorientation of the client to myths that work “better”.


Concept of Change/Development According to Adler's theory of change, the therapist uses a variety of strategies that help the client to identify his specific needs. The client is unique; therefore, the technique used must fit the situation of the client. Thinking, feeling, emotion and behavior can only be understood as subordinated to the individual's style of life, or consistent pattern of dealing with life. The individual is not internally divided or the battleground of conflicting forces. Adler believed that humans possess the freedom to act, determine our fate, determine our personality, and affect our style of life.


The goal of the therapy is to stimulate cognitive, affective and behavior change. Although the individual is not always fully aware of their specific goal, through analysis of birth order, repeated coping patterns and earliest memories, the psychotherapist infers the goal as a working hypothesis. The client approaches control of feelings and emotions. First, the client recognizes what kind of feeling he or she is having (angriness, sadness, frustration, etc). Once the client sees and knows the feeling; then he or she will try to imagine or think of something pleasant that had happened to him or her, replacing the bad feeling for a good one. By doing this, the client is in control of his or her emotions and can change the mood only by thinking differently. It is believed by Adlerians that thinking different thoughts can effectively change mood states.


The client is helped by the therapist to see life from another perspective. The client tries to put him or herself into another role. Change occurs when the client is able to see his or her problem from another view, so he or she can explore and practice new behavior. As the therapist explores the thinking, feeling and acting of the client, he or she directs the client into a new philosophy of life. Thus, the client is able to think about a new philosophy of life. He or she makes decisions and conclusions about his or her own life.


Adlerian psychotherapy can be broken down into three basic phases: 1) Understanding he specific style of life of the patient, 2) Explaining the patient on himself or herself, and 3) Strengthening the social interest in the patient. It attempts to bring each individual to an optimal level of personal, interpersonal, and occupational functioning. The objective of therapy is to replace exaggerated self-protection, self-enhancement, and self-indulgence with courageous social contribution.


Tools and Techniques Once the initial analysis has been completed and goals for treatment have been set, Adlerians employ a variety of techniques to encourage individuals to move forward and elicit change. Most of the techniques are action-oriented, focusing on facilitating life-style changes while working to help the individual learn to counteract discouragement, enhancing self-efficacy and increasing self-esteem. Treatment may occur in the form of multiple psychotherapy (whereby several therapists treat a single patient), individual psychotherapy, and/or group therapy.


Within the therapeutic relationship, the therapist is said to represent values the patient may attempt to imitate. In serving as models for their patients, Adlerian therapists therefore characterize themselves as “being for real”- genuine, fallible, and able to laugh at themselves. An emphasis on humor as an important asset is frequently utilized in treatment since “if one can occasionally joke, things cannot be so bad”. Other verbal techniques include giving advice while taking care to discourage dependency; frequent use of encouragement and support; and utilizing language that avoids moralizing by referring to behaviors as “useful” and “useless” as opposed to “good” and “bad”.


Image and video hosting by TinyPic


Some of the more action-oriented techniques include creative and dramatic approaches to treatment such as role-play, the empty-chair, acting “As if”, and psychodrama. Other techniques include task setting, creating images, catching oneself, and the Push-Button Technique. Dramatic techniques such as Role-play, the Empty Chair, and Acting “as if”, are all utilized to help the patient practice useful skills and behaviors as they “try on” new roles and styles of living. While these techniques provide valuable opportunities for patients to rehearse new life-skills, they also allow for the patient to make choices as to which roles they wish to discard, and which they wish to use in their everyday life. Psychodrama is technique that occurs exclusively in a group setting, whereby the internal struggles of a single patient (or “protagonist”) are worked though dramatically. The process occurs with the active participation (and support) of other members of the group who are employed by the protagonist to represent challenging aspects of his or her inner life, while he or she attempts to move “successfully” through it.


Creating images is another technique utilized by Adlerians in eliciting change. Based on the premise that “one picture is worth a thousand words”, patients are given (or generate) images to describe themselves. Use of this technique maintains that remembering this image, the patient can remember goals, and in later stages, can learn to use the image to laugh at oneself.


The Push-Button Technique also utilizes the patients’ own imagination in service of therapeutic goals. After being instructed to call upon two specific life experiences- one pleasant experience and one unpleasant experience- patients are encouraged to focus on the feelings each of these incidents evoke. This process is utilized to teach patients that they can create whatever feeling they wish by deciding what they think about. As a result, the patient finds that he is the creator, not the victim of his emotions, and the power of self-determination is enhanced.




Sources and Additional Information:










Cyclothymia (cyclothymic disorder)

Cyclothymia (si-kloh-THIGH-me-uh), also called cyclothymic disorder, is a mild form of bipolar disorder. Like bipolar disorder, cyclothymia is a chronic mood disorder that causes emotional ups and downs.


With cyclothymia, you experience periods when your mood noticeably fluctuates from your baseline. You may feel on top of the world for a time, followed by a low period when you feel somewhat blue. Between these cyclothymic highs and lows, you may feel stable and fine.


Compared with bipolar disorder, the highs and lows of cyclothymia are less extreme. Still, it's critical to seek help managing these symptoms because they increase your risk of bipolar disorder. Treatment options for cyclothymia include psychotherapy, medications, and — most important — close, ongoing follow-up with your doctor.


Image and video hosting by TinyPic


Symptoms


Cyclothymia symptoms include an alternating pattern of emotional highs and lows. The highs of cyclothymia are characterized hypomanic symptoms, which resemble those of mania, but are less severe. The lows consist of mild or moderate depressive symptoms.


Cyclothymia symptoms are generally similar to those of bipolar disorder, but they're less severe. When you have cyclothymia, you can typically function in your daily life, though not always well. The unpredictable nature of your mood shifts may significantly disrupt your life because you never know how you're going to feel — and you can't just will yourself to live life on an even keel.




Hypomanic phase of cyclothymic disorder





Image and video hosting by TinyPic


Signs and symptoms of hypomanic episodes of cyclothymia may include:
  • Unusually good mood or cheerfulness (euphoria)

  • Extreme optimism

  • Inflated self-esteem

  • Poor judgment

  • Rapid speech

  • Racing thoughts

  • Aggressive or hostile behavior

  • Being inconsiderate of others

  • Agitation

  • Increased physical activity

  • Risky behavior

  • Spending sprees

  • Increased drive to perform or achieve goals

  • Increased sexual drive

  • Decreased need for sleep

  • Tendency to be easily distracted

  • Inability to concentrate

Depressive phase of cyclothymic disorder

Signs and symptoms of depressive episodes of cyclothymia may include:
  • Sadness

  • Hopelessness

  • Suicidal thoughts or behavior

  • Anxiety

  • Guilt

  • Sleep problems

  • Appetite problems

  • Fatigue

  • Loss of interest in daily activities

  • Decreased sex drive

  • Problems concentrating

  • Irritability

  • Chronic pain without a known cause

When to see a doctor

If you have any symptoms of cyclothymia, seek medical help as soon as possible. Cyclothymic disorder generally doesn't get better on its own. If you're not sure where to start with treatment, see your primary health care provider. He or she may refer you to a mental health provider with experience in cyclothymia or bipolar disorder.


If you're reluctant to seek treatment, try to work up the courage to confide in someone, whether it's a friend or loved one, a health care professional, a faith leader, or someone else you trust. He or she can help you take the first steps to successful treatment.


If you have a loved one you think may have symptoms of cyclothymia, have an open and honest discussion about your concerns. You can't force someone to seek professional help, but you can offer encouragement and support and help your loved one find a qualified doctor or mental health provider.


Suicidal thoughts

If you're considering suicide right now, call 911 or your local emergency services number. If you just can't make that call, pick up the phone and reach out to someone else — immediately:
  • Contact a family member or friend.

  • Contact a doctor, mental health provider or other health care professional.

  • Contact a minister, spiritual leader or someone in your faith community.

  • Go to your local hospital emergency room.

  • Call a crisis center or hot line.

If you have a loved one who has harmed himself or herself, or is seriously considering doing so, take him or her to the hospital or call for emergency help.


Diagnostic Criteria


Diagnostic criteria are as follows:
- Symptoms present for at least 2 years, the patient has had periods of hypomanic symptoms and periods of low mood that don't fulfill the criteria for Major Depressive Disorder.
- The longest period the patient has been free of mood swings is 2 months.
- During the first 2 years of this disorder, the patient has not fulfilled criteria for Manic, Mixed, or Major Depressive Episode.
- Schizoaffective disorder doesn't explain the disorder better, and it isn't superimposed on Schizophrenia, Delusional Disorder or Psychotic Disorder Not Otherwise Specified.
- The symptoms are not directly caused by a general medical condition or the use of any substances, including prescription medications.
- These symptoms cause the patient clinically important distress or impair work, social or personal functioning.


Causes


It's not known specifically what causes cyclothymia. As with many mental disorders, research shows that it may result from a combination of:
  • Heredity — cyclothymia tends to run in families. One is 2-3 times more likely to have the disorder if someone in the immediate family has it or if an identical twin has it. In a study by Bertelsen, Harvard, and Huage (1977), if an identical twin had depression, 59% of the identical twins had it also. Heritability for women ranges from 36-44%; for men, 18-24%.

  • Your body's biochemical processes, such as changes in brain chemistry. Serotonin: Serotonin regulates other hormones like norepinephrine and dopamine, so when serotonin is low, the other chemicals may fluctuate, causing irritability, impulsivity and mood irregularities such as dysthymia and depression. Cortisol: Depressed individuals can have high cortisol levels. Cortisol is a stress hormone, and mood disorders often occur during stressful points in one’s life. Elevated stress hormones can affect functioning of the hippocampus, an important centre for memory and cognitive processes. Overproducing cortisol can also impair the brain’s ability to regenerate neurons in the hippocampus.

  • Environment and stressful events, as perceived by the individual. Job loss, relationship failure, identity change, natural disaster, learned helplessness and hopelessness, extreme feelings, negative thinking patterns.

  • Parenting styles.

Risk factors


Cyclothymia is thought to be relatively rare. But true estimates are hard to pin down because people may be undiagnosed or misdiagnosed as having other mood disorders, such as depression.
Cyclothymia typically starts during adolescence or young adulthood. The condition affects about the same number of men and women.


Tests & diagnosis


The person's own description of the behavior usually leads to diagnosis of the disorder.


Prognosis


This disorder usually has an insidious onset in adolescence or early adult life. It often develops with prolonged periods of cyclical, often unpredictable mood changes (e.g., the person may be regarded as temperamental, moody, unpredictable, inconsistent, or unreliable). This disorder usually has a chronic course, and has a 15%-50% risk that the person will eventually develop Bipolar I or II Disorder.


Most people do not need long-term therapy.


Treatment


The most important first step in the treatment of this disorder is to prevent alcohol or illicit drug abuse. Medication often is ineffective when the individual is still abusing alcohol or illicit drugs.


A combination of antimanic drugs, antidepressants, or psychotherapy are used to treat cyclothymic disorder. Medications used to treat this condition are called mood stabilizers.


  • Lithium. Lithium has been used for years in patients with bipolar disorder, and it may also help patients with cyclothymic disorder.

  • Antiseizure drugs. Valproic acid (Valproate), carbamazepine (Tegretol), oxcarbazepine (Trileptal), and lamotrigine (Lamictal) are the most established antiseizure drugs. Other antiseizure drugs used for bipolar disorders include gabapentin (Neurontin), zonisamide (Zonegran), and topiramate (Topamax).

  • Antipsychotics.

  • Antidepressants are not recommended because they can trigger a manic episode.

It has been repeatedly demonstrated that physical exercise can help with mood regulation and emotional stability


Patients may not respond to medications as strongly as do patients with bipolar disorder.




Sources and Additional Information:

Robert Sapolsky Lecture on Depression

We've all felt a little blue, down in the dumps, or just plain sad. But when a serious depression sets in, it could be weeks, months or even years before the feeling lifts. It is your enemy, and consider your fight with depression seriously. Learn more about the illness, learn more about yourself, and you will be able to develop an action plan of how to win the fight and become healthier, happier, and in harmony with your soul and body.
During a recent workshop presented by Stanford's Faculty and Staff Help Center, biologist Robert Sapolsky talked about the biological and psychological causes of depression, how to recognize its symptoms and how to handle the disease.
Depression is the world's fourth leading cause of disability and is on track to be second only to obesity-related disorders by 2025, Sapolsky said.
"Depression is incredibly pervasive and thus important to talk about," he said. "Depression is like the worst disease you can get. It's devastating."








About



Robert Maurice Sapolsky (born 1957) is an American scientist and author. He is currently professor of Biological Sciences, and Professor of Neurology and Neurological Sciences, and by courtesy, Neurosurgery, at Stanford University. In addition, he is a research associate at the National Museums of Kenya.

Chocolate against Stress and Depression

Researchers have found that chocolate can make some people who are prone to depression less anxious and less irritable. There is a downside, as the chocolate is laden with fat and sugar. Several recent studies provided the scientific background to the common knowledge that chocolate has a definite upside as an anti-depressant.


Image and video hosting by TinyPic


A study of 3,000 people by the Black Dog Institute found 45 per cent of people with depression craved chocolate. "Of those 45 per cent, 60 per cent found that the chocolate improved their mood when they were depressed," Joanne Crawford, study co-author said.


Researchers found that among the depressed, those who were anxious or worriers were more likely to benefit from the sweet treats. They believe it is the endorphins and opoids in chocolate which make people feel more relaxed. "The opoids are morphine-like and lower pain and that also flows through into mental wellbeing," Professor Gordon Parker from the Black Dog Institute said.


Swimming star John Konrads battled depression, often turning to chocolate when he felt low. "I thought it was a pick-me-up, almost like a cup of coffee, but to hear that it's a soother makes sense to me with hindsight," he said.


While it is too early for doctors to start prescribing chocolate for depression, this study does prove that it has tangible benefits in fighting mood disorders. "I think this will be reassuring to many people who will say this just merely confirms what I have found out over the years," Professor Parker said.


The only caveat is that even as an anti-depressant, when it comes to chocolate, moderation is the key.


Another study showed  that 40 grams of dark chocolate per day reduces the urinary excretion of the stress hormone cortisol and it almost normalizes the stress related differences in energy metabolism and gut microbial activities between participants with low and high anxiety traits. Already after one week metabolic changes were evident in the metabolic profiles of participants compared to the baseline analyses. This became more significant after two weeks of dark chocolate at 40 grams per day. The metabolic changes in both endogenous and gut microbial metabolism were evident.



Comparing the groups with low and high anxiety traits revealed a decreased level of urinary stress hormone levels in the participants with high level trait anxiety after two weeks of dark chocolate. This study strongly suggests potential beneficial implications of dark chocolate consumption for reduction of mental and/or physical stress and improvement of the metabolic response to stress. 


How Can Chocolate Really Help Depression Symptoms?



The carbohydrates in chocolate increase neurotransmitters, such as: serotonin, dopamine and phenylethylamine, which alleviate depression, and give general feelings of well-being. Cocoa also contains M A O inhibitors (monoamine oxidase inhibitors) which help prolong the benefits of neurotransmitters. Cocoa also raises endorphins, which increase pleasure and lessen pain.


The vitamins found in cocoa are:
- Vitamins B1,2,3,5, and 11 which, in conjunction with other vitamins, help release energy from food, and aid the formation of the body's defenses.

- Vitamin D which helps the uptake of calcium and phosphorus, good for teeth and bones.

- Vitamin E has antioxidant properties, helps build muscle, and promotes the production of red blood cells, and protects cell walls.


All these benefits come from pure cocoa, or dark chocolate, the higher cocoa percentage, the better. Chocolate with 80% cocoa, or higher, is perfect. Though of course, the higher the cocoa percentage, the more bitter the taste.


This pure chocolate, and Cocoa itself, will give you all these benefits. Although to the real chocolate lover, even milk chocolate will give them a good feeling. Just its texture, the smooth silkiness in the mouth, will give feelings of pleasure.


Limitations



Most of the studies concluded that the chocolate’s advantages on mood are thought to be short-lived, a momentary band-aid to a bigger difficulty. While chocolate may lift up your mood at first, it rapidly wears off. So, be careful to increase your dose to get the better anti-depressant effect. Otherwise, the positive influence of this “happy food” can be converted for the significant harm to your health.


Image and video hosting by TinyPic


Sources and Additional Information:
http://www.healblog.net/medical/can-be-chocolate-linked-to-depression/
 
Support : Creating Website | SEO Template | Free Template
Copyright © 2011. Depression: Symptoms and Treatment - All Rights Reserved
Proudly powered by Blogger