In your responses to your peers, you will take on the role of one of the physicians in the audience.

PSY 630 Interactive Assignment -Reply to Colleague Tracy Davis PowerPoint Presentation Script

Details: You are encouraged to post your required replies earlier in the week to promote more meaningful interactive discourse in this discussion. In your responses to your peers, you will take on the role of one of the physicians in the audience.

In your responses, consider two of the following aspects of the presentation:

• The content of the evaluation: Was it sound, well-reasoned, and based on substantial evidence?
• The format of the presentation: Was it easy to understand? Was the sequence of facts well-constructed? Were the visual aids helpful in understanding the meaning of the content?
• The video presentation: Was the verbal presentation clear? Was the pacing appropriate for the material(s)? Was the video helpful in understanding the meaning of the content?
(SEE COLLEAGUE TRACY DAVIS POST BELOW)
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Reply to Colleague Tracy Davis PowerPoint Presentation Script

Slide 2: Introduction

Depression, also referred to as major depressive disorder, is a chronic and life-threatening condition that affects about 9-10 % of the U.S. population. It is recurrent in nature and worsens the condition of a person with an underlying health problem (Advokat, Comaty & Julien, 2018). A major depressive disorder is an affective condition implying that patients experience profound alterations in their moods and emotions. The symptoms of the disorder include irritable mood, insomnia, fatigue, suicidal thoughts, worthlessness, inability to concentrate, and psychosis. A person is diagnosed with depression when these symptoms persist for more than weeks. The disorder accounts for 70 % of psychiatric hospitalizations, and it is important to evaluate how depression is treated. Antidepressants are an effective way of treating depression.

Slide 3: Neurotransmitter Theory behind Depression

Noradrenergic, serotonergic, and dopaminergic neurons are located in the hippocampus, where they influence many brain functions such as cognitive activities, memory, reward-processing, attention, and mood. Reduced functions of serotonin, dopamine and norepinephrine neurotransmitters in the hippocampus make a person depict major depressive functions, and this supports the observation that monoamines deficiency triggers depression (Hasler, 2010). Any condition, such as stress or trauma that reduces the hippocampal and frontal cortical regions or damages the existing neurons, leads to the onset of trauma. Hippocampal cells are also sensitive to stress-related damage, and this aggravates depression if left untreated. Antidepressants work by promoting the growth of the damaged cells and promoting the reuptake of transmitters in the central nervous system.

Slide 4: Anti-Depressants

Depression results from stressful conditions that damage the brain and inhibits its ability to recover from the inflicted damage. The immediate effect of taking antidepressants is the modulation of synaptic levels of serotonin, dopamine, and norepinephrine neurotransmitters to reduce depressive symptoms. They relieve the symptoms by reversing stress-related neuronal damage while promoting neuronal survival at the cellular level (Advokat, Comaty & Julien, 2018). Antidepressants act at the intracellular level, where they enhance the functioning of intracellular molecules that promote neuronal health and their plasticity. As a result, prolonged administration of antidepressants increases the hippocampal volume due to neuronal growth that is associated with the treatment of depression.

Slide 5: Drugs used in Treatment of Depression

There are various types of antidepressants today, but the evolution of their development started over fifty years ago. Imipramine and other tricyclic antidepressants (TCAs) were the common antidepressants that worked by blocking presynaptic transport protein receptors for norepinephrine and serotonin neurotransmitters. They were discovered together with monoamine oxidase inhibitors (Advokat, Comaty & Julien, 2018). Further evolution led to the development of second-generation antidepressants, and in the 1990s, selective serotonin reuptake inhibitors were marketed for the treatment of depression. Although TCAs and monoamine oxidase inhibitors were effective antidepressants, they were associated with adverse side effects that necessitated the development of more tolerable drugs that had fewer side effects.

Slide 6: Benefit-Risks Analysis: Benefits of Antidepressants

Antidepressants are effective in the treatment of depression. They relieve the symptoms of depression by promoting neuronal survival and growth while enhancing neuronal plasticity and blocking presynaptic reuptake transporter of transmitters associated with depression. These drugs improve the overall welfare of the patients because they enhance mood, sleep patterns, promote physical activities, and eliminate morbid preoccupations (Advokat, Comaty & Julien, 2018). They also reduce the chances of relapses, and they do not create euphoric feelings, and hence, they are not addictive. In addition, they have a high success rate, where about 50-75 % of depressed patients respond favorably to antidepressants. The efficacy of the drugs can be improved by increasing the dose or combining it with another antidepressant. Antidepressants have additional benefits because they help in treating anxiety and insomnia.

Slide 7: Risks/Side Effects of Antidepressants

Despite their therapeutic efficacy, antidepressants have various side effects. TCAs impair the cognitive and memory functions of the patient, and care should be taken when administering them to elder patients because they have a long half-life of about 15 hours. An overdose of TCAs leads to cardiac arrest and death, and caution is warranted when administering them to children. Prolonged use of antidepressants increases the rate of suicidality (Advokat, Comaty & Julien, 2018). They are also associated with sleep disturbance, and apathy, and patients also develop physiological symptoms. The drugs are also associated with pregnancy issues and sexual dysfunction. Hence, it is important to monitor patients who are taking these drugs for tolerability issues or side effects. All antidepressants increase the rate of falls. The mortality rate for TCAs is 1.22-1.59, while other antidepressants have a mortality rate of 1.08-1.47, where these rates are high in the case of mirtazapine (Coupland et al., 2018).

Slide 8: Effects of not Treating Depression

Cases of treatment of depression are prevalent in the U.S., mainly because of underreporting depression. Failing to treat the disorder using medications is fatal because depression is a progressive disease. As discussed, depression results from the stress that damages neuronal cells in the hippocampal region. These cells are very sensitive to stress, and further stress causes more damage to these cells, and this aggravates depression. When left untreated, depression symptoms continue to increase. The patients lose memory and cognitive functions and persistent migraines. In addition, spontaneous recovery rates are low at 23 % for patients with low-moderate depression (Whiteford et al., 2012). Further, depression increases suicidality, and it accounts for more than half of all suicides in the country. Approximately 20 % of people with untreated depression attempt suicide, leading to over 36,000 deaths (Halverson, 2019). Hence, untreated depression aggravates the condition and leads to suicide attempts and death.

Slide 9: Other Treatment Options

Apart from antidepressants, depression can also be treated using psychotherapy and, specifically, cognitive-behavioral therapy that works well when it is combined with antidepressants. Severely depressed patients can be treated using electroconvulsive therapy. Regular exercises also play an important role in reducing depression symptoms and can help in overcoming mild-moderate depression (American Psychiatric Association, 2020). Physical exercises engage the brain of the patients, and this eliminates negative thoughts, and they also release endorphins that are crucial in boosting moods and energizing the spirit (Helpguide, 2020). Exercises also generate new activity patterns in the brain that enhances calmness and promotes the overall well-being of a patient. In addition, they are not associated with side effects.

Slide 10: references

American Psychiatric Association. (2020). What is Depression? Retrieved from https://www.psychiatry.org/patients-families/depression/what-is-depression (Links to an external site.)

Coupland, C., Hill, T., Morriss, R., Moore, M., Arthur, A., & Hippisley-Cox, J. (2018). Antidepressant use and risk of adverse outcomes in people aged 20–64 years: cohort study using a primary care database. BMC medicine, 16(1), 36.

Halverson, J. (2019, Oct 7). What is the suicide rate among persons with depressive disorder (clinical depression)? Retrieved from https://www.medscape.com/answers/286759-14675/what-is-the-suicide-rate-among-persons-with-depressive-disorder-clinical-depression#:~:text=Depression%20plays%20a%20role%20in,depressive%20disorder%20is%20nearly%2020%25 (Links to an external site.).

Hasler, G. (2010). Pathophysiology of depression: do we have any solid evidence of interest to clinicians?. World Psychiatry, 9(3), 155.

Helpguide. (2020). The Mental Health Benefits of Exercise. Retrieved from https://www.helpguide.org/articles/healthy-living/the-mental-health-benefits-of-exercise.htm (Links to an external site.)

Whiteford, H. A., Harris, M. G., McKeon, G., Baxter, A., Pennell, C., Barendregt, J. J., & Wang, J. (2013). Estimating

 

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In your responses to your peers you will take on the role of one of the physicians in the audience.

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