Intrepersonal therapy focuses of difficulties in relationships such as grief reactions, roles disputes, and role transitions. For example, a person who has a child never learned how to make and trust a friend outside the family structure has difficulty establishing a friendship as an adult. Interpersonal therapy helps the person to find ways to accomplish this developmental task. Behavioral therapy seeks to increase the frequency of the client’s positively reinforcing interactions with the environment and to decrease negative interactions.
It may also focus on improving social skills. Cognitive therapy focuses on how the person thinks about the self, others, and the future and interprets his or her experiences. This model focuses on the person’s distorted thinking that in turn influences feelings, behavior and functional abilities. Selective serotonin reuptake inhibitors ( SSRIs ) are the first choice of drug therapy, but take 2 to 3 weeks to work. They act by increasing the amount of serotonin and norepinephrine or neuronal synapses in the brain.
MAJOR DEPRESSIVE DISORDER typically involves 2 or more weeks of a sad mood or lack of interest in life activities with atleast four other symptoms of depression such as anhedonia and changes in weight, sleep, energy, concentration, decision-making, self-esteem, goals. Major depression is twice as common in women and has a 1. 5 to 3 times greater incidence in first-degree relatives than in the general population. Incidence of depression decreases with age in women and increases with age in men.
Single and divorced people have the highest incidence. Depression in prepubertal boys and girls occurs at an equal rate ( Kelsoe, 2000 ) Depressed mood Anhedonism ( decreased attention to and enjoyment from previously pleasurable activities ) Unintentional weight change of 5% or more in a month Change in sleep pattern Agitation or psychomotor retardation Tiredness Worthlessness or guilt inappropriate to the situation ( possibly delusional ) Difficulty thinking, focusing or making decisions
Hopelessness, helplessness, and/or suicidal ideation ONSET AND CLINICAL COURSE. An untreated episode of depression can last 6 to 24 months before remitting. Fifty to sixty percent of people who have one episode of depression will have another. After a second episode of depression, there is a seventy percent chance of recurrence. Depressive symptoms can vary from mild to severe. The degree of depression is comparable to the person’s sense of helplessness and hopelessness.
Some people with severe depression ( 9%) have psychotic features ( APA, 2000 ). PHYSICAL FITNESS AND MOBILITY. Exercise and activity are important for older adults as a means of promoting and maintaining health. Physical activity can help keep the body in shape and maintain an optimal level of functioning. In addition, regular and moderate exercise typically results in feelings of well-being. Numerous studies have shown that exercise have shown that exercise has many benefits, including the following ( Christmas & Andersen, 2000 ).