Category: Depression

Summary

This epidemiology assignment is dedicated to exploring depression and associated health determinants. According to Villarroel and Terlizzi (2020), depression is characterized by feelings of sadness, emptiness, or irritability accompanied by significant bodily and cognitive changes. Depression is associated with substantial societal costs and greater functional impairment than many other chronic diseases, such as diabetes or arthritis (Brody et al., 2018). In 2019, approximately 18,5% of adult Americans experienced either mild, moderate, or severe symptoms of depression (Villarroel & Terlizzi, 2020). Additionally, women were more likely to experience depression, with 21,8% of adult American women having the symptoms as opposed to 15% of men (Villarroel & Terlizzi, 2020). Given this information, this paper focuses on explaining the possible health and social determinants of depression in women.

The issue of depression has a massive impact on American society if one considers the fact that depression affects almost 20% of the total U.S. population. According to Brody et al. (2018), depression created some difficulties in work and social life for 48,4% of adult men and 51,2% of adult women diagnosed with that mental health disorder. Moreover, 31,5% of adult men and 29,2% of adult women with depression reported moderate and extreme difficulties in work, home, or social activities (Brody et al., 2018). In this regard, depression poses a serious threat to the overall health of the American nation and the normal functioning of American society. Lastly, depression demands extensive studying in regard to associated health and social determinants since certain population groups, such as women and racial minorities, might be at greater risk. As such, the issue of depression in women has an additional incentive for exploration.

Data Interpretation and Social Determinants of Health

The data for interpretation and understanding of depression determinants in women was mainly acquired from the Centers for Disease Control and Prevention (CDC) databases. In addition, the adapted data from the U.S. Department of Health Office of Minority Health (OMH) was utilized for creating an overview of the data. Whereas the data was sufficient to create the overall health picture of depression in women, it is necessary to note that CDC conducted most analyses in four years from 2014 to 2018. Therefore, the latest information updates will likely occur at the end of 2022; the 2018 data is the latest available in most metrics.

First of all, the issue of depression in women was connected to a dangerous disease that might lead to depression  female breast cancer. Depression is one of the most common psychiatric symptoms in patients with breast cancer (Pilevarzadeh et al., 2019). In regard to mortality, female breast cancer took the second spot in the top 10 cancer types, with 20,1 deaths per 100,000 women (CDC, 2018). In absolute numbers, in the 2014-2018 span, 1.238,159 new cases of female breast cancer were reported, and 208,686 women died of this cancer type (CDC, 2018). In regard to particular races and ethnicities, CDC (2018) provided the following breakdown of female breast cancer cases and deaths:

• White women: 128 new cases and 20 deaths per 100.000 women;
• Black women: 124 new cases and 27 deaths per 100.000 women;
• American Indian and Alaska Native women: 73 new cases and 12 deaths per 100.000 women;
• Asian and Pacific Islander women: 98 new cases and 12 deaths per 100.000 women;
• Hispanic women: 96 new cases and 14 deaths per 100.000 women;

Judging from this data, a health picture of increased Black womens vulnerability to female breast cancer emerges. The social determinants of health, such as inequality and racial disparities, explain this issue. Firstly, Black women face a significantly higher risk of death in female breast cancer cases. For instance, the death ratio between Black and White women equals 1,35, or 1,4 if rounded. As such, Black women are almost 40% more likely to die from breast cancer than White women (OMH, 2021). The significantly higher risk of death may be associated with the development of depression symptoms in Black women. Secondly, Black women are at increased risk of depression due to the social factor manifested in family income level. According to Brody et al. (2018), women with family income below the federal poverty level (FPL) had the highest prevalence of depression  19,8%. For reference, in 2020, Black households had an annual median income of $45,870; meanwhile, the average median household income came out to $67,521 (Statista, 2021). Overall, such social justice and health inequities likely result in increased depression rates in Black women.

Tables 1, 2, and 3: A Detailed Explanation

The two additional determinants contributing to the greater risk of depression in women are represented in Tables 1 and 2, respectively. Table 1 presents the data adopted from the 2014-2018 female breast cancer in the United States and the 2021 data compilation by OMH. CDC (2018) divided the total cases into categories based on ethnicity. As a result, it became possible to highlight specifically vulnerable groups among the U.S. female population. In total, the biggest absolute number of new cases were registered among White women  128 per 100,000; however, Black women suffered significantly greater mortality. Breast cancer death ratios were calculated for women of all races via a simple method used by the OMH. The data on White women were taken as a benchmark, and the number of deaths per 100,000 women of other ethnicities was divided by that benchmark. Overall, a brief analysis allowed confirming the vulnerability of Black women to breast cancer.

Table 1. Health Determinant of Depression in Women: Female Breast Cancer

The small Table 2 showcases the influence of such social determinants as income level on the prevalence of depression. The pattern is obvious  the wealthier the household, the lower the probability of developing depression. The influence of social determinants was massive  women who had an income below the 100% of FPL were more than four times vulnerable to depression compared to those who made over 400% FPL.

Table 2. Social Determinant of Depression in Women: Level of Income

Finally, Table 3 provides the flat rates of depression prevalence in adult women of different ethnicities. In general, White, Black, and Hispanic women were equally predisposed to depression, whereas Asian women were much more resilient. Black women were 5% more likely to develop depression than White or Hispanic; meanwhile, Asian women were 63% less susceptible to depressive symptoms. This data corresponds with the social determinant of income and health determinant of breast cancer  Asian households are the richest by a large margin. In contrast, Black households are significantly poorer than White and Hispanic. In this regard, Black women belong to the highest depression risk group both from a health and social determinants perspective.

Table 3. Depression Prevalence in Adult Women (Aged 20 and Over) and Median Household Income.

Figure 1: Epidemiologic Model

Given the information from the databases, depression in women can be represented in a causal pie model. This epidemiologic model is the most convenient for showcasing risk factors or component causes that may contribute to the development of depression. Furthermore, the casual pie or sufficient-component cause model highlights the multifactorial nature of the disease (Shimonovich et al., 2020). Regarding the explored data, it is possible to reveal three-component causes of depression.

Firstly, gender (A) contributes to the risk of developing depressive symptoms. For instance, in 2019, 21,8% of adult American women aged 18 and over reported depression. In contrast, only 15% of men of the same age group reported depression (Villarroel & Terlizzi, 2020). In addition, women are significantly more vulnerable to breast cancer  a serious disease with high mortality rates that has a potential for causing or worsening depressive symptoms.

Secondly, depression is catalyzed by the component cause of income level. Income below the FPL resulted in a significantly higher prevalence of depression in women (Brody et al., 2018). Moreover, difficult socio-economic conditions can amplify other risk factors of depression. For example, neighborhood disadvantages and low socio-economic status were associated with an approximately 25% increased risk of estrogen receptor negative breast cancer in U.S. Black women (Barber et al., 2021). Therefore, income disparity serves as a strong and negative health determinant of depression.

Lastly, ethnicity can also act as a risk or resilience factor in depression. Whereas women of most ethnicities and races showed approximately equal resilience to depression, the institutionalized social and racial disparities may negatively impact other component causes. For instance, Black women were particularly vulnerable to breast cancer, which can also act as a risk factor for depression development. As such, it is important to realize that physical and mental diseases can often have underlying social determinants. In this regard, targeting these determinants, such as poverty, social, gender, or racial inequities, is necessary for improving the nations health.

References

Barber, L. E., Zirpoli, G. R., Cozier, Y. C., Rosenberg, L., Petrick, J. L., Bertrand, K. A., & Palmer, J. R. (2021). Neighborhood disadvantage and individual-level life stressors in relation to breast cancer incidence in US Black women.Breast Cancer Research, 23(1), 1-12. Web.

Brody, D.J., Pratt, L.A., & Hughes, J.P. (2018). Prevalence of depression among adults aged 20 and over: United States, 20132016. CDC. Web.

Centers for Disease Control and Prevention. (2018). Cancer statistics at a glance. Web.

Office of Minority Health. (2021). Cancer and African Americans. Web.

Pilevarzadeh, M., Amirshahi, M., Afsargharehbagh, R., Rafiemanesh, H., Hashemi, S. M., & Balouchi, A. (2019). Global prevalence of depression among breast cancer patients: a systematic review and meta-analysis.Breast Cancer Research and Treatment, 176(3), 519-533. Web.

Shimonovich, M., Pearce, A., Thomson, H., Keyes, K., & Katikireddi, S. V. (2021). Assessing causality in epidemiology: Revisiting Bradford Hill to incorporate developments in causal thinking. European Journal of Epidemiology, 36(9), 873-887. Web.

Statista. (2021). Median household income in the United States 2020, by race or ethnic group. Web.

Villarroel, M.A., & Terlizzi, E.P. (2020). Symptoms of depression among adults: United States, 2019.CDC. Web.

Introduction

Depression disorder is a common and dangerous condition that affects all aspects of those prone to this illness. Depressive disorders vary from temporary mild symptoms to severe and incapacitating clinical conditions. Consequently, a lot of research has been done on depression disorder intervention. While among the most common is interpersonal and psychodynamic therapy, there is also evidence of cognitive-behavioral therapy efficiency, which is considered the best measure.

Discussion

Cognitive-behavioral therapy is a talking therapy that allows the patient to express their feelings and thoughts and helps the therapist navigate the patient and give recommendations. The research performed by Walter et al. (2021) discussed such therapy by assessing 597 adolescents. The researchers evaluated the socioemotional signs of mental illnesses in a sample of diagnostically referred adolescents with clinical depression required to undergo regular cognitive behavioral therapy in a medical setting. Variations in different subsamples and the overall sample group were evaluated and compared to a group of patients with the discussed disorder who had undergone standard treatment (Walter et al., 2021). Moreover, the clinical significance of these variations was evaluated, and treatment adjustments were assessed by comparing patients who had undergone the therapy and patients who combined the therapy with medications. The findings indicated a statistically significant decrease in symptoms of depression and other psychological conditions in the overall sample, as judged by patients and family members (Walter et al., 2021). Thus, it might be considered that cognitive-behavioral therapy proves to be efficient when it comes to depressive disorder intervention.

Conclusion

When it comes to the LGBTQ+ community, the active process of coming out might be challenging, considering the conservative views of the majority of the U.S. population. According to a study that the Yale School of Public Health conducted, more than 80% of minority representatives wish to keep their true sexual orientation hidden (Poitras, 2019). Additionally, the research indicated that the United States is among the countries with the least coming-out rates (Poitras, 2019). Moreover, according to a study conducted by UCLA, there are approximately nine million LGBT individuals (Gates, 2021). Nevertheless, only those who identify as bisexual are comfortable with coming out experience (Gates, 2021). Thus, it can be seen from the research results that in the given environmental conditions of society, many LGBTQ+ people are uncomfortable with coming out.

References

Gates, G. J. (2021). How many people are lesbian, gay, bisexual, and transgender?Williams Institute. Web.

Poitras, C. (2019). The Global closet is Huge. Yale School of Medicine. Web.

Walter, D., Buschsieweke, J., Dachs, L., Goletz, H., Goertz-Dorten, A., Kinnen, C.,& & Doepfner, M. (2021). Effectiveness of usual-care cognitive-behavioral therapy for adolescents with depressive disorders rated by parents and patientsan observational study. BMC Psychiatry, 21(1), 1-15.

Introduction

Depression is a relatively common mental disorder that appears in different population segments. The condition is rather severe and complex because it has many additional contributing factors to its appearance, and the number of cases increases over time (PGCHealthZone, n.d.). The risk of getting a disease varies depending on the social group and its characteristics. Women tend to suffer from depression more often than men, teenagers depressive episodes appear more often than adults and the segment with low income and education levels is exposed more significantly to the condition than those with high-paid jobs (Remington et al., 2016, p. 869). Additionally, sexual and ethnic minorities are subjected to the disorders progression due to discrimination and systematic oppression. Depression is a risk factor for developing addictive behaviors and substance use (McKenna, 2021). On the contrary physical illnesses such as heart problems, diabetes or cancer can serve as stimuli for the occurrence of the condition.

Data and Methods

For the research used secondary sources such as scholarly analyses, articles, and data from the government website. The information includes the numbers of people from different risk groups who are affected by depression. The statistics about the prevalence and comorbidity rates of depression are provided from the Medicare Chronic Conditions Dashboard (CMS, 2021) and are portrayed in the table included in the paper. Upon entering the portal, on the land hand-side, the states are listed, it is necessary to select the national checkbox and the state for which one wants to see the data comparison, in this case Maryland was selected. Then, there is a graph with various conditions, and it is necessary to select depression. At this point, the graphs and map present the comparison between Maryland and the US national average. At the top of the page, there are options to modify the data. One can select gender as either male or female, age group as either below or above 65 years old, and enrollment as either all, Medicare and Medicaid, or Medicare only. The data and tables shown in this paper are taken using variations of these settings, primarily all under the Medicare only enrollment, other than the age and gender prevalence. Several other CMS data platforms were used for supporting data. CMS data remains as one of the most reliable stemming from a federal agency with reporting data nationally and from every US jurisdiction.

Prevalence of Depression Within the Medicare Population in Maryland

Depression is not an uncommon phenomenon and occurs all over the world among different population groups. The general prevalence of the disease in Maryland among the Medicare population is 15.29% which is virtually similar to the national average of 15.22% (CMS, 2021). Depression has many various aspects that influence its appearance and cause major problems in peoples mental state. There are many causes of depression, starting from the biological to psychological, and often it combines with other illnesses. Sometimes one disease can cause depression, and otherwise, the depression might lead to other health problems. Especially the situation worsened during the Coronavirus pandemic and caused massive mental issues among the population. Medicare beneficiaries faced economic difficulties and complications with accessing healthcare and ensuring certain basic needs (Balasuriya et al., 2021). Notably, according to CMS, the prevalence of the general rate in Maryland is 18.02%, a 3% increase from the Medicare only indicator. Remington et al. (2016) links depression with low socioeconomic achievement and social barriers such as ethnic discrimination that may lead to it. People suffering with mental health issues, including depression, are typically poorer, lack stability (unable to keep a job, relationships), and have negative responses to stressors. While that position may qualify them for Medicare or Medicaid, the rate of healthcare utilization or adherence is likely much lower, worsening prevalence of the chronic conditions and comorbidities.

Comorbidity rate for Medicare Beneficiaries with Depression

The comorbidity rate aims to identify how many conditions occur along with the selected illness. According to the data retrieved from CMS, 45,2% of beneficiaries from Medicare struggle simultaneously with five or more conditions besides the depression itself. Approximately 28.71% have 3-4 diagnoses, 21.09% have 1-2 diseases, and only 5.02% have solely depression (CMS, 2021). There is a certain reason why the comorbidity rate demonstrates the highest percentage of Medicare beneficiaries with more than five additional conditions and the least of those who only have depression. For the most part that matches the national average, with Maryland percentages slightly lower at lesser co-morbidities.

Considering the initial disease itself, the main organ that is affected is the brain. Inevitably it influences the physical state and leads to changes in the physiological processes in the human body (Gardner, 2018). Some of the most widespread symptoms include the constant feeling of tiredness and exhaustion, low libido, problems with sleep, and lack of appetite. Although those symptoms that cause bodily reactions are significant, there is a more severe factor that can stimulate the appearance of other illnesses. The lack of serotonin usually induces multiple mental struggles, and people might lose interest in their regular activities, job, and relationship and even start experiencing suicidal thoughts and intentions.

Along with the frustration, the difficulty or inability to find a way from the condition might push an individual towards self-destructive behaviors and new disorders. Due to the fact that people with depression experience physical symptoms and emotional struggles, they try to find a way to avoid it or at least minimize it as much as possible (McKenna, 2021). Consequently, a decent number of individuals become victims of addictions. Most of the time, it implies substance and alcohol use, but it may include smoking. However, it may work otherwise when people initially struggling with addiction eventually start dealing with depression. Other conditions such as diabetes, cancer, high blood pressure, chronic pain, or heart disease can lead to the development of the disorder (Gardner, 2018). It is as ell connected with the inability to cope with the mental exhaustion, draining, and physical pain.

The Difference in Prevalence Rate among Subpopulations in Maryland

Figure 3: Conditional prevalence among age groups and genders

Expectedly the prevalence rate differs between the subpopulations such as gender and age groups, race-ethnicity, income, and geographical position. For instance, the prevalence rate among women is 20%, and among men is 11%. (Data.CMS.gov., n.d.). It is seen that number of women with depression is almost twice higher than men, and there are certain reasons for this. Older women, for instance, experience mental disorders connected with menopause, which is supplemented with the gain of weight, sleeping problems, and stress. However, many of those factors are associated with pregnancy and motherhood. Severe biological and hormonal changes in womens bodies cause mood swings and even deep frustration. Furthermore, such occurrences as miscarriages, infertility, and complications during the pregnancy may individually or cumulatively lead to depression. Motherhood as well appears to be a stressful period for women, especially in the beginning after they give birth. Change in the lifestyle, overload with parental responsibilities, and troubles in the relationships serve as primary reasons for developing the condition.

In addition, younger people and the middle-aged population group suffer from depression noticeably more often than older ones. Individuals before age 65 have a 33.45% prevalence rate, while older adults aged 65+ only have 16% (CMS, 2021.). Adolescents are at the group risk of regrading the mental disorder and suffer from it more often than adults. Puberty is a turbulent period of life for each individual, and regular mood swings can transform into depression. Although the influence of hormones on the mental state and the overall wellbeing might be troubling, it is not enough to induce the disease. Social factors are an important driving force in the appearance of the psychological issue in teenagers. Regular adolescents often experience a crisis of identity and confusion about their role in life and the future of adulthood (Mayo Clinic Staff, 2019). Additionally, family conflicts and issues in school and with peers deeply affect the already unstable position of the child and synergetically can lead to depression (Mayo Clinic Staff, 2019). Furthermore, in that case, girls are at higher risk of developing the disorder than boys since they reach the period of puberty at an earlier age.

The prevalence rate among the different races and ethnicity varies and shows other numbers in the statistics of Medicare beneficiaries. White people struggling with depression make 19%, while the black population  14%, Hispanic  13%, and Asian/pacific islanders  9%. In general, ethnic minorities are at risk factor of struggling with mental illnesses and depression in particular (Data.CMS.gov., n.d.). Due to social inequality and discrimination, they are exposed to financial struggles, poor education, and fewer opportunities for quality healthcare (Remington et al., 2016, p. 20). Still, the central problem is that racial minorities regularly have to deal with untreated depression. Although the white population more often struggles with major depressive disorder, African Americans, for instance, are exposed to chronic depression (Bailey et al., 2019). Usually, specialists fail to notice the signs of the condition, and eventually, it remains untreated (Bailey et al., 2019). Overall, this is a result of the structural inequality and inability to prioritize psychological struggles due to other difficulties such as unemployment, low salary, and adaptation to the surrounding environment.

Although ethnical minorities are a risk group, they are not the only ones who are affected by the factors mentioned above. Those who do not have an education or job and live in poverty far more often suffer from depression (Remington et al., 2016, p. 869). Individuals who live in dysfunctional areas are more likely to be exposed to severe psychological illnesses than those who live in safe and flourishing neighborhoods (Remington et al., 2016, p. 871). Thus, the geographical position is a significant indicator, and it relates to the urban and rural areas. However, the prevalence rate among Medicare beneficiaries in the urban and rural areas is the same and consists of 17% each per territory (CMS Chronic Conditions Public Use Data. n.d.). Nonetheless, mental disorders appear more often in urban areas rather than in rural (Remington et al., 2016, p. 869). The reason for this might be the higher pace of living and overload of activities, and daily stressful occasions.

Predisposing, Reinforcing, and Enabling Conditions

Since depression is a relatively common psychological disorder and often appears among the population, it requires serious attention. People with different characteristics and backgrounds can be exposed to the disease and should have the ability to receive an early diagnosis and intervention. Considering the particular determinants such as age, ethnicity, geographical position, and gender, some representers are a risk group. Women, adolescents, racial minorities, and urban citizens are the ones whose needs have to be most represented. Due to the barriers induced by Covid-19, the number of self-reported cases of depression increased. Covid-19 reportedly triggered a 25% increase in depression due to the pressure of multiple stress factors (World Health Organization, 2022). People felt significantly more stressed and less secure financially and emotionally due to the limitations of social connection and working possibilities. Older adults become the most vulnerable in this situation and face depression because of not accessing and maintaining their basic needs. Meanwhile, young people and women were significantly affected as well, being disproportionally at risk of suicide and self-harming behaviors or having pre-existing conditions that are linked to depression.

The depressive disorder should be examined, considering the possibility of supplementing illnesses. Some diseases such as diabetes, cancer, or substance abuse may be the factors that contribute to the appearance of the condition. Many chronic diseases act in synergy, so depression can have a compounding risk on health outcomes. In a national survey, disability was found in 51% with diabetes, but 78% with both diabetes and depression (Remington et al., 2016). The relationship between depression, as with many mental illnesses can be bidirectional, as many physiological and chronic conditions impact mental health, so does mental health impact the physiology. Depression can be seen in 40-60% of patients who have had a heart attack, while 1 in 4 people with cancer suffer from depression (Remington et al., 2016). In order to reinforce the factors that impact the appearance of the condition, it is crucial to detect specific details and set priorities. Firstly, it is necessary to consider the gender, age, and race of the person. Secondly, as supplementing factors should be viewed the income level and geographical position. Alongside it, there is a need to identify whether there are other diseases and, if so, which cause depression or vice versa.

The public health intervention program should focus on the risk groups mentioned above and consider their specifics. Since the majority are women and teenagers, it has to be safe for the female participants to share their problems and get support. In the case of working with children, the specialist has to be experienced in work, particularly with adolescents, because their condition is rather unstable due to puberty. The approach should demonstrate inclusivity and understanding of the specifics of people with different cultural backgrounds and consider it during the intervention. Moreover, the governmental policies should focus on the training of the professionals and bringing awareness to the public through educational institutions and the workplace. Finally, the program necessity has to be accessible because a decent number of depressive cases are caused by poverty and low income, so those people could be allowed easily to get help.

Conclusion and Recommendations

Overall, depression is a rather severe disorder that requires specific attention intervention. Women, adolescents, social minorities, and people with lower income are the risk groups whose needs have to be addressed in the first place. Depression may be a supplementing disease to other conditions or vice versa, it can cause different disorders. Thus, the medical specialists have to get additional training and education on detecting the symptoms of depression, among other occasions, and precisely identify what serves as the initial cause of the health problems. Such practice will ensure effective treatment and will allow the patients to recover in a shorter period of time.

However, based on the findings, the majority of the causing factors have roots in the social aspects of the population, such as poverty, pandemic, and discrimination. In order to eliminate the causes, the healthcare and social system specifically requires major changes on the macro level, and it might take a long time until the risk factors are reduced. Nevertheless, there are certain preventive methods that can be implemented to minimize the cases of depression. The government should focus on education about the issue and removing the stigma from having a conversation and turning to specialists for help. It might include special programs in schools, universities, and workplaces about the symptoms of depression and the reasons that lead to it.

References

Bailey, R. K., Mokonogho, J., & Kumar, A. (2019). Racial and ethnic differences in depression: current perspectives.Neuropsychiatric disease and treatment, 15, 603. Web.

Balasuriya, L., Quinton, J. K., Canavan, M. E., Holland, M. L., Edelman, E. J., Druss, B. G., & Ross, J. S. (2021). The association between history of depression and access to care among Medicare beneficiaries during the COVID-19 pandemic.Journal of General Internal Medicine, 36(12), 3778-3785. Web.

CMS Chronic Conditions Public Use Data. Chronic conditions prevalence, state/county 2018 [Infographic]. Web.

CMS. (2021). Medicare chronic conditions dashboard: State level [Infographic]. Web.

Data.CMS.gov. (n.d.). Mapping Medicare Disparities by Population [Infographic]. Web.

Gardner, A. (2018). 10 Medical Conditions That Are Linked to Depression. Health. Web.

Mayo Clinic Staff. (2019). Depression in women: Understanding the gender gap. Mayo Clinic. Web.

McKenna, J. (2021). How Are Depression and Substance Abuse Related? WebMD. Web.

PGCHealthZone. Depression: Medicare Population [Infographic]. Web.

Remington, P., L., Brownson, R., C., and Wegner, M., V. (2016). Chronic Disease, Epidemiology, Prevention, and Control (4^th ed.). American Public Health Association.

World Health Organization. (2022). COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. Web.

Introduction

The video provides an interview with Alison, who feels depressed. The woman is 38 years old and talks about how she finds it hard to cope with everyday things, causing them to pile up and put pressure on her. Some months she feels tired, and her mood is always low, despite having children and working at the supermarket. Alisons primary complaints are the constant fatigue and depression that keep her from feeling well.

History of Present Illness

Alison came to the appointment independently after her sister advised her to learn more about her condition with a specialist. According to the woman, the constant fatigue had been present for several months. Alison reports that during that time, she had stopped taking care of her appearance and had lost some weight due to a lack of sleep. The woman points to fatigue, which causes daily activities to become insurmountable obstacles. She notices that her boyfriend Dave does not want to communicate with her and Alisons condition worsens. The disease probably began gradually, affecting her whole body at once. Alison believes that her illness is severe and taking a toll all the time, and the environment is worsening the condition. She gets relief after talking to her sister or interacting with her children.

Mental Health Review of Symptoms

Alison reports the following symptoms she observes over time she considers herself ill. First and foremost is a problem with sleep: sleep does not bring relief and recovery, sleep is restless, and waking up at night does not allow for further rest. Alison also reports that she cannot fall asleep for a long time, and sometimes reading a book before bed helps her, but being alone before falling asleep bothers her the most. Second, a drop in energy and fatigue is other symptoms that put pressure. This causes Alison to cope less with daily activities, and at work, she cannot perform routine activities such as talking to customers or arranging merchandise. Third, communicating with her sister or friends is also tricky: more often than not, Alison is so exhausted that she cannot participate in discussions. Because of this, her relationship with her boyfriend Dave has deteriorated, and she considers herself a burden on him. Separately, Alison talks about her difficulties with her children: she feels useless and feels she cant help them in their lives.

Mental Status Exam

Alison can be evaluated in the following categories: observations, mood, cognition, perception, behavior, and thoughts. Observations analysis shows shaky, quiet speech, a little unkempt, a little lethargic, and no eye contact. Alisons mood is depressed and anxious, and the woman cries frequently. Assessment of cognition  Alison concentrates poorly and sometimes forgets how to do the things she does daily. The patients behavior is normal, not aggressive, restless, or tired. Alison is fixated on troubling thoughts which interfere with her sleep and daily routines; she is poor at sticking to plans and has a subordinate social role.

Diagnosis and Plan

Alison most likely has a depressive state accompanied by the typical symptoms of sleep disturbance, increased fatigue, decreased communication ability, and anxiety. The following plan for resolving depression is recommended for this case.

1. Re-interviewing and assessing risk behaviors.
2. Providing the patient with a treatment plan and socializing with it by conceptualizing problems.
3. Setting treatment goals with the patient.
4. Behavioral activation and creating a safe environment for behavior change.
5. Social-behavioral and cognitive therapy with possible involvement of medication.
6. After symptom reduction, the continuation of observation.

The therapeutic benefit of using psychedelics in treating various mental illnesses is controversial. Despite the potential of psychedelics to help the patient, there is a risk to make things worse as the drugs of this type might be dangerous for the patients mental state. This work critically analyzes five studies exploring the effects of a specific psychedelic (psilocybin) in treating a specific mental health disorder (depression). This work is a literature review that aims to discuss the topic and compare and contrast psychedelics with traditional forms of psychological treatment.

First of all, it is essential to understand the general effects of psilocybin on the brain that are present in the current literature. According to Kuypers (2020), small doses of psilocybin can positively affect cognitive processes, including time perception and divergent and convergent thinking, and the corresponding brain regions. However, the same study has found that using psilocybin increases anxiety and may create a cycling pattern of depression and euphoria (Kuypers, 2020). Therefore, it may be dangerous to administer small doses of psilocybin to patients suffering from depression as it does not guarantee a positive effect and can contribute to the development of another severe mental illness. Compared to the traditional psychological treatments, psilocybin may provide similar improvements, but it is also associated with high risks, meaning that more scientific knowledge is required to support psilocybins therapeutic value.

The risks of using psychedelics in treating patients with mental health disorders cause the related question concerning the reasons to use them instead of traditional psychological treatments. According to Roseman et al., (2018), psychedelic therapy may be more appropriately thought of as a distinct form of (drug-assisted) psychotherapy than as a pure pharmacotherapy. However, the current treatments have limited effectiveness and adherence (Davis et al., 2021). That is why new methods and techniques, including the usage of psilocybin, are constantly explored to find more effective ways of treating mental illnesses such as depression.

The importance of studying the positive effects of psilocybin is explained in recent studies. They suggest that 1 or 2 administrations of psilocybin with psychological support produce antidepressant effects (Davis et al., 2021). The research of Hibicke et al. (2020) has also provided evidence to that suggestion. The randomized clinical trial conducted by Davis et al. (2021) shows that psilocybin with therapy is efficacious in treating major depressive disorder. The trial consisted of two sessions, using 20 mg and 30 mg of psilocybin (Davis et al., 2021). Therefore, conducting more clinical trials may lead to discoveries and provide more evidence of the positive effects of psilocybin in treating mental illnesses.

As it is known, depression is a complex mental illness, meaning that it can be associated with complicated treating. It is questionable whether psychedelics can be effective in such cases. For instance, the study of Roseman et al. (2018) explores the effects of psilocybin in treating patients with treatment-resistant depression (TRD). The study describes another clinical trial which involved twenty patients with treatment-resistant depression underwent treatment with psilocybin (two separate sessions: 10 and 25 mg psilocybin) (Roseman et al., 2018). Another specificity of this study is that it aims to test the effectiveness of psilocybin in treating TRD in the long term (Roseman et al., 2018). Although the study shows psilocybins contribution to the long-term positive outcomes, it also reveals the psychedelics association with increased anxiety (Roseman et al., 2018). That fact has also been discussed in another study reviewed in this work, meaning that future work is necessary to determine psilocybins efficacy more accurately and consider ways of reducing anxiety symptoms.

Another critical point regarding exploring psilocybin effects is understanding its therapeutic mechanisms, which were not addressed in the studies reviewed previously. The study conducted by Carhart-Harris et al. (2017) measures cerebral blood flow and resting-state functional connectivity (RSFC) dependent on the blood oxygen level in patients before and after a psilocybin treatment. The researchers collected data from 19 patients using functional magnetic resonance imaging (fMRI) (Carhart-Harris et al., 2017). According to the researchers findings, all patients demonstrated reduced depressive symptoms correlated with decreased cerebral blood flow and increased RSFC (Carhart-Harris et al., 2017). Further exploration of psilocybins therapeutic mechanisms can help understand its similarities and differences with the medications used in current psychological treatments.

Overall, the current literature demonstrates the positive effects of using psilocybin in treating depression. The studies analyzed in this review provide evidence that small doses of psilocybin can decrease the symptoms of depression. However, several studies also report that psilocybin might be associated with increased anxiety. Compared to the traditional psychological treatments, psilocybin can have similar positive effects, but the current literature lacks the knowledge to address the corresponding risks. Therefore, further exploration of the subject and conducting more clinical trials are advisable to better understand the effects of psilocybin.

References

Carhart-Harris, R. L., Roseman, L., Bolstridge, M., Demetriou, L., Pannekoek, J. N., Wall, M. B., & Nutt, D. J. (2017). Psilocybin for treatment-resistant depression: FMRI-measured brain mechanisms. Scientific reports, 7(1), 1-11.

Davis, A. K., Barrett, F. S., May, D. G., Cosimano, M. P., Sepeda, N. D., Johnson, M. W., & Griffiths, R. R. (2021). Effects of psilocybin-assisted therapy on major depressive disorder: a randomized clinical trial. JAMA psychiatry, 78(5), 481-489.

Hibicke, M., Landry, A. N., Kramer, H. M., Talman, Z. K., & Nichols, C. D. (2020). Psychedelics, but not ketamine, produce persistent antidepressant-like effects in a rodent experimental system for the study of depression. ACS chemical neuroscience, 11(6), 864-871.

Kuypers, K. P. (2020). The therapeutic potential of microdosing psychedelics in depression.Therapeutic advances in psychopharmacology, 10, 1-15.

Roseman, L., Nutt, D. J., & Carhart-Harris, R. L. (2018). Quality of acute psychedelic experience predicts therapeutic efficacy of psilocybin for treatment-resistant depression. Frontiers in pharmacology, 8, 974.

Depression is a severe mental health disorder that can substantially affect the life of diagnosed persons. It can be defined as a condition that impairs the patients cognition, the ability to control emotions, motivation, memory, and motoric function (Dean & Keshavan, 2017). Several perspectives can be applied to describe the disease and understand its nature. Thus, this post will discuss biological and social-cognitive perspectives on depression and the difference between these approaches.

The social-cognitive perspective states that the disorders development is influenced by the events in the patients life and their way of thinking. Specifically, the theory claims that human behavior is influenced and shaped by an individuals expectations, thoughts, beliefs, and social environment (Bennett et al., 2018). The author of the theory, Albert Bandura, pointed out that depressed people tend to believe they are responsible for the adverse events in their lives and those events negatively affect their self-concept, thoughts, and expectations (An American Addiction Centers Resource, 2020). Thus, cognition and the environment of an individual are key predictive factors for depressive disorder.

In contrast, the biological perspective views depression as a condition influenced by natural factors, such as genetics and the chemistry of the brain. According to Dean and Keshavan (2017), emotional processing can be impaired by such biological factors as an extreme amygdalar response to stressful events or hyperactive hypothalamic-pituitary-adrenal (HPA) axis. Abnormal dopaminergic transmission and altered mesolimbic pathways, among other factors, can also affect the development of the condition (Dean & Keshavan, 2017). Overall, genetic predisposition and neurochemistry of the brain are the main predictors of depression. Thus, the main difference between the social-cognitive and biological perspectives is the different views on the causes of the disorders development.

In summary, depression is a serious syndrome that can be influenced by a wide range of factors. The social-cognitive theory states that it results from the adverse environmental events, thoughts, beliefs, and expectations of the affected persons. These factors affect each other, leading to the development of depression. In contrast, the biological perspective states that the disorder can be explained by genetics and the abnormal neurochemistry of the brain.

References

An American Addiction Centers Resource. (2020). Cognitive theories of major depression  Ellis and Bandura. MentalHelp.net. Web.

Bennett, B., Sharma, M., Bennett, R., Mawson, A. R., Buxbaum, S. G., & Sung, J. H. (2018). Using social cognitive theory to predict medication compliance behavior in patients with depression in Southern United States in 2016 in a cross-sectional study.Journal of Caring Sciences, 7(1), 18. Web.

Dean, J., & Keshavan, M. (2017). The neurobiology of depression: An integrated view.Asian Journal of Psychiatry, 27, 101111. Web.

Many teenagers do not like fish. Some girls simply hate its characteristic odor and the way it looks on the plate. Why should I eat this ugly demon from deep waters? Girls! You should eat fish because it will help you to be smart, beautiful, and happy!

Why Fish?

Remember that adolescence is one of the most important periods of your life as you build the body you will be using for the next 100 years (that is, of course, if you have a healthy lifestyle). Certainly, you need to have enough exercise, and your diet should be balanced. However, you should also know the benefits of some particular products. Fish is a magicians hatyou can get loads of great things out of it.

It will Help You Be Even More Beautiful!

Of course, good health makes you beautiful. Everyone knows this simple truth. Fish is rich in omega-3 polyunsaturated fat that helps prevent heart attacks. This element also improves your bodys resistance to other diseases. However, health may seem like a dull topic at your age.

You will be surprised to learn that fish helps females to be beautiful. Fish is rich in protein that is essential for the development of muscles. Skinny girls seemed attractive back in the 1980s. Now, strong and healthy bodies are in fashion. Firm abs and hips will make you a superstar! On top of that, fish reduces the risk of developing arthritis.

Of course, you need healthy joints to be a strong and empowered woman. Your eyes enchant and subjugate. Nevertheless, it can be difficult to do that through thick lenses. Mind your eyes health! Fish has the necessary elements to keep your eyes healthy, bright, and beautiful.

It Will Help You to Be Smarter!

Fish is legendary for its outstanding effect on peoples brains. This product is the best source of such important elements as omega-3 fatty acids. Moreover, it has been proved that people who eat fish regularly have a larger gray matter in the brain that controls memory. Eating fish is specifically important during adolescence when your brain is still developing. Your academic performance will improve.

It will Help You Be Happier!

It has been found that omega-3 is also an important element that exerts a positive influence on the parts of the brain that regulate our emotions. In simple terms, you can be happier if you eat fish weekly. Of course, your mood will also improve if you feel that you are a high achiever and a gorgeous young lady.

Meal Ideas for You and Your Friends!

Another breathtaking thing about fish is the many ways it can be cooked. You can cook a healthy fish meal in any way. You can grill, roast, or bake it! You can eat your favorite tacos and be healthy, beautiful, and smart!

Organize a grill party, and have fun! The only rule here is to add vegetables, and these can be your favorite vegetables. Try grilling them, and use some fresh vegetables to go with the hit of the party, fish. Just remember that balance is the key to your success.

Of course, you may still think that some things are just not good enough for you. However, fish is not on this list. Explore how to be healthy and happy with this stunning product.

Introduction

Depression can be defined as a state of anxiety, sadness, hopelessness, and worthlessness (Kail & Cavanaugh, 2011). It can affect people across all ages, who present with diverse signs and symptoms (Blatt, 2004). It has been shown that there are different types of depression, which require unique approaches to diagnosis and treatment (Kail & Cavanaugh, 2011).

This paper aims at discussing how a person would know whether a relative had clinical depression or was sad due to specific changes or losses in life. It also focuses on highlighting the behaviors that could indicate that a person undergoing depression requires therapy. Finally, it offers recommendations concerning therapy and the consequence of such therapy in the elderly.

Clinical depression or typical depression

It would be important to determine whether a relative had clinical depression or was sad because of changes in life. This would help in determining the course of action in treatment. Clinical depression persists in a patient longer than the other type of depression, and it makes an individual not carry out his or her daily activities in a normal way. The following signs would characterize relative suffering from clinical depression (Blatt, 2004; Kail & Cavanaugh, 2011):

• Insomnia or hypersomnia
• Lack of appetite
• Changed concentration
• Restlessness
• Fatigue
• Worthlessness
• Considerable weight loss or gain
• Persistent suicidal thoughts

On the other hand, depression that is caused by changes or losses in life does not last long, and there are no severe symptoms that could guarantee medications (Blatt, 2004). This type of depression can be resolved through the application of counseling. Thus, it would be important to assess whether a relative encountered major changes in life. Changes could be brought by new jobs and responsibilities, among others (Blatt, 2004). Losses could be due to the death of a close family member or friend and loss of a job, among others.

Forms of behavior

It is important to note the behaviors in a person undergoing depression that imply that he or she requires therapy (Kail & Cavanaugh, 2011). Most importantly, clinical depression should be treated when detected so that a person cannot result in life-threatening acts such as committing suicide. The following behaviors would indicate that a person requires therapy:

• The abrupt change of mood patterns
• Suicidal thoughts
• Hopelessness
• Prolonged anxiety
• Considerable weight loss or gain
• Social withdrawal signs

Therapy and the consequence

A student would recommend the use of antidepressant medications aimed at curing the symptoms of a depressed patient (Kail & Cavanaugh, 2011). However, they would be selected based on behavior patterns that would be present in a patient. Specifically, monoamine oxidase inhibitors (MAOIs), which treat depression by blocking the enzyme monoamine oxidase, would be recommended. Examples of the medications are phenelzine and isocarboxazid. The medicines would be suggested because they have fast modes of therapeutic activities (Henry et al., 2007).

The consequence of administering the drugs is that they would adversely react with other drugs and some types of food (Henry et al., 2007). To avoid the consequence, it would be important to tell a patient the drugs that he or she would not use while using the antidepressants. Also, aged cheese and meats should be avoided.

References

Blatt, S. J. (2004). Experiences of depression: Theoretical, clinical, and research perspectives. New York, NY: American Psychological Association.

Henry, C., MBaïlara, K., Poinsot, R., Casteret, A. A., Sorbara, F., Leboyer, M., & Vieta, E. (2007). Evidence for two types of bipolar depression using a dimensional approach. Psychotherapy and psychosomatics, 76(6), 325-331.

Kail, R. V., & Cavanaugh, J. C. (2011). Human Development: A Life-Span View: A Life- Span View. Boston, MA: Cengage Learning.

Introduction

This paper reviews the article titled, Effectiveness of integrative and instrumental reminiscence therapies on depression symptoms reduction in institutionalized older adults: An empirical study by Karimi et al. (2010) and published in the journal of Aging and Mental Health 14(7), 881-887. This article presents the research findings of a study conducted in Iran to assess how effective integrative, as well as instrumental reminiscence therapies are in the management of depression in older persons.

There was a major focus on reduction of the symptoms of depression. Numerous studies on this study topic have been conducted, and while some appear to affirm the impact of these reminiscence interventions, there are many cited inconsistencies. This study sought to venture into this area in an attempt to support, disapprove or even come up with new findings on this topic of study.

Justification/ problem statement

The study sets off with a study topic that is extensively expounded in the background/literature review section, substantially supported by numerous recent citations from previous studies on this topic. The study is justified by the fact that a consideration of reminiscence in sub-categories and not as a unitary occurrence would perhaps provide acceptable findings, unlike previous studies; which is possibly the rationale behind the inconsistencies in these research findings.

Owing to this occurrence, previous studies failed to win enough reliability to facilitate substantial conclusions. Therefore, Watt and Wong (1991) proposed that the major reason behind these variances would be in the fact that reminiscence studies were conducted with an approach to reminiscence as one phenomenon; thus, they categorized it into integrative, instrumental, and escapist, among other categories. For that reason, this study chose to consider instrumental and integrative classes of reminiscence interventions singly.

Hypothesis/ purpose

The study hypothesized that integrative and instrumental therapies lower the symptoms of depression significantly in elderly adults. The abstract, concisely presented, provides the purpose of the study, which is deeply expounded in the introduction section with heavy support from varied citations. This helped in assessing the effectiveness of integral reminiscence intervention and instrumental reminiscence intervention in lowering depression symptoms in adults, particularly those in nursing homes. The abstract further summarizes the methodology, the findings and a conclusion, thus giving the reader an overview of the study.

Study Design

Participants

One hundred and nine people (109) from Kagrizak Nursing Home volunteered for the study, but only 94 passed the initial interview from which only 48 were found eligible. Eligibility demanded that the subjects ought to have been in the nursing home for more than six months, be 60 years and above, not currently under depressants (or if they did, they had to have been stabilized on this therapy for three months and above), and should have been suffering from depression.

Thirty-nine participants (39) were randomly selected from the eligible ones, but 10 participants were left out for various reasons, including suffering from other illnesses or failing to attend 60% of the sessions. Thus, the research finally ended up studying 29 subjects, aged between 64 and 87 (12 males, 17 females). Nine participants were evaluated for instrumental reminiscence and ten were in the integrative reminiscence class. A control group (active social group of discussion) was selected to distinguish specific from general group effects. The evaluation was carried out by clinical psychologists (masters degree holders) who were blind to the therapy of the participants.

Methods and materials

The participants were subjected to a MMSE interview (Iranian version) to assess their mental state, whereby a score less than 21 designated cognitive impairment. The GDS-15 was used to measure depression symptoms (to those who would not read due to low vision or illiteracy, the GDS-15 was performed by interview); the GDS-15 has 15 items of which ten are indicative of symptoms if answered in the affirmative, and the other five indicated depression when answered in the negative. The Iranian version of GDS-15 was used for this study.

The intervention manual of Watt and Cappelies (2000) was used to conduct these interventions, with slight adjustments on some materials to make them culturally fitting, as well as take care of those who were illiterate since most participants were not literate. Six 90-minute weekly sessions were carried out in the form of three groups, headed by a therapist with a masters degree under the supervision of a clinical psychologist. Each week, participants were required to remember different themes, including history of their family, achievements in life, main life turning pints, love and hate history, affliction experiences, and life meaning among others.

Participants were further required to think on the following sessions topic as homework to make it easy for them to bring to mind the themes in the next session. The control group members participated in all the sessions, tackling topics like physical problems and how they influence daily lives, family association alterations, and older adults status based on the laws of religion as well as public, and challenges facing the young among other issues.

Data analysis

The researchers of this study used the ANCOVA test to draw the distinction between the pre-test scores and the post-test scores (with depression severity as the variable of covariate) of all the groups that were being studied. A p-value below 0.005 was considered statistically substantial. The ANCOVA test tested the possibility of other factors influencing the result of the variable that was being tested. The Scheffe post-hoc test was used to determine the most significant reminiscence intervention group from the three.

Results

The findings indicated that the post-test scores of the symptoms of depression of the three groups substantially disagreed after excluding the scores of pre-test (covariate). These results are duly summarized in a table, thus making it easy to understand and figure out this concept. Further, the most significant group (integrative) was explicitly determined by use of Scheffe post-hoc test, and the results are equally represented in another table. This makes for easy and conceptual grasp of these results.

A comparison of the integrative and the social groups revealed a distinct variance between the two, whereby the symptoms of depression among the integrative group were found to be substantially lower in comparison to those of the control. On the other hand, no substantial disparity was observed between the instrumental group and the control. These are overtly observable from a table presenting these findings. These findings, in combination, substantially indicate that integrative reminiscence therapy is more effective in depression symptom reduction compared to instrumental intervention.

Discussion

A statistically substantial reduction in the symptoms of depression in older adults was demonstrated by comparing a control group with the integrative group. These findings were in line with the research findings of previous studies conducted by Chin, (2007). Capppelieze and ORourke, (2006) conducted a study on the functions and consequence of reminiscence in general and found out a significant reduction of symptoms, which is also consistent with results of this study.

Therefore, it is right to say that integrative reminiscence therapy is clinically significant since it reduces depression symptoms in adults (Hsieh & Wang, 2003). The covariate variable, which represented the severity of depression, was found to be statistically substantial. This was also in line with the findings of Pinquart et al. (2007).

However, in the instrumental group, no statistically substantial reduction was found, despite the GDS-15 indicating a relative reduction. The mean score was 9.22 (pre-test), which falls within the moderate depression range, and 7.017 (adjusted post-test) implying mild depression. While this would be indicative of clinical significance, the Scheffe post-hoc test indicated that the effect was not statistically substantial. This differed slightly with the findings of Watt and Cappelieze (2000), who found out that there was a clinically significant reduction in depression symptoms ranging from moderate to high.

This study at first (six weeks) found out a significant improvement in depression symptoms in both interventions, but later (three months) the integrative reminiscence turned out more effective. However, Watt and Cappelieze (2000) stated that the results would not be overly reliable since they used a small sample size; this could somewhat validate the findings of Karimi et al. (2010) in the present study.

Further, the finding that the integrative reminiscence intervention is better than instrumental intervention is not consistent with the findings of Capppelieze, ORourke and Chaudhury (2006). The difference is attributed to the disparity in process components of these interventions; integrative intervention components appear familiar to the illiterate (major participants in the current study), while instrumental is best fitted for out of institutionalized adults. Moreover, the manual used for intervention evaluation was initially meant for use with the literate. Thus, it was first adapted to fit for use in this current study. Conceivably, further adaptation would yield different results altogether.

The authors justify the use of a small sample size, arguing that a large one would hamper sharing of the feelings of all the members of a group, and it would be difficult to create relationships and confidence in a large sample sized group. Nevertheless, the small sample size is considered to be a limitation, which spurs questioning of the results. Further, the study focused solely on a single variable, symptoms of depression, which is also a limitation.

Conclusion

Generally, this article follows a logical presentation of findings; the title, abstract, introduction, study design, results, discussion, conclusion, acknowledgement, and reference are all presented in the common order and as described above. The sections are also tackled extensively. The general language used is devoid of scientific and statistical jargon, which makes for easy comprehension of the whole study by both experts and non-experts. Results are presented in written form, coupled with tables for easy following.

The authors derived a lot from previous studies; which adds to the reliability and validity of their findings, besides the use of approved standard manual for evaluation. The fact that the findings were consistent with most previous findings and a rationale for any inconsistent determined also boosts reliability and validity of the study. It is can be observed that citations, besides being relevant, were recent. Most of them were from the year 2000 and above, and only a handful were from the 1990s.

The study sought to study the effect of instrumental and integrative therapies on depression symptoms, as well as test the hypothesis that both interventions significantly reduced depression symptoms. The study design employed apparently helped the achievement of all this as depicted in the wide discussion of the research findings presented in this article. It can, thus, be concluded that the research was successful. However, as suggested, a manual test adapted for use in particular situations is important, and larger sample sizes should be considered for better and consistent results in future studies.

References

Cappeliez, P., ORourke, N., & Chaudhury, H. (2005). Functions of reminiscence and mental health in later adulthood. Aging and Mental Health, 9(4), 295301.

Chin, A. H. (2007). Clinical effects of reminiscence therapy in older adults: A meta-analysis of controlled trials. Kong Journal of Occupational Therapy, 17(1), 1022

Hsieh, H. F., & Wang, J. (2003). Effect of reminiscence therapy on depression in older adults: A systematic review. International Journal of Nursing Studies, 40(4), 335345.

Karimi, H., Dolatshahee, B., Momeni, K., Khodabakhshi, A., Rezaei, M., & Kamrani, A. A. (2010). Effectiveness of integrative and instrumental reminiscence therapies on depression symptoms reduction in institutionalized older adults: An empirical study. Aging and Mental Health 14(7), 881-887

Pinquart, M., Duberstein, P. R., & Lyness, J. M. (2007). Effects of psychotherapy and other behavioral interventions on clinically depressed older adults: A meta-analysis. Aging and Mental Health, 11(6), 645657

Watt, L. M., & Cappeliez, P. (2000). Integrative and instrumental reminiscence therapies for depression in older adults: Intervention strategies and treatment effectiveness. Aging and Mental Health, 4(2), 166177.

Watt, L. M., & Wong, T. P. (1991). A taxonomy of reminiscence and therapeutic implications. Journal of Gerontological Social Work, 16(1-2), 3757.

Introduction

The modern life rhythms that revolve around people make us feel stressed about every single event-taking place in our lives. As a result, communication, daily life, and working patterns become nothing but fixed mechanisms that are deprived of any additional thoughts and perspectives. Scientists claim that such an attitude to life directly influences peoples mental health, making them feel emotionally drained and hence, leaving them with no energy to look at life in a different light.

In such a way, we voluntarily lock ourselves up in a vicious circle of sadness and self-consciousness instead of opening up to the world. It goes without saying that creativity is one of the most beneficial ways to bring some bright colors to the daily routine and let yourself think outside all the boxes stored by society. So, there are four tips on how to make creativity an inseparable part of both your working and personal life:

Sketch and doodle everything that meets the eye (more than meets the eye is also encouraged)

While we already cannot imagine our day without scrolling Instagram feed and slowly killing our self-esteem, the actual talent that might be hidden deep inside has no chance to get out. Even when it is not about finding hiding passion, sketching things you see develops your mindfulness skills, as you learn to notice things in an ongoing flow of events. Carrying around a small notebook and pencil can also be a valuable tool in terms of writing down some random ideas that visit your mind once in a while.

Take the creative course you always wanted

Todays web-resource is giving people everything they could possibly imagine when it comes to education and entertainment. Now, try to remember how many times you looked at the free Coursera course on design or entrepreneurship that became history eventually. Today is the day you should give your dreams another shot.

Nobody can be punished for trying something out, especially when the technology has made it so much easier. If you imagine yourself as a designer, but you cannot make a plain sketch, there is a great opportunity to embark upon the digital design. Some online platforms exist to provide you with ready templates and images (from landing page examples to simple stitches) you could use in the creation process. All you have to do is open your mind to everything that is happening around and grab a bit of inspiration.

Find another route

While this tip may sound too philosophic and deep, its main message remains literal. In order to make most of our precious time, we have our best to find the most efficient road to the office, gym, and home. Moreover, we have even established some patterns on where to stop for lunch so that the meal would not take ages to get done yet having the same taste every single day. However, what if the coffee shop around the corner has the best coffee you could possibly drink? What if the route that takes five minutes longer to commute is full of architecture and landscapes that ignite your inner self? Try them out, and let cut yourself loose once in a while.

Visualize your dreams and thoughts

Nowadays, peoples plans and dreams seem to go no further than calendar and phone notes. It leads to the conclusion that people have completely forgotten what it feels like to dream just as when they were kids. However, instead of making a scrapbook, you may create a colorful visualization board that will remind you of the reasons you wake up every morning. Some of the mood boards might be full of family pictures and memories that warm your heart better than a fireplace.

Others, however, might include your sincerest dreams, or things you have always wanted to try. For example, if you have always dreamt about taking up horseback riding, you could print out an image of any horse you like, which will serve you as a kindly reminder that life is too short to postpone small pleasures.

All the following advice notes are, of course, just a part of a big creativity journey that might enlighten your life and that of people who surround you. However, these tips are the perfect small steps towards happiness and contentment with the way things happen, as it is faulty of people to think they are powerless in the face of fate. Hence, it is up to you to decide whether you are ready for your life to take a small detour on the way.