Discussion #3

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 Describe the differences between reactive and biological depressions. Reactive depression occurs in response to a stressor or problem in an individual’s life. In some cases, these stressors or problems may not be negative, but even positive life changes can be a stressor to cause an individual to experience reactive depression. Some of these positive situations could include moving away for college, getting pregnant, or coming back home after being deployed; while negative situations could include losing a job, going through a breakup, or being diagnosed with a life altering medical issue. Biological depression occurs when there is no reaction to stress, but at times can occur spontaneously, when an individual has little to no stress in their lives (Preston et al., 2021). In many cases biological depression can be traced back to conditions that alter an individual’s neurotransmitter, receptor, or gene function in areas of the limbic system (Preston et al., 2021).  What happens when the two types of depressions overlap? When the two types of depressions overlap the number of cases for clinical depression becomes more significant. When presented to the clinician in the initial intake many individuals may present as having reactive depression, but as time goes on with individuals there are more psychological symptoms that appear. This psychological stress can impact an individual’s brain functioning in a negative way which can in turn lead the clinician to find the individual has biological depression.  How do you distinguish between atypical depressions and the other types? Atypical depression is found in individuals who have been diagnosed with bipolar disorder. The way you are able to distinguish atypical depression with other types is atypical depression is a subgroup of major depressions, so as a clinician we have to take a look at what symptoms the individual is experiencing and look at the other major depressive disorders to properly support the individual’s diagnosis. Atypical depression has many different symptoms, but many are brought on by a particular event which could include increased eating, elevated sensitivity and low energy or a boost in energy depending on the situation.  What treatments work for these different categories of depression. The treatment work for these different categories of depression are antidepressants. The effectiveness of using antidepressants for treating reactive, biological, the overlap of reactive/biological, and atypical depressions is as high as 80 percent (Preston et al., 2021). There are many ways to start with treatment plans for individuals who fall into each of these different categories. First could be a combination of psychotherapy and medication while antidepressants alone can help aid in an individual’s recovery of depression. A second approach with an individual who is diagnosed with atypical depression could be the use of Monoamine Oxidase Inhibitors (MAOIs) or bupropion, while Serotonin Reptake Inhibitors (SSRIs) could help aid in an individual who may be

diagnosed with a different type of depression because this antidepressant’s side effects are minimal. I believe this is a situation that is case by case and individual by individual. Continuing to utilize psychotherapy is very important to the success of each individual as it is important to see how the antidepressant is working within the individual who is prescribed. It is important to figure out each case and what the plan of action would be for that specific individual.  How would working with clients with mood disorders impact your approach or treatment? I believe working with a client who has a mood disorder has to be intentional approach and the client cannot be placed in a box of diagnosis. Being intentional, like I would be with all clients is the first step in my approach for treatment, but being more open minded to antidepressants would be a change I would make. Yes, I would still include psychotherapy with my treatment plan alongside the antidepressants, but I would screen each individual of any disorders that can alter their psychological makeup. Focusing on the client and their treatment plan will help me distinguish how I would approach them. I would figure out their needs and where they currently are and then take the steps to use medication, psychotherapy, and in-patient therapy which all can either be short-term or long-term depending on the client.  How would you know when they might need a referral to a prescriber? There are many different signs that might need a referral to a prescriber. These include impaired thought process or judgement, grief with transitions to clinical depression, the presence of mania, long-term presence of dysthymic symptoms, depressive or mixed mood, inappropriate behavior, major depression with atypical symptoms or vegetative state, significant impairment of daily functioning, suicidal impulses or psychotic symptoms and lack of response to psychotherapy (Preston et al., 2021). Each of these signs can and will be seen which then can be a referral, but making sure I have the individual’s best interest at heart to make the referral will be of the utmost importance.  What lingering question(s) do you have about applying this content in clinical or consulting practice? What would be the first step you would take in diagnosing someone with a mood disorder? After diagnosis, how long do you believe it would take for you to make a referral to a prescriber? Do you feel you need to diagnose someone with a mood disorder before making a referral to a prescriber? Reference Preston, J., O’Neal, J., Talaga, M., & Moore, B. (2021). Handbook of Clinical Psychopharmacology for Therapists. (9 th ed). New Harbinger Publications. Oakland, CA.

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