Online tool for depression treatment.

1. Online tool for depression treatment. _______________ Julia Fedotova 3/25/2013

2. Outline _______________ • Depression (Unipolar) • Background • Characteristics • Symptoms • Popular Treatment and Relapse • The Ultimate Answer tool • Positive psychology • Functionality • Why it could be effective for depression treatment, prevention and post-treatment maintenance

3. Depression Statistics Most common psychiatric illness The World Health Organization predicts that 30% of the world population will be depressed by 2020 Depression is among top health conditions causing disability in most parts of the World # 1 condition that causes work disability in the United States of America

4. Depression Symptoms Sadness Negative affect (guilt, shame, fear) Low Self-Esteem Loss of interest in life’s pleasures Hopelessness • Not a normal reaction to life events • Prolonged • Severe • Lack of positive emotions • Reoccurring (Natural course: 85% within 10-15 years after initial episode) • Not always related to personal circumstances

5. Etiology Genetic Personality Environmental Biological/neurochemical theory: 'chemical imbalance' in the brain (particularly serotonin and norepinephrine neurotransmitter imbalance) Cognitive theory: cognitive biases and negative view of self, the world and the future are activated by stressful life events

6. Most common treatments Antidepressant Medication is #1 choice in the US About half of the patients respond Side effects High-relapse rates when medication is stopped (Most patients relapse within 1 year) Psychotherapy (EBT suggests a shift from medication psychotherapy) Medication/Psychotherapy combo Most Effective short term Therapy just as effective as over long term

7. Psychotherapy Treatment Major Psychotherapy CBT (cognitive-behavioral therapy) DYN (Psychodynamic therapy) IPT (interpersonal therapy) PST (Problem-Solving therapy) BA (Behavioral Activation) SST (Social Skill training) SUP (Nondirective Supportive Therapy) No major differences in outcomes in comparative study of all 7 type (Cuijpers, et. al., (2008). 7 meta-analyses of 53 studies/2,757 patients) IPT slightly more effective SUP slightly less effective CBT and IPT are best treatment options ( Empirically supported/laboratory settings) (Westen, et. al, 20004) Require maintenance

8. Relapse-recurrence Post CBT treatment with no continuation therapy 29% within 1 year 54% within 2 years Comparable to other psychotherapies, but lower than for pharmacology Continuation-phase CBT reduced relapse-recurrence 21% at end of the continuation treatment (12% superior to other psychotherapy treatments) 29% at 1 year follow up (Vittegal, Clark, Dunn & Jarrett, 2007, meta-analysis of 28 world published studies including 1,880 participants )

9. Based on positive psychology (Seligman) Identify resilience factors through research on failure and helplessness Build resilience skills Optimism is a key/interpretation of negative events as: Temporary Local Changeable PERMA: Building blocks of resilience Positive emotion Engagement Relationships Meaning Accomplishment Online tool

10. Want is important now? Ponder Ask or answer questions Search the database for the solutions Track results Make wish list Keep a journal See your graphs 3 Take survey 2 1 4 5 6 7 8 impotancece(x,y,z)*weight_type(x,y,z)* SUM(importansatisfaction(x,y,z))=

11. Why it can be effective Similarity to IPT and other effective treatments. Focuses on present and intends to bring life changes It helps to identify areas that require the most attention Allows to pursue strategies specific to the identified problem areas Helps anticipate interpersonal triggers for depressive symptoms Journal/Track changes over time and see patterns Self-reported/Subjective Well Being Empirical Evidence for positive psychology interventions use strength in new way & gratitude online exercises (Seligman, 2005).

12. Why it can be effective May help to interpret events as local 20 categories May help to interpret events as temporary Tracking over time Journal Learning about people experiences through searching for answers May help to interpret events as changeable Tracking over time Journal Learning about people experiences through searching for answers

13. Why it can be effective • May lead to positive emotion • Realization how well one is doing in all other areas of life • Realization may lead to gratitude and the gratitude exercise showed the largest positive changes in Seligman’s study. • Sharing emotions and feelings with others • By helping other people who are going through the same issues • Writing about experiences and emotions • Journal/questions • Wish list • Not alone in their suffering • Empathy from people who give advice

14. Advantages Free Online! Available real-time, any time Maintenance therapy is not frequent (every other week, monthly) Can ask a questions or get support from others when need it. (compare to by-monthly) IPT an CBT are time-limited Don’t have to be diagnosed with depression Anonymous Shame Men are less likely to seek treatment No stigma

15. Advantages Available to everyone Variety of conditions differ in severity and time course DSM-IV categories not empirically supported and controversial. (Westen, et. al., 2004). Preventions Adequate treatment is not available to everyone Therapist practice what they are trained to do and not necessarily the empirically supported types of therapies (Westen et al.,2004) NO everyone responds to conventional treatment Insurance might not be available for maintenance treatments Other treatments might not be affordable

16. The Message Marketing campaign Mobile enabled Future Directions • The Ultimate Answer on-line tool can be an effective solution for depression treatment as well as prevention and post-treatment maintenance.

17. Q&A • What would make you to use on-line tool? • Who would you rather get answers from? • People who experienced similar issues or moods in the past • Professional psychologist? • Psychiatrist? • Anyone who is available to share or give an advice? • Questions We would love to hear your feedback! ultimate_answer TheUltimateAnswer Thank you! www.TheUltimateAnswer.org

18. References Butcher J.N., Munika, S., Hooley, J.M (2009). Abnormal Psychology(14th Ed.).Boston: Pearson Education, Inc. Cuijpers, P., van Straten A., Andersson, G., Oppen, P.(2008). Journal of Consulting and Clinical Psychology. Psychotherapy for Depression in Adults: A Meta-Analysis of Comparative Outcome Studies. 6 (76), p. 909-922 Hollon, D., Thase, M.,, Markiwitz, J. (2002) Treatment and Prevention of Depression. Psychological Science in the public interest 3(2), p. 42 – 77. Lyubomirsky, S. (2007). The how of happiness: A new approach to getting the life you want. New York: Penguin Press. Pennebaker J. W. Writing About Emotional Experince. (1997) Psychological Science, 8(3), p. 162-166. Tan S. (2006). Journal of Psychology and Christianity, Vol. 25(1), p. 68-73. Applied Positive Psychology: Putting Positive Psychology into Practice Seligman, M. E. P., Steen, T. A., Park, N., & Peterson, C. (2005). Positive psychology progress: Empirical validationof interventions. American Psychoiogist, 60,410-421. Vittengl, J., Jarrett, R., Clark, L. (2009). Continuation-Phase Cognitive Therapy’s Effect on Remission and Recovery. Journal of Consulting and Clinical Psychology, 77(2), 367 – 371. Wada, K., Sasaki, T., Jitsuiki, H., Yoshimura, Y., Erabi, H., Hada, Y., Yamashita, M. (2006).Manic/Hypomanic Switch During Acute Antidepressant Treatment for Unipolar Depression Journal of Clinical Psychopharmacology. 26 (5), 512-515 Westen D., Novotny, C., Thompson-Brenner, H. (2004). The Empirical Status of Empirically Supported Psychotherapies: Assumptions, Findings, and Reporting in Controlled Clinical Trials.