RELATIVE EFFICACY OF COGNITIVE BEHAVIOURAL THERAPY & HOMOEOPATHIC MEDICINES

1. RELATIVE EFFICACY OF COGNITIVE BEHAVIOURAL THERAPY & HOMOEOPATHIC MEDICINES ON DEPRESSIVE PATIENTS Dr. Girija Shankar Shukla MD, PhD Professor & Associate Dean, Faculty of Health Sciences Sam Higginbottom Institute of Agriculture, Technology & Sciences, Allahabad (INDIA) Email: girija.shukla@shiats.edu.in

3. Depression? • Depression is an illness that affects our thoughts, feelings, behavior and overall health. • One feels sad or down for long periods of time • It can even have physical affects on one’s body

4. “A depressed person can feel hopeless, helpless and worst of all alone” (Ayer, 1997) • People suffering from depression always feel they’ve done something wrong when things go bad • Many times people with depression become irritable and upset at small things

5. Who Gets Depressed • Mental health professionals used to believe that depression was an adult’s disorder. • In fact depression can affect anyone from infants to teens to adults even older.

6. Hopelessness Increased irritability, anger, or hostility Low self esteem Withdrawal Loss of appetite or constant hunger Alcohol or drug abuse Self injury Discussion or thoughts of suicide Feelings of guilt Inability to concentrate Difficulty with relationships Symptoms of depression

7. Common Types of Depression • Major Depression • Dysthymia • Bipolar Disorder • Seasonal Affective Disorder (SAD)

8. Major Depression • Begin suddenly, possibly triggered by a loss, crisis or change • Interfere with normal functioning • Continue for months or years • It is possible for a person to have only one episode of major depression. It is more common for episodes to be long lasting or to occur several times during a person’s life

9. Dysthymia • People with this illness are mildly depressed for years. They function fairly well on a daily basis but their relationships suffer over time.

10. Bipolar Disorder • People with this type of illness change back and forth between periods of depression and periods of mania (an extreme high). • Symptoms of mania may include: • Less need for sleep • Overconfidence • Racing thoughts • Reckless behavior • Increased energy • Mood changes are usually gradual, but can be sudden

11. Season Affective Disorder • This is a depression that results from changes in the season. Most cases begin in the fall or winter, or when there is a decrease in sunlight.

12. Causes of Depression • There is not one single cause of depression, it is usually a combination of things. • Stress is however the leading cause of depression. • Other things such as genetics, traumatic events, low self esteem, stress and physical illness can also contribute to depression.

13. 10-25 percent of women and 5-12 percent of men will likely become depressed in their life One of eight women will develop depression but only one in three women will seek care 15 percent of those with severe depression will commit suicide 70 percent of antidepressant prescriptions are given with misdiagnosis Major depression occurs most often in the mid to late 20’s Depression occurs most frequently in women 25-44 years of age. (Statistics, 2003-2007) Depression Statistics

14. Cognitive Behavioural Therapy(CBT) • Cognitive Behavioural Therapy(CBT) is a psychological treatment that addresses the interactions between how we think, feel and behave. CBT is a process of teaching, coaching, and reinforcing positive behaviours. CBT helps people to identify cognitive patterns or thoughts and emotions that are linked with behaviours..Evidence now supports the effectiveness of CBT for many common mental disorders. For some disorders, carefully designed research has led international expert consensus panels to identify CBT as the current “treatment of choice”.

15. Characteristics of Cognitive-Behavioral Therapy: • Thoughts cause Feelings and Behaviors. • Brief and Time-Limited. • Emphasis placed on current behavior. • CBT is a collaborative effort between the therapist and the client. • Client role - define goals, express concerns, learn & implement learning • Therapist role - help client define goals, listen, teach, encourage.

16. Based on "rational thought." - Fact not assumptions. • CBT is structured and directive. Based on notion that maladaptive behaviors are the result of skill deficits. • Based on assumption that most emotional and behavioral reactions are learned.  Therefore, the goal of therapy is to help clients unlearn their unwanted reactions and to learn a new way of reacting. • Homework is a central feature of CBT.

17. Methodology • Total Sample Size- 208 • Pre Test & Post Test Groups- 4 (G1, G2, G3, G4) • G1- Only Homoeopathic Medicines • G2- Only CBT • G3- Combined Regimen Therapy • G4- Placebo Therapy

18. Methodology (Contd.) • Case Taking of Patients • Determination of Type of Therapy • Follow Up of Patients & Assessment of Progress • Use of Different Instruments • Organizing Sessions for CBT.

19. Sex wise distribution of respondents

20. Family size wise distribution of the respondents

21. Family type wise distribution of the respondents

22. Locality wise distribution of the respondents

23. Financial status of respondents

24. Occurrence of depression on the basis of aetiological incidence

25. Homoeopathic Medicines Used

26. Scores of Pre & Post Test Groups

27. Homoeopathic Medicines on Depression in different age groups

28. Response of CBT on Depression in different age groups

29. Response of Combined Regimen Therapy on Depression in different age groups

30. Response of PLACEBO therapy on Depression in different age groups

31. Response of over all treatment on Depression in different age groups

32. Conclusion • Combined therapy regimen of Homoeopathic Medicines and CBT works very effectively and provides wonderful relief to the patients. • Placebo Therapy is very effective for those patients who are suffering from mild psychosomatic disorders and have vague complaints.

33. Conclusion (Contd.) • Mental symptoms in Homoeopathy have incredible value. Any prescribing is made keeping the mental symptoms of patient in central attention. Hence they are very effective in treating psychological disorders. They bring dramatic changes in the thoughts of patient by de-rooting the culprit from the body.

34. Conclusion (Contd.) • CBT was found as psycho educational form of psychotherapy. Its purpose is for patients to learn new skills of self-management that they will then put into practice in everyday life. It adopts a collaborative stance that encourages them towards optimistic attitude.

35. Recommendation • Following points are very important to live a healthy and cheerful life free from depression: • Healthylife style leads to lesser amount of depression. • Development of supportive relationship. • Practicing regular physical exercises, meditation, relaxation techniques and having sound sleep are components of training in CBT.

36. Nutritious diet boosts mood naturally. • Proper time management and coping with stress is required.

37. Recommendation (Contd.) • Balancing emotions and remaining optimistic. • Seeking professional support, when ever any negative thoughts are disturbing frequently. • Life skill training is important for not losing psychological balance in adversity also as ups and downs are part of the life. • Setting the goals as per your capacity. • As for as possible following the system of extended family is beneficial.

38. In built shock absorbers are to be developed within family support system. • frequency of family and professional get- together are to be increased. • Counseling for the management of depression is to be made part of medical training as behavioral medicine procedure.

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