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Ocd action depression-and-ocd

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Ocd action depression-and-ocd

  1. 1. Depression and OCD Dr Costas Papageorgiou Consultant Clinical Psychologist OCD Treatment Programme Priory Hospital Altrincham www.costaspapageorgiou.com
  2. 2. Overview of Presentation • • • • • Impact of OCD on life and functioning Overlap between OCD and depression Diagnostic criteria for depression Assessment of OCD and depression Treatment of OCD and depression - Behavioural activation - Cognitive therapy - Metacognitive therapy - Anti-depressant medication
  3. 3. The Impact of OCD • OCD can affect people’s quality of life and their daily functioning • The impact of OCD can lead to many people also experiencing sadness, symptoms of depression or clinical depression • Differences and similarities between sadness, symptoms of depression and clinical depression
  4. 4. Exercise 1 • To what extent has OCD impaired… - Your ability to work or study? - Your home management skills? - Your ability to enjoy social leisure? - Your ability to enjoy private leisure? - Your general relationships? - Your sexual relationship? • What impact has OCD had on your life and mood?
  5. 5. Overlap between OCD and Depression • OCD often co-exists with other problems • The most common additional problem with OCD is depression • About one-third of individuals with OCD suffer from depression • 11% of individuals with depression develop OCD
  6. 6. What is Clinical Depression? • Depressed mood • Loss of interest or pleasure in nearly all activities • Changes in appetite • Sleep problems • Change in psychomotor activity
  7. 7. What is Clinical Depression? • Decreased energy, tiredness and fatigue • Sense of worthlessness or guilt • Difficulties concentrating or making decisions • Thoughts of death or suicide
  8. 8. Exercise 2 • Given the list of symptoms of depression, can you get an idea of whether or not you or someone you care about is suffering from depression? • What steps have you considered in seeking help?
  9. 9. Overlap between OCD and Depression • Depression nearly always starts after OCD, which suggests that it is the result of having OCD • Depression can often lead to hopelessness as well as pessimism about recovering, which can affect people’s ability and efforts to overcome OCD • Depression can make OCD last longer, seemingly “confirming” people’s fear that OCD will never disappear
  10. 10. Dealing with OCD and Depression • Addressing problems of OCD with co-existing depression can be challenging but is necessary • When OCD co-exists with depression, it is vital to be able to provide comprehensive assessments of the problems together with integrated or combined treatments
  11. 11. Assessment of OCD and Depression • Key goals are to determine if there are any coexisting problems such as depression • To be able to formally assess the severity of depression including suicide risk • Assess person’s living situation and supports from family and significant others that could be used in treatment
  12. 12. Treatment of OCD and Depression • For treatment of OCD with depression to be effective, three forms of care must be offered: (1) Parallel care: Give equal consideration to the co-existing problem (2) Sequential care: Prioritise all care issues so do not wait for OCD problems to improve to see if depression lifts (3) Integrated care: Allow all team members to participate in the care of the individual
  13. 13. Treatment of OCD and Depression • CBT - Behavioural activation: - Changing behaviour - Monitoring daily activity - Avoidance vs. activities - Scheduling daily activities - Reduce inertia and activities - ACTION is needed
  14. 14. Treatment of OCD and Depression • ACTION stands for: - Assess if avoidance is present - Choose to avoid and be depressed or to do a different activity - Try the activity chosen - Integrate new behaviours into a routine - Observe the results - Never give up
  15. 15. Treatment of OCD and Depression • CBT - Cognitive Therapy: - Learning that thinking leads to emotions - Negative thoughts contribute to low mood - Identifying negative thoughts is a starting point - Recognising thinking errors in negative thoughts - Seeing thinking corrections in negative thoughts - Challenging and testing negative thoughts
  16. 16. Treatment of OCD and Depression • Metacognitive therapy for depressive rumination (Adrian Wells and Costas Papageorgiou, 2004): - Recognising and identifying rumination - Using similar strategies for dealing with OCD intrusions and ruminations - Learning that rumination is not uncontrollable - Leaning to stop the factors that start and keep rumination going
  17. 17. Treatment of OCD and Depression • Anti-depressant medication: - Consider for moderate to severe depression - Selective Serotonin Reuptake Inhibitors (SSRIs) - Most sides effects resolve within days - Improvements are usually within 4-6 weeks - Anti-depressants also help to carry out some of the tasks involved in treatment for OCD
  18. 18. Discussion • Questions • Case studies • Advice and recommendations • There really is a light at the end of the tunnel, but it is not a train coming towards you!

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