Pathorpharmocologic Foundations

  1. Depression

Depression is a serious and common medical illness which negatively affects how a person feels, ways of thinking and acting. Depression causes loss of interest and feelings of sadness in activities which were once enjoyed. For instance, depression leads to physical and emotional problems and reduce a person's ability in functioning at home and work. Depression has no one cause because it depends on the unique combination of individuals environmental conditions and genetic makeup. There are various factors associated with depression. First, is the brain chemistry or physical structure, family history, traumatic events, hormonal changes as well as other changes. Depression is divided into nine different types including dysthymia, psychotic, bipolar disorder, atypical, seasonal affective, postpartum despair, premenstrual dysphoric disorder, situation, and significant depression. Else, depression can be treated through combining various medical treatments and lifestyle therapies including medications, psychotherapy, alternative therapies, light therapy, exercise and avoiding alcoholic drugs.

A1. Pathophysiology of Depression

Depression, as World Health Organization describes it, refers to a mood disorder that is characterized by particular symptoms like loss of interest, lack of appetite, sadness, poor concentration, sleep disturbance, low esteem and feeling of guilt. Individuals who suffer from depression show varying degrees of hopelessness and helplessness, insomnia, inability to concentrate, loss of interest and feel of sadness which could be accompanied by thoughts of death.

The understanding of the pathophysiology of depression is very challenging because a single hypothesis cannot explain the disorder symptomatology. Pathophysiologic mechanisms include immunologic, neurogenesis, monoamine hypothesis, environmental, genetic and endocrine factors. On genetic factors, various studies and research have explored the likelihood of linking depression and genes. For instance, a British research group currently secluded a gene that seems to be prevailing in various family members having despair. The gene 3p25-26 was present in more than eight hundred relatives having recurring depression where scientist trust that forty percent of individuals having the disorder traces to a genetic link. Environmental and supplementary factors comprise the remaining sixty percent. Immunological changes during psychiatric and depression side effects caused by cytokines use in treating cancer and hepatitis provides evidence favoring the depression disorder. Additionally, an imbalance in hormones plays a significant role in despair. The probable mechanism is a defaulting in the hypothalamic-pituitary-adrenal (HPA) axis which is the system managing the body's stress response. After receiving a scary situation, the hypothalamus produces substances like CRF which stimulates the pituitary gland to produce different hormones preparing someone for a response. Moreover, environmental factors which are linked to depression vulnerability are associated with changed cerebellar resting-state synchronization. When independently considered both the cerebellar resting -state depression liability and connectivity are caused by the convergence of several environmental and genetic factors. For instance, environmental factors that may lead to depression are synthetic chemicals like preservatives/food additives, genetically modified foods, hormones/drugs, industrial byproducts as well as pesticides which bombard our bodies. The other non-chemical environmental stress sources are natural disasters, electrical or noise pollution together with other catastrophic factors. Else, events such as lasting stress at home or work, childhood abuse, coping with losing a loved one or traumatic acts are considered environmental.

The combination and linkage of the listed factors have been implicated in the depression pathogenesis rather than a unitary product. Therefore, the environmental stressors as well as heritable genetic factors which act through endocrine and immunologic responses initiates functional and structural changes in various brain regions leading to dysfunctional neurotransmission and neurogenesis then manifesting as a constellation of symptoms presenting as depression (Duman, 2014).  For instance, the Hypothalamo-Pituitary-Adrenal axis is the main neurobiological link between such factors and depression development.

Depression is considered a possibly life-threatening ailment affecting millions of people around the globe. For instance, depression occurs at any stage from youthful to late life and is an incredible cost to society because it causes severe disruption or distress and if untreated it can be deadly. For instance, the psychopathological situation comprises of symptoms with depressed or low attitude, anhedonia, and low fatigue or energy. The other symptoms like the psychomotor and sleep instabilities, low self-esteem, feeling of guilt, suicidal propensities and autonomic as well as gastrointestinal disorders are always existing. Depression is not just a homogenous sickness but rather a multifaceted phenomenon with several sub-types and likely more than one etiology. The disease includes a disposition to intermittent and often liberal mood troubles, symptomatology variances range from minor to severe signs with or lacking psychotic features and relations with other somatic and psychiatric syndromes.

A2. Standard of Practice for Depression

The standards of practice for depression should be in line with the methods aimed at preventing and curing the disease among all the affected individuals. For instance, education and training are one of the best ways in which society can best deal with depression. Physicians should ensure that they maintain the best practices to guarantee that patients adhere to proper measures and guidelines. Physicians should create and keep a healing alliance which collaborates with the victim in making decisions as well as attendance to the preferences or concerns regarding treatment. Consequently, physicians should ensure that the psychiatric assessment is complete and evaluate patient safety. The other standard practices for physicians include evaluating the patient’s safety, the establishment of appropriate treatment setting, assess functional damage and life quality together with organizing the patients care with colleague clinicians. Furthermore, monitoring of the victim’s psychiatric standing, integrating measurement into management as well as education provision to the family and patient are among the standards of practices which should be adhered to by every physician.

High care standard for depression patients ensures that victim’s benefit from reduced antidepressants increased access to psychological interventions and support through active-follow-up and structured monitoring as well as reduced risks of chronic relapsing depression. For instance, individuals suffering from depression must receive an assessment identifying symptoms severity, the scope of associated functional impairment and the episode duration.

People suffering from depression require collaborative care which refers to an innovative way of treating anxiety and depression. The practice involves various health professional who works with a patient in helping overcome their challenges. Thus, collaborative care always involves a medical doctor, psychiatrist, and case manager. For instance, the methods used in allocating patients to routine or are not free from bias and many patients do not provide information or follow-up on their outcomes. Collaborative care appears better than routine care in anxiety improvement since it increases the patients' number using the medication in line with recent guidance and improves mental health-related life quality. Hence, patients who are treated with collaborative are more satisfied.

A2a. Depression Evidence-Based Pharmacological Treatments in Florida

Depression is among the top favorite mental ailment in the United States. The latest research on despair indicates that the disease results from a combination of biotic, psychological, genetic as well as environmental factors. The risk aspects for the depression include family history, fundamental life changes like infection, strain, and trauma as well as other types of physical ailments and medications.

Depression among the Florida adolescents appears to nearly matching the national averages where 9.6% of the Floridians aged between 12-17 suffered from the disorder in 2013 (Hersen & Hasselt, 2013). A similar case is mostly correct in the Panama City Beach although less than thirty-one percent received specialized treatment for their ailment meaning that 69% of Florida adolescents lacked treatment. Therefore, such a condition probably results in abusing most of the elements in Florida because youngsters look towards self-medicating t

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