D, and serotonin; and decreased serum cortisol (Cui et al., 2021; Mayank, 2023). Beta-endorphins are produced in the body in response to exposure to sunlight. An element of the hypothalamic–pituitary–adrenal (HPA) axis, beta-endorphins are associated with decreased levels of stress, pain, and depressive symptoms, as well as impacting sleep cycles, circadian rhythms, eating habits, and cognition. Vitamin D, activated in your body by sunlight, triggers the production of serotonin. Similarly, researchers have found an inverse relationship between levels of vitamin D and serotonin (Seo, 2022; Mayank, 2023). Research on the impact of exposure to sunlight found a positive association between mental health and exposure to sunlight in operating room nurses (Wang et al., 2023) and a negative association between exposure to sunlight, depressive symptoms, and suicidal thoughts (Komulainen et al., 2022). The American Psychiatric Association guidelines for the treatment of seasonal and nonseasonal major depressive disorder recommend light therapy as low-risk and low- cost (Guideline Development Panel for the Treatment of Depressive Disorders, 2019). Sunlight recommendations include exposure from dawn until 9 or 10 a.m. (Mayank, 2023). Early morning exposure anchors your circadian rhythm to morning, linking light to day and dark to night and producing chemical responses, including the production of melatonin, to support the circadian cycle (Mayank, 2023). Light therapy, utilizing wavelengths of light that mimic sunlight and dawn, can be used at the recommended 10,000 lux of light for 20-30 minutes within the first hour of awakening (Mayo Clinic, 2022). Light boxes should be placed 16 to 24 inches from the face, with eyes open with an indirect gaze toward the light (Mayo Clinic, 2022). Side effects may include headache, nausea, agitation, eye strain, and potential hypomania in people with a history of bipolar disorder (Terman & Terman, 1999). Yoga Yoga, a system and practice of movement, breath, and mindfulness that can be done alone or in groups, professionally or self-led, is conditionally recommended for use as part of a patient’s treatment plan for depressive Psychological Treatments The American Psychological Association’s Clinical Practice Guidelines for the Treatment of Depression in Adults (2019) recommend seven evidence-based psychotherapy interventions in addition to psychiatric medications (specifically, SSRIs, SNRIs, and NDRIs). These seven evidence-based practices in psychology (EBPP) include behavioral therapy, cognitive therapy, cognitive- behavioral therapy (CBT), interpersonal psychotherapy (IPT), mindfulness-based cognitive therapy (MBCT), psychodynamic therapy, and supportive therapy. Psychological treatments alone or with other types of treatment, like psychopharmacology, may be effective in reducing depressive symptoms (APA, 2019). Cognitive-Behavioral Therapy Cognitive-behavioral therapy (CBT) is an effective treatment for both chronic and acute depressive episodes (Gautam et al., 2020). The CBT model assumes that depressive disorders are a combination of cognition, behavior, and biochemistry. Psychopharmacology addresses the biochemical aspects of depression, whereas CBT addresses the cognitive and behavioral interplay throughout the course of depressive episodes (Gautam et al., 2020). The therapist is an essential component of CBT. Therapists should possess a number of skills and qualities in order to
symptoms. A systematic review of literature utilizing yoga as an interview for the treatment of depression examined 23 studies, concluding that yoga was an effective intervention for the reduction of depressive symptoms (Bridges & Sharma, 2017). Compared to waitlist, treatment as usual, and attention control, yoga participants showed a greater decrease in symptoms of depression. Symptoms were further reduced by increased number of yoga sessions per week (Brinsley et al., 2021). The benefits of yoga are both immediate/acute and cumulative, and people must continue to practice yoga to experience continued benefits with no known specific “dose” for maximal benefit (Scott et al., 2019). Acupuncture Acupuncture, a form of traditional Chinese medicine that uses the insertion of needles into meridian to rebalance the flow of life force, is recommended by the APA (2019) as an adjunctive treatment to antidepressant medication. As research has been marked by relatively few high- quality randomized controlled trials with sufficient power, a 2023 systematic review, performed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, found that “acupuncture either in isolation or as an adjunct to pharmacological treatment, has clinical benefits and can be considered a safe option for managing depression” (Chen et al., 2023, p. 48). Research suggests a significant correlation between the number of acupuncture treatments and a decrease in symptoms (Armour et al., 2019). Self-Assessment Question 5 Which of the following treatments, according to the American Psychological Association’s “Guideline for the Treatment of Depression,” are conditionally approved? (Select all that apply.) a. Bright light therapy b. Yoga c. Acupuncture d. Tai Chi e. Exercise Monotherapy f. St. John’s Wort Monotherapy enhance the therapeutic alliance (Cooper & Lesser, 2021). Some characteristics of an effective therapist are: • Ability to communicate warmth, genuineness, sincerity, and openness. • Ability to empathize with the client and the client’s perspective. • Ability to put aside personal biases. • Ability to make assessments and plan treatment strategies. • Ability to work collaboratively with the client’s significant others, including team members. • Ability to organize treatment plans and follow up with client progress. Therapists need to evaluate the suitability of the treatment strategies for particular clients. Young et al. (2014), Gautam et al. (2020), and Beck and Haigh (2014) identify the following specific client characteristics that may enhance the effectiveness of CBT: • Introspective and possessing the ability to reason abstractly • Well-organized, good planners, and conscientious about carrying out responsibilities • Employed • Not excessively angry • Flexible and less rigid in their thinking
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Book Code: PCIL1525
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