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Depression Can Now Be Treated Without Medication

Acceptance and commitment therapy is a form of Cognitive behavioural therapy which primarily focuses on mindful suppressing, managing, and controlling of emotional experiences people go through due to chronic pain.

Depression Can Now Be Treated Without Medication

There is a strong link between chronic pain and major depression.

HIGHLIGHTS

  1. ACT is based on mindfulness acceptance & diffusion of negative thoughts.
  2. It helps people with chronic pain in a rheumatology context.
  3. Self efficacy reflects a person's belief to self manage their condition.
Many people around the world feel anxious or depressed at times. Chronic pain due to prolonged illness, losing a loved one, getting fired from a job, going through a divorce, and other traumatic events in one's life can lead a person to feel sad, lonely, scared, nervous, or anxious. These feelings are normal reactions to life's stressors. But some experience these feelings daily for no apparent reason, making it difficult to carry on with normal, everyday functioning. These people may have an anxiety disorder, depression, or both.

It is not uncommon for someone with an anxiety disorder to also suffer from depression or vice versa. Nearly one-half of those diagnosed with depression are also diagnosed with an anxiety disorder. About one in 21 people (4.7 percent) of people suffer from major depression at any point in time and anxiety is the most common of all mental disorder and currently affects about one in 13 people (7.3 percent) out of which 65% of the people suffer from chronic pain.
Also read: Depression Can Increase Risk Of Heart Disease

Researchers in the field of psychology believe that Acceptance and commitment therapy is form of cognitive behavioural therapy which is based on mindfulness therapy theorising that greater well-being can be attained by overcoming negative thoughts and feelings. ACT focuses on behaviour change consistent with patients' core values rather than targeting symptom reduction alone.
It primarily focuses on 3 areas:

1. Acceptance- Whether it be a situation you cannot control, a personality trait that is hard to change or an emotion that overwhelms, accepting Letting feelings or thoughts happen without the impulse to act on them will allow you to move forward.


2. Choose a valued direction

3. Take action

Its important to observe your irrational behaviour and sensations and cognitively defuse these psychologically heightened experiences. This process provides a significant reduction in self-reported depression and anxiety among patients whore also suffering from prolonged illness characterized by chronic pain.

Lead author Dr. Noirin Nealon Lennox from Ulster University in Northern Ireland said that to further validate the role of ACT in the treatment of chronic pain, specifically in a rheumatology context, a randomised controlled clinical trial that includes measures of physical and social functioning within a Rheumatology service would be desirable.

To assess the potential benefits of an eight-week programme of Acceptance and Commitment Therapy (ACT) in people with persistent pain, measures for pain acceptance- a situation which uncontrollable and activity engagement to lessen the pain, were taken using the Chronic Pain Acceptance Questionnaire. Hospital Anxiety, depression Scale and self-efficacy were used as measures of psychological distress , taken at the time of assessment, on the final day of the programme, and at the follow up six-month review. Self-efficacy is an important concept as it reflects the belief by an individual that they can effectively self-manage their condition.

For those chronic pain patients with scores at all three time points, there were statistically significant improvements in all parameters between baseline and at six-months follow-up, including the change in mean score of depression, anxiety, self-efficacy, activity engagement and pain willingness.

In this study, patients were referred into the ACT programme by three consultant rheumatologists over a five-year period. Over one hundred patients' outcome measures were available for a retrospective analysis.

A previous systematic review had concluded that ACT is efficacious for enhancing physical function and decreasing distress among adults with chronic pain attending a pain rehabilitation program. It uses a wide range of experiential exercises to undermine the power of destructive cognitive, emotive, and behavioural processes. It helps clients to fundamentally change their relationship with painful thoughts and feelings, to develop a transcendent sense of self, to live in the present, and to take action, guided by their deepest values, to create a rich and meaningful life.

This study was presented at the Annual European Congress of Rheumatology (EULAR) 2017.

(With Inputs from ANI)

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