Kristal K Vigil,SPT- University of New Mexico
Major Depressive Disorder (MDD) is prevalent in the United States with over 30 million adults meeting the criteria at some point in their lives. MDD can also occur repeatedly in one’s lifetime. When experiencing MDD one can have cognitive deficits in different areas such as processing speed, working memory, and executive functioning. Another characteristic of MDD is negative cognitive biases which is seen as negatively processing emotional behaviors. This is a negative interpretation of information based on their bias and then not being able to utilize positive cognitive biases to combat the negative. Individuals then ruminate on these maladaptive thought processes and are unable to reappraise the situations.
Genetics have been found to play a role in the development of MDD, however, life-changing injuries can also pose as a trigger to negative cognitive biases. Signs the physical therapist should recognize are interference of normal functioning of the individual which can include work, sleep, and eating. Symptoms to be aware of are low mood, anhedonia, hopelessness, and suicidal ideations. There are screening tools that can be used in the clinic such as the Geriatric Depression Scale and the Beck Depression Inventory II.
There are medications to aid in the signs and symptoms of depression. These drugs inhibit the reuptake of serotonin, dopamine, and norepinephrine allowing for the chemicals to remain in the synaptic cleft for longer amounts of time. As physical therapists, knowing the side effects of these drugs is important for patient safety because they can cause orthostatic hypotension, fatigue, confusion, tachycardia, and sedation. In instances where there is an excessive accumulation of serotonin (serotonin syndrome), the patient can present with tachycardia, myoclonus, hyperreflexia, or tremors.
If you are in crisis having suicidal thoughts call National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or text the Crisis Text Line (text HELLO to 741741).
- Billek-Sawhney B, Wagner A, Braun J. Depression. Journal of Acute Care Physical Therapy. 2014; 5 (2): 77-88. doi: 10.1097/01.JAT.0000453142.16547.86.
- LeMoult J, Gotlib IH. Depression: A cognitive perspective. Clinical Psychology Review. 2019;69:51-66. doi:10.1016/j.cpr.2018.06.008