Depression As One of the Major Causes of Psychosis: Analytical Essay

The main focus of the assignment is a client (Mr. X, a family member) I have come across who suffers from mental health issues, to be precise depression and psychosis; depression is one of the major causes of psychosis. Main focus of the assignment is on depression, firstly the essay focuses about the illness itself and then about the individual’s concerns as well as looking at the different theories of communications from different psychological perspectives and to finish off with will critically analyze the power imbalances, disadvantages as well as the inequalities the client group faces in the community.

Depression and psychosis worries the lives of several different people; it comes across in many different forms and according to studies it’s been around for many centuries (Cooper and Anderson, 2017). Around 2 thousand years before Greek doctor and researcher Hippocrates branded the disorder melancholia, within the Greek community there was a belief that “psychosis stimulates of the body humour, particularly dark bile” (Vagos and Pereira, 2018). Initial studies of depression and psychosis can be seen in different texts of the bible, it is detailed clearly in the bible regarding King Solomon believed to have suffered from evil spirits and low mood swings which eventually caused him to commit suicide, which can be referred to nowadays as psychosis (Sturman, 2019). More recent literature and studies show many of the politicians, artists, poets, and writers such as Winston Churchill, Abraham Lincoln, Thomas Mann, and many more suffered from depression and psychosis, proving once again its been around of many years (Sturman, 2019). There are also studies looking into animal moods and depression, as researchers believe depression doesn’t just exit in human beings (McEwan, Gilbert, and Duarte, 2011).

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The kinds of individuals who grieve from depression and psychosis differ and it shouldn’t be categorized to the look of an individual confined inside a mental hospital astounding backward and forwards (Psychosis: Psychological, Social and Integrative Approaches, 2012). From a High court Judge to a homeless person on the street are all different individuals who are vulnerable to depression Beck 1994 titles that 1 in 4 individuals suffers from depression sometime in their lifetime (Depression, 2011). Depression and psychosis can differ depending on the severity of individual’s symptoms, its period, and its regularity; henceforth persons can alter as to whether the condition of depression and psychosis being mild, moderate, or severe (Weeks, Heimberg and Heuer, 2011. Psychosis is also seen as a contributing factor to many other conditions such as social anxiety, eating disorders, substance abuse, and schizophrenia (VLACHANTONI, 2017). Some individuals will recover rapidly from depression and most individuals will show some recovery within the first six months, but minority of 20% of cases may suffer from a chronic course; which is a person who can have many symptoms of the disorder at various level of severity for at least two years or more (Depression, 2011). 50% of individuals who are diagnosed will revert back, regardless of treatments, although it showing counseling reduces this rate significantly (VLACHANTONI, 2017)

There are different ways to diagnose and assess depression and depression can be put into different categories. Excellent communication skills are vital when building the judgment of psychosis as the illness frequently clutches a lot of stigma and individuals are frequently unwilling to disclose the gravity of their symptoms (Trepka et al., 2014). It is important to make sure when communicating with individuals who suffer from this illness; the information that’s been communicated has been understood by the client (Weeks, Heimberg, and Heuer, 2011). In many situations, it is seen that professionals use medical terminologies, jargon, and words, often forgetting the fact the person they are making communication to may not understand these terminologies (Trepka et al., 2014). While being a carer for someone suffering from this illness with in my family over the period of time, there are times when the depression made the person feel very bad and lonely, where they felt extremely low in mood and having feeling of being unworthy. I can recall escorting my family member to their doctor, how the doctor concluded the individual is suffering from bio polar disease therefore the doctor altered the individuals medications, after leaving the surgery I can recall my the individual being even more depressed than how they originally entered, feeling more useless this could have been eliminated more easily if the doctor could have explained more about the situation and communicated more effectively.

When Mr. X, went to meet his psychiatrist, the room looked more like a head teacher’s office, the room itself was small and white, there was a big office desk and a chair behind it, the room was quiet blank as there was no pictures on the wall, the only decoration Mr. X could recall was the paper works and pile of other paper on the doctors' desk. While waiting to be seen, Mr. X was waiting for 20 odd minutes over his appointment time before he was seen to, as on meting there was no apology mentioned as this made the individual worse as he felt that he wasn’t worthy and important enough to be seen on time. The combination of feeling unimportant and the illness itself made him feel even more low in mood, when he was entering the room he felt disempowered. As Mr. X walked in to the room he noticed the degree certificate hanging on the wall and the Dr sitting perfectly in his suit, where as Mr. X was sitting in a corner wearing some clothes he managed to get out of the wardrobe, which was ironed or had some stains on.

Referring to the Oxford English Dictionary symbolic means, 'expressed, denoted or conveyed by a symbol'. Symbolic communication, consequently, contains behavior, actions or communications, which signify or represent something else (Weeks, Heimberg, and Heuer, 2011). As professionals it is important to be aware of the symbolic communication and signals we giving off to our clients through keeping up with the time, the layout of the room, our dress code therefore it is important to maintain these as these speak to our clients symbolically which can be interpreted literally by our clients (Depression, 2011). The first initial contact a client might have when they arrive for their appointment will be the receptionist, therefore they play an important role, if an individual is ignored at the desk while the person sitting on the other side is busy on the phone or talking to colleague, this automatically creates an impression to the clients they are not important (Kennedy, 2015). It transports an absence of respect and acknowledgment of a person he is an individual (D'Ardenne and Mahtani 2010). It is also suggested by the same author that the shame and stigma of being ignored or being treated rudely can set an image of not devaluing respect and lack of worthiness.

According to (Kennedy, 2015) waiting rooms all vary in size, space, seating, the way you are welcomed as an individual, these all matter to individuals, if the waiting room had peeling walls, dirt, bad odour of urine, broken furniture, this would automatically create an image in the individuals mid as they are only as worthy as layout of the room is. With comparison to this the clinical examination room that the psychiatrist saw Mr. X in was an ideal image of symbolic communication at its worst.

Breakwell and Rowett (2009) argued that the interview room is the professional and not the client's place, therefore the individuals arriving at a professional's room is expected to respect the territorial rules for example not moving the chairs or sitting on the desk, etc. then the author moved on discussing how symbolic of power and control territory is. Lisman and Lishman (2009) agree and then further argue with this then conclude that the even though the interview room is not the client's territory, therefore they generally respect the symbols of authority and the professionals should be aware of this and should have an understanding of symbols and ideals this will represent in terms of authority and control. In this scenario, the way the psychiatrist sat behind the desk, didn’t not convey the right message, as the client felt that he wasn’t interested, this created a distance emotionally and physically between the two. It was mentioned by Mr. X he wold have felt more confortable if the desk wasn’t there, according to D'Ardenne and Mahtani (2010) the physical space and territory between professionals and clients has an effect of the bond which is created between the two. They also mentioned that the having pictures and photographs on walls will make the clients more welcoming, especially those who are from different ethical backgrounds.

It was also mentioned by Mr. X, he felt uncomfortable and scared as he saw the psychiatrist sitting in the office with a suit, where as he was just wearing his scruffy clothes, it was suggested by Rees and Wallace (2015), if the psychiatrist wore just a shirt and trousers (dressed formally) would have made the client feel more comfortable, the power imbalance would not have been such a different and the symbolic communication him putting forward would have increased positively.

Keeping up with time is the next issue of symbolic communication, which aroused in Mr‘s case. According to Mr. X, he was left waiting for more then 20 minutes without any communication, which was very daunting for him as he felt his time and himself didn’t seem to be any important to anyone. According to Rees and Wallace (2015) “Unreliability symbolizes to many individuals as a lack of concerns to them”. This therefore could bring back their unpleasant memories from past, especially relating it to people in their own life. As professionals, it is important for us to understand the importance of timekeeping and the image this could portray to others when we are late or not organized.

Symbolic communication is essential and vital, but as professionals, we should be aware of our non verbal communications. Psychologists for many years now have been researching regarding Non-verbal communications and professions. Lambert, Glacken and McCarron, (2010) suggested that verbal communication is all about the information that’s been spoken and given whereas non verbal communication works like the music being the words, in this case, it communicated the professional's true feeling towards the clients. Edwards (2015) lead a study and stated that non-verbal communication had more impact on an individual than the certain verbal and if it comes to the point where verbal and the non-verbal communication were in clash the verbal tended to be overlooked by the clients. Even though non verbal communication is important it can create trouble as it is open to misinterpretation. An individual swinging his or her foot according to Edwards (2010) can be interpreted as rage, irritation, boredom and energy. Edward then moves on talking about the awareness we should have about the uncertainties of non-verbal communication and proposes that, it is the uncommon behaviour of clients and professionals that portrays the most significance.

Lishman and Lishman (2009) elaborate non-verbal communications into two categories, proxemics and kinesics. Proxemics is concerned about the personal space of an individual and kinesics refers to the movements, eye contact, and gestures. Proxemics is different in each individuals, it mainly depends on an individuals age, gender, race, class etc. There are countless cross-cultural differences in how close person’s like to be to each other, and women prefers closer physical distances than men do. The study went further on discussing that the distance an individuals keeps differs from person to person, it is the individuals choice, however, in this scenarios, the psychiatrist sitting behind the desk portrayed a negative image of intimidation and confrontation, if Mr X and the psychiatrist was sitting next to each other in a slight angle the power imbalance would have been positive.

Whilst Mr X was talking to the psychiatrist, the psychiatrist never involved in conversation with him. Good practice would always emphasis that it is vital for investigative and reflection to happen all the time while working with mentally ill patients (Lambert, Glacken and McCarron, 2010). It is important to ask open-ended questions, as Mr. X was asked direct questions where he was only able to answer yes or no answers. Leaving rooms to get notes and other things interrupts effective communication and empathy was not shown to client any time at all. The use of medical terminologies also intimidated the client and extended the power imbalance between the two even further. At this point Mr X didn’t know what he was going through, to Mr X, he could have been talking about almost anything other than what he was having.

For any professional to positively work and keep good communication skills with individuals who have mental health issues, the professionals need to totally recognize what an individual who is experiencing depression/psychosis is feeling (Baldwin and Hirschfeld, 2015). Service users suffering from depression can frequently look aggressive or very inactive; they often have motivational problems such as indifference and loss of interest in their everyday life (Baldwin and Hirschfeld, 2015). They could be feeling empty, anxious, shame or guilt, their intelligence or cognitive skills may not be compromised instead they might have poor concentration and negative ideas about the surroundings, self and the way they look at their future (Baldwin and Hirschfeld, 2015).

Some biological side effects of depression are insomnia, loss of appetite, changes in hormones etc, when looking into these side effects and the duration it affects an individual; it will be easy to conclude most people have suffered with depression at some point in their life (Cooper and Anderson, 2017). When working with individuals who suffers with depression it is important to keep that in mind, therefore keep in mind the personal space we should have between the client and the professional, sometimes all it takes is a hug to help the individual feel better, sometimes breaking the barrier of professionalism can help them more (Psychosis: Psychological, Social and Integrative Approaches, 2012). To conclude this assignment concerning effective communication and depression, the scenario my family member experienced effective communication plays a huge rule when dealing with patients who suffer from depression. An individual’s communications cannot be taught or can be read in a book, it takes a practical experience and needs to get feedback and do reflective practice on this; analyze your own skills.

Reference

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