Session 16 - Early detection of depressive and mixed episodes

Summary

Goal

The goal of this session is to teach patients to detect their depressive episodes as soon as possible; this is not as easy as it sounds because many of them have difficulty in detecting the first signs, especially in the case of inhibited or anergic depressions with a low cognitive load and little mental suffering. Sometimes patients do not see a doctor until they have been seriously depressed for several weeks.

Procedure

• After an informal conversation and answering the patients’ questions, we can spend the first half hour of this session going over the first assignment we gave last session to see how many patients have been able to drawing up their own Personal List of Operational Warnings and their List of Early Warning Signs, which the group and the therapist can help to improve.

• The next step can be to go round the group and list symptoms of depression on the blackboard.

• Just as we did in Session 15 (see p. 163), with the aid of the group we can cross out some symptoms that are not useful as warning signs, and explain clearly why we are doing so.

• We go round the group again to write the General List of Warning Signs.

• Finally, we try to identify three or four operational signs for each patient. In the majority of groups we have run so far, it is not too difficult to bring our patients to this point with respect to depressive episodes, and sometimes early signs have even been found.