Severe Depression - the benefits of in-home treatment to manage symptoms and prevent relapse

When a low mood becomes persistent and lasts over fourteen days, it is often referred to as a depression. This grey cloud can often loom and last for many weeks, and in severe cases, months or years. Severe depression will affect a person’s ability to work, live a happy, healthy life and can devastate personal relationships. Therefore, it is imperative to seek professional medical help at the earliest opportunity.

At Brevin, we take a bespoke approach to each case of depression as every patient will display slightly different symptoms and have a particular set of circumstances that are taken into consideration when devising the personalised treatment plan.

Medication for depression

After an initial consultation with one of our doctors, medication will almost certainly be recommended for those diagnosed with severe depression and if the patient is currently using medication that they feel is not helping, prescriptions will be altered to encourage a more positive response. Selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs) can work well for cases of severe depression and tend to work best when used alongside complementary psychotherapy treatments.

Complementary therapies

Brevin’s in-home treatment service more often employed after a patient has been hospitalised for acute depression and wishes to return to their home, or potentially they have been advised to seek treatment in a hospital but feel they would be better cared for at home, not preferring an admittance to a mental health ward.

Our specialist mental health nurses have years of experience in caring for those suffering from severe depression and work alongside a dedicated team of clinicians, the patient and their family to determine the most appropriate level of care.

Many of our specialist nurses have been trained in Cognitive Behavioural Therapy (CBT) or other alternative therapies such as EDT, utilising techniques and exercises to help their patients within the home, including ‘behavioural activation’ which can be highly effective as a coping strategy when a depressive state intensifies.

Those suffering from severe depression will often need constant reassurance and positive affirmations to complete even basic tasks such as eating, drink and washing. One of our leading mental health nurses and clinical services manager, Leanne explains how beneficial consistent in-home care can be for those suffering from depression:

‘We find our patients respond best when they are cared for in a home environment by a Key Nurse. They will be the main point of contact and subsequently will develop a deep understanding of every individual’s needs, forming a trusting relationship with both the patient and their family. This relationship can then help prevent the risk of relapse by combining forces to ensure everyone is aware of potential triggers that could encourage another depressive episode’.

Treatment-resistant depression

Occasionally patients can find that their mental state does not improve even with a structured treatment plan, referred to as treatment-resistant depression. In this instance the team would work together to develop an alternative plan, perhaps utilising different medication or therapies such as electroconvulsive therapy (ECT) which has proven to be effective in very severe cases of depression.

Relapse prevention plans

An essential part of treating severe depression is developing a strategy to limit the potential risk of relapse once the condition of the patient has stabilised or seen an improvement. We use a variety of techniques to create these plans, enlisting the help of the Psychiatric Team, Key Nurse, Carers, the patient and their loved ones. The relapse prevention plan will often include the following:

  • Consistent monitoring of the patient and their mental state (e.g. weekly or twice weekly)
  • Discussion of triggers that can cause a relapse and ways to avoid and cope with them
  • A maintenance dose of medication (if needed)
  • Arranging an ongoing course of trauma therapy (if required)

We have found that patients who share their relapse prevention plan with their family and GP have a decreased chance of relapse, as those close to them will have a greater understanding of what can trigger the episode, identifying the signs at the start of the decline, which makes treatment more effective at an earlier stage.indentifying the signs at the start of the decline, which makes treatment more effective at an earlier stage.indentifying the signs at the start of the decline, which makes treatment more effective at an earlier stage.,identifying the signs at the start of the decline, which makes treatment more effective at an earlier stage.

Occasionally, a patient suffering from severe depression will need hospitalisation, and Brevin will work with empathy to support both the patient and their family through this time, as well as putting a plan in place for home support and treatment upon discharge.

If you or a loved one are suffering from depression and would like more information about how we could help you at Brevin, please contact us.

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