A nurse is discussing the various treatment approaches for Major Depressive Disorder (MDD) with a client. Which treatment modality involves stimulating the brain electrically or magnetically to induce changes in neuronal activity and neuroplasticity?

Choice A rationale:

Pharmacological interventions involve the use of medications to treat conditions like Major Depressive Disorder (MDD). This does not involve stimulating the brain electrically or magnetically. While antidepressant medications can have an impact on neuronal activity and neuroplasticity, they are not classified as brain stimulation therapies.

Choice B rationale:

This is the correct answer. Electroconvulsive therapy (ECT) is a treatment modality that involves passing an electrical current through the brain to induce a controlled seizure. This has been found to be effective in cases of severe depression where other treatments have not worked. Other somatic therapies might include repetitive transcranial magnetic stimulation (rTMS) and vagus nerve stimulation (VNS), both of which involve modulating brain activity through electrical or magnetic means.

Choice C rationale:

Psychotherapeutic interventions involve talking therapies aimed at addressing psychological and emotional issues. These therapies do not directly involve electrical or magnetic stimulation of the brain. While they can certainly lead to changes in neuronal activity and neuroplasticity, they are not the primary modalities for brain stimulation.

Choice D rationale:

Cognitive-behavioral therapy (CBT) is a specific type of psychotherapeutic intervention that focuses on changing thought patterns and behaviors. While CBT can lead to changes in brain activity and neuroplasticity, it does not involve direct brain stimulation through electrical or magnetic means like ECT or rTMS.

Choice A rationale:

Bipolar disorder involves distinct periods of both elevated mood (mania or hypomania) and depressive episodes. The scenario describes persistent feelings of sadness, guilt, worthlessness, weight loss, and insomnia, which are characteristic symptoms of major depressive disorder (MDD) but not necessarily indicative of bipolar disorder.

Choice B rationale:

An adjustment disorder is characterized by emotional or behavioral symptoms that arise within three months of experiencing a stressor (e.g., a major life change or event). The persistent feelings of sadness, guilt, worthlessness, weight loss, and insomnia described in the scenario are beyond the typical time frame for an adjustment disorder.

Choice C rationale:

The correct answer. Major depressive disorder (MDD) is characterized by persistent feelings of sadness, loss of interest or pleasure, changes in weight or appetite, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue, feelings of worthlessness or excessive guilt, difficulty concentrating, and recurrent thoughts of death or suicide. The client's symptoms align closely with the diagnostic criteria for MDD.

Choice D rationale:

A normal response to stress usually involves transient feelings of sadness or anxiety in response to a stressor. However, the client's symptoms of persistent feelings of sadness, guilt, worthlessness, weight loss, and insomnia are indicative of a more serious and prolonged condition like major depressive disorder (MDD).