(Select All That Apply): A nurse is educating a client about the psychosocial factors that can influence or be influenced by depression. Which of the following factors are associated with depression and its effects on cognitive processes? Select all that apply.

Choice A rationale:

Electroconvulsive therapy (ECT) and other somatic therapies are considered main treatment options for Major Depressive Disorder (MDD). ECT involves passing electric currents through the brain to induce controlled seizures, and it's often used in severe cases of depression that haven't responded to other treatments. Somatic therapies encompass a range of interventions that directly target the body, such as transcranial magnetic stimulation (TMS) and vagus nerve stimulation (VNS). These treatments are supported by extensive research and clinical evidence, particularly for cases where pharmacological interventions haven't been effective or suitable.

Choice B rationale:

Pharmacological interventions are indeed a mainstay in MDD treatment. However, while they are effective for many individuals, they might not work for everyone and can have side effects. Hence, the treatment approach should be tailored to the individual's needs and preferences.

Choice C rationale:

Herbal supplements are not considered main treatment options for MDD according to established clinical guidelines. While some herbal supplements might have anecdotal support for mood enhancement, their efficacy and safety are not well-established through rigorous scientific research and clinical trials.

Choice D rationale:

Physical exercise has been shown to have a positive impact on mood and can be a beneficial adjunct to MDD treatment. However, it's typically not considered a standalone main treatment option. Rather, it's often recommended as a complementary approach alongside other evidence-based treatments.

Choice E rationale:

Mindfulness-based cognitive therapy (MBCT) is a psychological approach that combines mindfulness meditation with cognitive behavioral techniques. While MBCT has shown promise in preventing relapse for individuals with recurrent depression, it's usually used as a psychotherapeutic adjunct to other main treatments like pharmacological interventions or psychotherapy.

Choice A rationale:

Genetic theory suggests that a person's genetic makeup can predispose them to develop depression, but it does not specifically address the role of neurotransmitters in depression. While genetics can contribute to the risk of major depressive disorder (MDD), this choice doesn't focus on the neurotransmitter imbalances.

Choice B rationale:

Neuroendocrine theory pertains to the role of hormones in depression, particularly abnormalities in the hypothalamic-pituitary-adrenal (HPA) axis. While hormones play a role in mood regulation, this theory does not primarily revolve around neurotransmitter imbalances.

Choice C rationale:

Neurotransmitter theory proposes that an imbalance of neurotransmitters, such as serotonin, norepinephrine, and dopamine, contributes to the development of major depressive disorder. This theory aligns with the idea that these neurotransmitters are responsible for regulating mood, motivation, reward, cognition, and stress response.

Choice D rationale:

Environmental theory suggests that external factors, such as life events and stressors, contribute to the development of depression. While environment can indeed influence depression, it does not specifically address the neurotransmitter imbalances that are central to this question.