ISSN: 1935-1232 (P)

ISSN: 1941-2010 (E)


Case Report - Clinical Schizophrenia & Related Psychoses ( 2022) Volume 0, Issue 0

Mental behavioural therapy to reduce major depressive episodes
Mohammad Nayef Ayasrah1* and Mohamad Ahmad Saleem Khasawneh2
1Associate Professor of Special Education, Al Balqa Applied University/ Department Science of Educati, Jordan
2Assistant Professor, Special Education Department, King Khalid University, Saudi Arabia
*Corresponding Author:
Mohammad Nayef Ayasrah, Associate Professor of Special Education, Al Balqa Applied University/ Department Science of Educati, Jordan, Email:

Received: 05-Dec-2022, Manuscript No. CSRP-22-82253; Accepted Date: Dec 21, 2022 ; Editor assigned: 06-Dec-2022, Pre QC No. CSRP- 22-82253 (PQ); Reviewed: 16-Dec-2022, QC No. CSRP-22-82253 (Q); Revised: 19-Dec-2022, Manuscript No. CSRP-22-82253 (R); Published: 22-Dec-2022, DOI: 10.3371/CSRP.MMWY.100132


The objective of this study is to determine whether or not mental behavioural therapy is useful in lessening the severity of major depressive episodes that are accompanied with psychotic symptoms. This research is very important when thinking about the prevalence of depression throughout the world. For the purpose of this analysis, a case study technique was used. For the purpose of this study, a male responder who suffered from severe depression and psychotic symptoms was employed. The Beck Depression Inventory was used in order to make determinations about the severity of depression. The diagnosis was arrived at by a combination of observation, in-person interviews, and psychological testing. The initial mental health state of the patient is evaluated by the researcher in order to determine the appropriate course of intervention and psychotherapy. The interventions that are used in mental-behavioural therapy typically take place over the course of six sessions. These sessions cover a variety of topics, including the formulation of problems, the catching of ideas, the testing of reality, the elimination of destructive beliefs, and the activation of positive behaviours. The researcher used the method of forgiveness in the hopes that it would make the patient feel less guilty. Following participation in the psychological intervention, it was discovered that the primary symptoms of patients suffering from major depressive episodes that were also experiencing psychotic symptoms were of a milder kind.


Mental • Behaviour • Therapy • Depression


Depression is characterised by psychological distress as one of its core symptoms; hence, suicide is always associated with depressive individuals. Depressive episodes are mood disorders that include a person's physical, cognitive, affective, behavioural, and motivational states [1]. People with depression often experience negative emotions, with hopelessness and despair being the most prevalent. People with depressive disorders have spells of sorrow and tears at regular intervals [2].

As a consequence of these symptoms, individuals with depressive disorders will have difficulty concentrating, deep feelings of guilt, a lack of energy and interest, major changes in eating behaviour, suicidal thoughts, and a sense of having failed in some manner [3]. In addition, individuals will experience changes in their level of activity, difficulty with their usual sleep patterns, and difficulties with their perception and cognitive functioning [4]. Common signs of depressive disorders include impairments in social and occupational functioning, as well as in interpersonal relationships [5].

Mood and emotions are associated with the onset of depressive disorders [6]. Individuals express their own brand of emotion, termed mood, which may be detected by others in their surrounding area. Emotion, on the other hand, refers to a highly complex state of feeling that encompasses not only mental and somatic processes, but also behaviour associated with affect and mood. Emotions that remain for a lengthy amount of time may tint a person's perception of the world around him [7]. These feelings might be positive (such as joy, pride, love, or admiration) or negative (such as wrath, despair, or contempt) (such as suspicion, sadness, anger, disappointment, guilt). Emotions are feelings that are absorbed in consciousness, while affect is oriented toward deeper urges that may be conscious or unconscious [8]. In contrast, mood is a subjective element of emotional experience that can be transmitted by individuals and seen by others, such as angry behaviour.

Major depressive illness will affect 15% of the population at some time in their life. Women are more likely than males to have depressive disorders, which have a prevalence of 25%. This proportion is much more than the percentage of men who experience depression [9]. The disparity in these numbers is attributable to hormonal changes, the influence of childbirth, variations in sources of psychological pressure, and behavioral patterns in various cultures about women's helplessness [10]. These elements all contribute to the issue. Depression often affects individuals between the ages of 20 and 50, with the average age being 40 years old. It is also possible to acquire a serious depressive disorder throughout infancy or in adulthood.

People with depressive disorders often report having less energy than normal, making it harder for them to carry out their everyday duties [11]. Approximately eighty percent of those diagnosed with a depressive disorder suffer from sleep disturbances [12]. This might entail waking up in the middle of the night and being reminded of their problems. Depressive disorders are related with both decreased appetite and weight loss in patients. On the contrary, some patients find up gaining weight.

Psychotic symptoms, including hallucinations and delusions in particular, are more likely to occur in the context of severe depressive illness [13]. The hallucinations and delusions that manifest are almost often associated with sin and the associated emotions of shame. If you do not have the support of close friends and family members who understand what you are going through, these symptoms will grow much worse. More than two-thirds of unhappy people around the globe have contemplated ending their lives by committing suicide at some time, and 10%–15% of these individuals ultimately do so. Some individuals with mood disorders are unaware that they are depressed and may not exhibit the normal symptoms of having a mood disorder. Nonetheless, they continue to suffer from mood problems. On the other hand, they exhibit behaviours consistent with withdrawal from family, friends, and the activities they formerly valued that need the engagement of others.

A person who battles with depression will act as a participant in this investigation. The discovery of this result was made feasible by an investigation of the individual's psychological state [14]. After marriage, the mental health of the participants in this research deteriorated because they were unable to acquire consistent employment and their partners abandoned them. Moreover, the people were unable to find a replacement companion. The individual in question has a growing impression that he cannot exert control over the bad ideas that continue to enter his mind. These range from feelings of remorse and despair to the belief that he has entirely lost his mind due to his experiences. The individual further adds that he continues to hear voices telling him he is a sinner and that he has no control over his situation. He also notes that this has been occurring for some time. The majority of the time, he has difficulty concentrating, which eventually leads to job performance concerns. The patient's sleeping difficulties continued to worsen until he or she was unable to fall asleep or keep asleep at all. The patient's health deteriorated to the point that he was unable to sleep at all. Even if the individual is able to fall asleep, he will awaken with an overwhelming sense of shame and a rapid pulse. This happens regardless of whether or not he is able to obtain sufficient rest. Moreover, the person seems to be experiencing more and more suicidal ideas.

Patients with depressive disorders have a chance of making a full recovery with the support of antidepressant medication and mental behavioural treatment. Behavioural therapy aims to modify cognitive, affective, and behavioural processes by emphasizing the role of the brain in analysing, selecting, questioning, and responding upon stimuli. This is achieved by emphasizing the importance of the brain in analysing, selecting, questioning, and taking action. This is related to the idea that people are capable of absorbing irrational notions in addition to reasonable ones, and that absorbing irrational thoughts would result in emotional and behavioural issues. It is believed that the person will be able to change his unwanted behavior by altering the environment in which his thoughts and emotions are now placed.


This study was carried out using the one-case study technique as its primary research strategy. A study strategy known as the single case technique is used to determine the efficacy of a treatment on several individuals who are included in a single group or topic. In this particular investigation, there was one adult male participant who was 34 years old. According to the findings of a psychological evaluation that made use of the Beck Depression Inventory, the person being evaluated suffered from serious depression. The subject has provided the researchers with complaints and a history of complaints; as a result, the researchers will be using an assessment design that includes behavioural and residential observations, history taking, cognitive assessment using a clinical approach, and personality assessment using the Beck Depression Inventory. This assessment design will be used. It is necessary to conduct an evaluation in order to gather information on the subject's psychological status, to map the issues that were encountered by the subject, to arrive at a diagnosis, and to give relevant treatments. The method of purposive sampling was used to choose the participants for this investigation. The selection of samples in accordance with the required characteristics is necessary for unusual circumstances in which it is difficult to collect samples and calls for in-depth research. People who have particular knowledge regarding the situation that is being studied have been selected as the subjects of the research.

In this particular research endeavour, an A-B follow-up design was used. The A-B design is the fundamental framework for a single-experiment research project. Measurement of the state of the target during the baseline phase of the A-B-follow up design is one of the primary procedures that is carried out. After that, intervention is carried out. During the period in which the intervention is being carried out, the subject's condition will be continually observed, and measurements and follow-up will also be carried out.

In addition to using the person who was the focus of the study as the primary source of data, the researcher also made an effort to locate informants to use as secondary sources of data. Informants are those who are familiar with the topic being researched or who have had previous interaction with the subject and are knowledgeable about the issue that is being investigated. Informants are required to be impartial or free of any personal interest in smearing other individuals, in addition to having comprehensive knowledge pertaining to the issue that is being investigated.

Results and Discussion

The individual in question does in fact have a great lot of expectations when seen from the point of view of impulse or encouragement; but, the vast majority of the time, he does not modify these expectations to fit his own capabilities. This desire does not come with a considerable quantity of strength that can be used for combat. The individual demonstrates a mentality that is easily defeated by failure, and as a consequence, often give up when faced with a challenge. But when it doesn't work, the individual throws the blame on other people or the environment rather than accepting responsibility for his own acts rather than blaming others or the circumstances. When the subject discovers that they are presented with the same difficulty in the future, they have a propensity to go to others for reinforcement or a solution. This is because they have developed a habit of doing so. The effective manipulation of desire often generates tension with regard to the subject matter that is being addressed.

It is challenging for the subject to achieve agreements with other individuals on what he wants, and the subject is unable to articulate what he wants in a straightforward manner [15]. This issue arises as a result of the fact that the subject often depends on the people who are closest to him, and as a consequence of this, he is reluctant to make demands that are suitable. For example, the subject's desire to have a girlfriend is met with resistance from the subject because there is a mismatch between the subject's expectations and the fact of the situation. The subject wants to have a girlfriend. A person puts themselves at danger of establishing a dependent on other people whenever they cope with their stress in harmful ways, for as by engaging in risky sexual behaviour or drinking to excess (Figure 1).


Figure 1. Thought Condition

The person is more interested in having social interactions with those who are able to guide his conduct and provide encouragement. If we locate other individuals who have the subject's personality, they won't be able to become involved in a relationship with us. It is common for participants to feel better at ease conversing with one another one-on-one rather than in large groups. Due to the nature of the subject's connection with his elder brother, the subject thought it was appropriate to discuss his issues with his older brother. As a result of his older brother's guidance and support, the subject was able to feel comfortable discussing his issues with his older brother. The subject represses his desire for love from the social environment because he is uneasy with the idea of having connections with the other people in the group. However, the subject does truly genuinely require affection from the social environment. This attitude is a sign of the subject's unwillingness to make requests to people on whom he relies, which is why he has this attitude (Figure 2). 


Figure 2.Physical and Feeling Condition

The person has an intellectual capacity that is about par for the course. The subject has a level of understanding that is satisfactory in relation to the standards prevalent in his environment. However, the person experiences an overwhelming amount of worry whenever they are put in an unfamiliar circumstance. Because the subject has a strong capacity to grasp social standards, but anxiety whenever he needs to engage in that setting, this is what gives birth to the subject's unfavourable opinions about the circumstance or the people around him.

Due to the introverted and reticent nature of the topic, they prefer engaging in alone activities while at school. The individual was not interested in becoming a member of the group, and even if he had been, the request to do so came from a mutual acquaintance. The individual in question has, ever since infancy, had the belief that he is a youngster who is lacking in some advantages. The reason for this is because the topic never receives any positive reinforcement from the parents when it is discussed at home. Because of this mindset, the person is hesitant to participate in a significant amount of social activities. The guy had a crush on a girl back when he was a senior in high school. The person makes further attempts to contact the lady and convey his sentiments to her. However, none of them were interested in discussing the matter further. The subject, as a result of these two occurrences, began to think of himself as a guy who did not benefit from any benefits. The individual suffers from a cognitive distortion known as arbitrary inference, which occurs when the individual forms conclusions without taking into account any pertinent facts.

Drinking is another maladaptive coping mechanism that the individual is stuck in, and it's a trap. Drinking is by far the most popular form of coping used by those who have a propensity for depression, particularly in western cultural contexts. People who suffer from depressive illnesses often choose to medicate themselves with alcohol, but they also frequently choose to self-medicate with illicit narcotics. One of the mistakes that might be made in the process of coping is being affected by human personalities that are fragile when confronted with issues. The topic has always been the kind of person that tries to steer clear of sticky situations ever since they were a youngster. The act of attempting to find acceptable solutions to improper situations only serves to further ensnare the subject in the problem. The individual in question does not seem to be aware of this particular fact. On the one hand, the subject believed that his conduct merited the label of sinner, and he believed that society had branded him unfavourably as a result of his behaviour. On the other side, the subject had a great deal of resentment against his cousin, who had been the one to introduce him to the dark world in the first place. The topic is fuming with rage but is unable to express it in any meaningful way.

There are a variety of things that might contribute to psychological anguish. Psychopathology is caused by a complex interaction of biological, developmental, and environmental factors. The majority of cases of depression are brought on by genetic predisposition (also known as inheritance) in addition to disorders that disrupt the normal chemical make-up of the brain. A traumatic experience that occurs at a critical time of psychological development might result in cognitive vulnerability. Character flaws that make a person susceptible to mistakes in problemsolving strategies, cognitive biases (distortions) such as making incorrect assumptions and aiming for goals that are impossible to achieve, and other negative outcomes.

The individual was exposed to a stressful incident, which left him susceptible to cognitive impairments. Cognitive vulnerability refers to the manner of thinking that a person has that has a tendency to lead conduct toward a certain kind of psychological suffering. The dynamics work as follows: the subject have a personal character that is susceptible because he possesses a personality that is reliant on others. In spite of the fact that the subject's elder brother has also struggled with melancholy, the subject relies heavily on his older brother. When confronted with a challenge, the subject relies on the assistance of other individuals to find a solution, and the solutions that the subject employs are not adaptive, which results in cognitive vulnerability. Inappropriate coping strategies have the effect of causing recurring cognitive distortions, which, over time, may develop into delusions.


The character has a transformation of perspective as he acquires the knowledge that he must actively practice keeping a positive frame of mind regardless of the problems that life presents to him. in order to elicit positive emotions and behaviours as a response to the triggering event. In addition to this, the subject makes an effort to follow a regular schedule by engaging in activities such as doing some light exercise first thing in the morning and raising chickens in the backyard. Since the beginning of the consultation in September of the previous year, the subject has seen major transformations in their appearance. For example, they have decluttered their house and seem much younger in general. He is conscious of, and able to exert control over, his negative feelings, which is an additional advantage. Participants were taught "thought-stopping tactics" in the fifth and final intervention, which was designed to teach them how to successfully break away from a train of thinking. 

After that moment, the psychologist may continue treatment by shifting their attention to the child's connection with the parent. Family counselling is one approach that might be used in this situation. Attention training is one form of method that may be adapted so that it can be used with patients who suffer from depression. If you are still interested in adopting mental behavioural therapy, this is something that you should consider. Each client is instructed in a unique set of skills that are intended to assist them in developing a greater appreciation for the times that they are now experiencing. Patients who suffer from depression often struggle to pay attention to the here and now and to keep themselves present.


The authors extend their appreciation to the Deanship of Scientific Research at King Khalid University for funding this work through Small Research Groups under grant number (RGP.2 /136/43)


Citation: Ayasrah MN, Saleem Khasawneh MA, "Mental Behavioural Therapy to Reduce Major Depressive Episodes". Clin Schizophr Relat Psychoses 16S2 (2022) doi: 10.3371/CSRP.MMWY.100132

Copyright: © 2022 Ayasrah M.N, et al. This is an open-access article distributed under the terms of the creative commons attribution license which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.