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Introduction
While depression can develop as a result of various events, situations, and activities, one can attempt to prevent it or reduce its severity. According to the CDC (2018), in the United States, depression affects more than 15 million people annually. Patients with a family history of depression are at risk of developing this disorder. One of the potential exacerbating factors that can lead to depression is smoking.
People with mental health-related conditions such as anxiety and depression may find it challenging to quit their habit. Nonetheless, smoking cessation can delay or prevent the development of depression (Bakhshaie, Zvolensky, & Goodwin, 2015; Leventhal, & Zvolensky, 2015; Luger, Suls, & Vander Weg, 2014). The goal of this paper is to develop a smoking cessation plan for a patient at risk of depression, using a mHealth application based on Acceptance and Commitment Therapy (ACT).
Preventable Disease Overview
Depression (otherwise called Major Depressive Disorder or MDD) is a condition that affects ones mental health. MDD is primarily connected to mood changes a person with depression experiences sadness and apathy while also losing interest in personal hobbies and passions and having difficulty completing daily tasks. A set of symptoms characterizes the typical representation of this disorder. These include negative feelings (sadness, hopelessness, or emptiness), possible sensitivity and irritability to words or actions of others, a lack of investment in previous interests, and lack of energy (CDC, 2018).
Other manifestations may include insomnia or excessive sleeping, excessive eating or a lack of appetite, as well as memory and concentration issues and physical pain. Depression is usually diagnosed with the help of DMC-5 after a clinician assesses the patients symptoms and excludes other medical conditions. The associated findings of a physical examination could include signs of insomnia, restlessness, poor social health, distress.
Evidence-Based Intervention
It should be noted that smoking cessation is not the only action that has to be taken by people to prevent the development of depression. However, multiple studies show that this intervention can improve peoples mental health. According to Luger et al. (2014), current smokers suffer from MDD more often than non-smokers and former smokers as well. Therefore, if the patient will quit smoking, the risk of depression may decrease significantly. The intervention of smoking cessation can also be followed by negative outcomes, especially in people who already experience mood changes (Leventhal, & Zvolensky, 2015). Therefore, the strategy should not require the patient to stop smoking without any additional support.
The proposed intervention is based on a mHealth application that is founded on the principles of ACT. According to Bricker et al. (2014), a variety of mHealth apps exist to help smokers to quit their harmful habits. A smoking cessation app with an ACT foundation focuses on the persons commitment to behavioral change, recognizing that motivation and urge realization are necessary parts of the process. For example, through the application, people can access former smokers stories and advice, learn how to accept their cravings, and become self-compassionate in forgiving harmful behaviors (Luger et al., 2014). The app also assists individuals in tracking the amount of smoked and skipped cigarettes and visualizing their progress.
Implementation: Teaching Plan
The medical specialist should explain to the patient the link between depression and smoking. Then, one can recommend a smoking cessation app as a way to start monitoring the patients tobacco use. It may be vital for the individual to understand that a personal commitment can be more valuable than a simple promise to the healthcare professional. The participant should also receive additional information about the effects of smoking and its cessation.
For example, the CDC website has a section called Tips from Former Smokers it contains information about mental health, personal stories from former smokers, and additional resources for learning and support (CDC, 2018). The patient should also be recommended to talk to family members and close friends so that they would be aware to check up on the patients health and progress with the intervention.
Evaluation
A simple smoking cessation assessment can give the healthcare provider all required information about the patients progress. A questionnaire can include questions about the patients cessation history, smoking environment, feelings related to treatment, and personal lifestyle changes. A test of addiction can also serve as a tool in determining the effectiveness of the intervention plan. For instance, the Fagerström Test of Nicotine Dependence can be utilized ( Instrument: Fagerstrom Test, n.d.). This test considers the persons main challenges in the process of smoking cessation. If the proposed plan is unsuccessful, the strategy can be modified to include therapy sessions with the patient, meditation, motivating phone calls, and other interventions that are more involving.
Summary
The link between smoking and depression is highlighted in scholarly work. By quitting such harmful habits as smoking, individuals can lower the risk of developing mental health problems. The use of mHealth applications and ACT is a way to provide the patient with independence to make personal decisions while encouraging improvement at the same time. The proposed intervention should lead to the patient losing the habit of smoking without experiencing adverse outcomes of withdrawal. Smoking is a problem that can negatively affect many areas of a persons life, and its cessation can bring positive changes.
References
Bakhshaie, J., Zvolensky, M. J., & Goodwin, R. D. (2015). Cigarette smoking and the onset and persistence of depression among adults in the United States: 19942005. Comprehensive Psychiatry, 60, 142-148.
Bricker, J. B., Mull, K. E., Kientz, J. A., Vilardaga, R., Mercer, L. D., Akioka, K. J., & Heffner, J. L. (2014). Randomized, controlled pilot trial of a smartphone app for smoking cessation using acceptance and commitment therapy. Drug and Alcohol Dependence, 143, 87-94.
Centers for Disease Control and Prevention [CDC]. (2018). Mental health conditions: Depression and anxiety.Â
Instrument: Fagerstrom Test for Nicotine Dependence (FTND). (n.d.).Â
Leventhal, A. M., & Zvolensky, M. J. (2015). Anxiety, depression, and cigarette smoking: A transdiagnostic vulnerability framework to understanding emotionsmoking comorbidity. Psychological Bulletin, 141(1), 176-212.
Luger, T. M., Suls, J., & Vander Weg, M. W. (2014). How robust is the association between smoking and depression in adults? A meta-analysis using linear mixed-effects models. Addictive Behaviors, 39(10), 1418-1429.
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