Depression, anxiety, and situational disorders

Outreach workers, even if mainly concerned with severe psychoses, must regularly deal with depression, anxiety, and situational disorders. This chapter summarizes the practical approaches to these problems. In depression, the value of general support, regular structured assessments, and the use of CBT are proposed. The overlap of situational depression with bipolar depression is explored. CBT is equally indicated with anxiety disorders, but outreach workers can have a particular role in graded exposure. The judicious use of medication should not be overlooked. The two situational disorders described are post-traumatic stress disorder (PTSD) and bereavement. The chapter ends with a brief review of what used to be loosely called ‘neurotic disorders’ such as OCD and eating disorders. The successful care of psychotic individuals is often dependent on close attention to these more general problems.