According to the World Health Organization, depression is a prevalent illness found worldwide with at least 300 million people affected in 2018. Increased level of depressive symptoms may lead to suicide, a global issue in that is considered the second leading cause of death among people ages 15-29 years old. In Occupational Therapy literature, most psychiatric patients have the tendency to feel extreme sadness and hopelessness to the point where there is loss of interest in doing things that they used to find significant or purposeful. Depression, being considered to be one of the leading causes of disability worldwide, is also a major contributor to different conditions such as cardiac problems, hypertension, and many more.
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As discussed in the Diagnostic and Statistical Manual for Mental Disorders, fifth edition or commonly known as DSM-5, the signs and symptoms of depression include constant feelings of hopelessness, sadness, and emptiness; diminished pleasure or interest; and the recurrent thoughts of suicide and death. A depressive episode is considered when these manifestations occur for at least two weeks, with noticeable changes of prior functioning, and when a person’s occupational performance is impaired. Depression is a mood disorder that affects an individual’s will to do things that they consider meaningful and productive. Occupational therapists aim to help persons with depressive disorders to improve their health and well-being through the use of purposeful activities and occupations, including but not limited to, therapeutic art activities (American Psychiatric Association, 2015).
Occupational Therapy, as defined by the World Federation of Occupational Therapists, is a client-centered profession that deals with promoting the clients’ health and well-being through the use of occupations. It is a health profession that aims to enable clients to participate and engage in daily life activities. Occupational therapy practitioners work with people and communities to improve their ability to participate on activities that they find meaningful through remediation of impairments, or by modifying and providing compensatory approaches to either the activity or environment to promote engagement in occupations. Furthermore, occupational therapy practitioners work with people of different ages and in different settings, including mental health. Occupational therapists assess their clients’ cognition and psychological needs. Additionally, occupational therapists help improve their client’s self-esteem and confidence in social situations, which may be affected among people living with depression.
Occupational Therapy plays a critical role in helping people with depression. Occupational therapists can help persons with depressive symptoms balance their work, leisure, and relationships by providing a schedule that includes activities and strategies to ensure clients meet their responsibilities and roles that are meaningful and expected of them (Opp, 2018). Occupational therapists examine life roles of clients with depression and help them adapt with their responsibilities by providing them opportunities to participate in activities to gain a sense of fulfillment, which may range from work-oriented activities to art activities. Furthermore, occupational therapists aim to improve the health and well-being of their clients through purposeful activities. Structured arts and crafts are graded activities that has the potential to relieve the clients’ depressive symptoms and encourage them to do creative tasks. Doing these tasks will provide them a sense of fulfillment for them and thus encourage them to do more occupations that they will find enjoyable and enriching for them (Armada, Fernandez, Garcia, Perido, Salutillo & Santos, 2016).
Art therapy was first described as a therapeutic intention to promote recovery among patients suffering mental illness (Blomdahl, 2016). Research states that art therapy plays a role in recovery from a mental illness as it enhances patients’ self-perception, promotes change in a personal level, improves patients’ ability to meet the demands in daily life, and strengthen patients’ boundaries (Gunnarson & Eklund, 2009). The feasible effects of art therapy can be carried over to daily living, thus improving a patients’ well-being and self-esteem in performing activities of daily life. Furthermore, there are recent studies that discuss how art therapy performed in various clinical conditions decreased depressive symptoms. However, there are limited evidence on how art therapy is performed as an intervention in clinical practice (Blomdahl, 2016).
Emerging research in medicine and allied health sciences demonstrate that incorporating art therapy in interventions is an effective and health-enhancing method in alleviating levels of depressive symptoms (Malchiodi, 2012). A research study conducted by Armada et. al in 2016 discuss the effectiveness of art therapy in relation to the depressive symptoms of persons in a psychiatric facility. The study was conducted by incorporating graded paper folding activities along with the traditional treatment in a mental health facility. The participants of the study were divided into two groups: the experimental and the control group. An assessment called the Beck’s Depression Inventory was used to assess levels of depression prior the treatment. The experimental group received arts and crafts activities for 8 weeks, while the control group adhered to the traditional treatment methods of the facility. After the treatment period, the Beck’s Depression Inventory was re-administered, and results of the study show that persons receiving art therapy had lower levels of depression as compared to the control group.
Another study was conducted by Perruzza and Kinsella in 2010 that talks about the effectiveness of art therapy. The purpose of their study was to gather and analyze different research studies that are available that pertains to incorporating art activities in occupational therapy interventions. The researchers conducted a systematic review of 23 articles published between 2000 and 2008. The research articles were obtained in multiple electronic searches using five online databases with keywords: ‘Creative Occupation’, ‘Health’, ‘Art’ and ‘Occupational Therapy’. In terms of client groups, the articles were mostly represented by persons with mental illness. Qualitative findings show that six predominant themes were identified as the results of using art therapy across the studies, namely: (1) enhanced perceived control, (2) building a sense of self, (3) expression, (4) transforming the illness experience, (5) gaining a sense of purpose, and (6) building social support. Arts and crafts should be seen as an uplifting occupation, and occupational therapy practitioners and researchers need to understand the value of what arts and crafts can potentially offer in therapeutic practice (Perruzza & Kinsella, 2010).
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In conclusion, research studies suggest the use of creative arts in treatment of patients with depression. It is stated that structured arts and crafts helped lower the levels of depressive symptoms of persons admitted in a psychiatric facility, and that creative arts were seen as an uplifting occupation. As an occupational therapy practitioner, I would recommend art therapy as a form of intervention to decrease the levels of depressive symptoms among persons with depression considering that it is a major issue, we are facing in 2018. For the staff of mental health facilities, it is encouraged to engage persons with depression in art therapy in the goal of eliciting depressive symptoms of the patients to maximize their engagement in different areas of occupations, such as activities of daily living (ADL), instrumental activities of daily living (IADL), leisure and social participation. For the future researchers, it is recommended to continue studies about art therapy which might yield positive results in evidence-based studies regarding the level of symptoms of patients with depression.
References
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Armada, C., Fernandez, M., Garcia, J., Perido, R., Salutillo, E., & Santos, C. (2016). Effects of Origami Paper Folding Activities on the Depressive Symptoms of Persons with Psychiatric Disorders. Davao Doctors College, Undergraduate Research for Occupational Therapy.
- Blomdahl, C., Gunnarsson, B. A., Guregård, S., Rusner, M., Wijk, H., & Björklund, A. (2016). Art therapy for patients with depression: expert opinions on its main aspects for clinical practice. Journal of Mental Health, 25(6), 527–535. https://doi-org.proxy.library.nyu.edu/10.1080/09638237.2016.1207226
- Cuypers, K., Krokstad, S., Holmen, T. L., Knudtsen, M.S., Bygren, L. O. & Holmen, J. (2011). Patterns of receptive and creative cultural activities and their association with perceived health, anxiety, depression and satisfaction with life among adults: the HUNT study, Norway. Journal of Epidemiology and Community Health, 66(8), p698-703.
- Gunnarsson B, Eklund M. (2009). The tree theme method as an intervention in psychosocial occupational therapy. Aust Occup Ther J, 56, 83–91.
- Horghagen, S., Fostvedt, B., & Alsaker, S. (2014). Craft activities in groups at meeting places: supporting mental health users’ everyday occupations. Scandinavian Journal of Occupational Therapy, 21(2), 145–152. https://doi-org.proxy.library.nyu.edu/10.3109/11038128.2013.866691
- Kim, D. (n.d.). The effects of a combined physical activity, recreation, and art and craft program on ADL, cognition, and depression in the elderly. Journal of Physical Therapy Science, 29(4), 744–747. https://doi-org.proxy.library.nyu.edu/10.1589/jpts.29.744
- Malchiodi, C. (Ed.). (2012). Art therapy and health care. New York: Guilford Publications.
- Müllersdorf, M., & Ivarsson, A. B. (2012). Use of Creative Activities in Occupational Therapy Practice in Sweden. Occupational Therapy International, 19(3), 127–134. https://doi-org.proxy.library.nyu.edu/10.1002/oti.1327
- Opp, A. (2018). Occupational Therapy and Depression: Reconstructing Lives. Retrieved from https://www.aota.org/about-occupational-therapy/professionals/mh/articles/depression.aspx
- Perruzza, N., & Kinsella, E. A. (2010). Creative arts occupations in therapeutic practice: A review of the literature. British Journal of Occupational Therapy, 73(6), 261-268. doi: 10.4276/030802210X12759925468943
- WFOT (2015). WFOT | About Us | About Occupational Therapy | Definition of Occupational Therapy. Retrieved 6 October 2015, from http://www.wfot.org/AboutUs/AboutOccupationalTherapy/DefinitionofOccupationalTherapy.aspx
- World Health Organization. (2018, March 22). Depression. Retrieved from http://www.who.int/news-room/fact-sheets/detail/depression
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