A client asks a nurse about the differences between major depressive disorder (MDD) and dysthymia. Which of the following responses by the nurse is accurate?

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:

Acetylcholine and gamma-aminobutyric acid (GABA) are not the primary neurotransmitters involved in regulating mood, motivation, reward, cognition, and stress response. Acetylcholine plays a role in memory and muscle control, while GABA is an inhibitory neurotransmitter that helps regulate anxiety and sleep. These neurotransmitters are not as closely associated with the functions mentioned in the question.

Choice B rationale:

Glutamate is a major excitatory neurotransmitter in the central nervous system, and epinephrine (also known as adrenaline) is a hormone that prepares the body for the fight-or-flight response. While both glutamate and epinephrine play important roles in various physiological responses, they are not primarily responsible for regulating mood, motivation, reward, cognition, and stress response as mentioned in the question.

Choice C rationale:

Serotonin, dopamine, and norepinephrine are all key neurotransmitters involved in the regulation of mood, motivation, reward, cognition, and stress response. These neurotransmitters have been extensively studied in the context of mood disorders like Major Depressive Disorder (MDD). Serotonin is often associated with feelings of well-being and happiness, dopamine is linked to pleasure and reward pathways, and norepinephrine is involved in the body's stress response. Imbalances in these neurotransmitters have been implicated in the development of mood disorders.

Choice D rationale:

Endorphins and oxytocin are important neurotransmitters, but they are not as directly related to the regulation of mood, motivation, reward, cognition, and stress response as the neurotransmitters mentioned in choice C. Endorphins are known for their role in pain modulation and feelings of pleasure, while oxytocin is often referred to as the "bonding hormone" and is associated with social connections and childbirth.