Multiple activities change intervention, a developing psychosocial tool for severe depression: initial report of cases

Many depressed individuals are labelled as treatment resistant, refractory, or difficult to treat depression. Such depression is highly disruptive and leads to multiple adverse outcomes in a person’s life including marital turmoil, unstable employment, and early mortality. The so-called newer techniques, involving electricity or magnetism—are unproven, costly, not easily available, may lead to harm, and may require surgery and anaesthesia. With no effective treatment modality available, these cases of severe depression become significant, as they reported remarkable recovery with a novel psycho-social intervention called multiple activities change intervention or MACI. A 36-year man Kumar presented with severe depression of 15-years duration. At the time of presentation, he was faced with multiple physical and psychological symptoms, workplace difficulties, and domestic disharmony and violence. He had been taking selective-serotonin-reuptake-inhibitors and lorazepam, and his BDI-II score was 36. MACI was administered that led to sharp reduction in symptoms and other all-round improvements. BDI-II score fell to three, and all psycho-pharmaceuticals were gradually stopped. He stopped considering himself mentally ill. All this and more happened within a space of 100 days. Two other similar cases are being reported.