DEPRESSION

MD AAQUIB SAHRWARDI

M.S.W (MEDICAL & PSYCHIATRY)

Depression is a common mental disorder that causes people to experience depressed mood, loss

of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low

energy, and poor concentration

Common symptoms

(A) reduced concentration and attention;

(B) reduced self-esteem and self-confidence;

(C) ideas of guilt and unworthiness;

(D) bleak and pessimistic views of the future;

(E) ideas or acts of self-harm or suicide;

(F) disturbed sleep

(G) diminished appetite.

 

Somatic symptoms

• Loss of interest or pleasure in activities that are normally enjoyable;

• Lack of emotional reactivity to normally pleasurable surroundings

and events;

• Waking in the morning 2 hours or more before the usual time;

• Marked loss of appetite;

• Weight loss (often defined as 5%or more of body weight in the past

month);

Types of depressive episodes1. Mild depressive episode

• Without somatic syndrome

• With somatic syndrome

2. Moderate depressive episode

• Without somatic syndrome

• With somatic syndrome

3. Severe depressive episode without psychotic symptoms

4. Severe depressive episode with psychotic symptoms

1. Mild Depressive Episode

Depressed mood, loss of interest and enjoyment are usually regarded as the most

typical symptoms of depression, and at least two of these, plus at least two of the

other symptoms should usually be present for a definite diagnosis. None of the

symptoms should be present to an intense degree. Minimum duration of the whole

episode is about 2 weeks.

An individual with a mild depressive episode is usually distressed by the

symptoms and has some difficulty in continuing with ordinary work and social

activities, but will probably not cease to function completely.

2. Moderate Depressive Episode

At least two of the three most typical symptoms noted for mild

depressive episode should be present, plus at least three (and preferably

four) of the other symptoms. Several symptoms are likely to be present

to a marked degree, but this is nonessential if a particularly wide

variety of symptoms is present overall. Minimum duration of the

whole episode is about 2 weeks. An individual with a moderately

severe depressive episode will usually have considerable difficulty in

continuing with social, work or domestic activities.

3. Severe Depressive Episode without Psychotic Symptoms 

The sufferer usually shows considerable distress or agitation, unless

retardation is a marked feature. Loss of self-esteem or feelings of

uselessness and suicide is a distinct danger in particularly severe cases.

It is presumed here that the somatic syndrome will almost always be

present in a severe depressive episode.

4. Severe Depressive Episode with Psychotic Symptoms

A severe depressive episode which meets the criteria

given for above and in which, delusions and

hallucinations are present. The delusions usually involve

ideas of sin, poverty, or future disasters, responsibility for

which may be assumed by the patient. Severe

psychomotor retardation may progress to stupor.

Causes

• Heredity -- a gene called SERT that controls the brain chemical serotonin has been linked to depression.

In addition, some studies show that people with depressed family members are more likely to be

depressed.

• Changes in the brain -- some imaging studies suggest that people with depression may have physical

changes in their brains.

• Long-term stress, such as from loss, abuse, or being deprived as a child

• Being exposed to low levels of light, in SAD

• Sleep problems

• Social isolation

• Not getting enough of some vitamins and minerals

• Serious medical conditions, such as heart attack or cancer

• Certain medications, including those for high blood pressure, or irregular heartbeat

Risk factors• Having had depression

• Family history of depression

• Suicide attempt -- having made a suicide attempt while depressed raises the risk of another episode of depression

• Being a woman -- more women than men seem to have depression. This may be because women tell their doctors

about their symptoms more often than men. Or hormone changes may make women more likely to have depression.

• Stressful life events, such as the death of a loved one

• Just having given birth to a baby (postpartum)

• Having a long-lasting illness, including autoimmune diseases (such as lupus), cancer, heart disease, chronic headaches,

chronic pain, anxiety, obsessive-compulsive disorder, and borderline personality disorder. Medical conditions that

cause shifts in hormones, such as thyroid disorders or menopause, may also contribute to depression.

• History of abuse, such as mental, physical, or sexual

• Lack of a support system, such as a network of close friends or family

• Alcohol or drug abuse -- 25% of people with addictions have depression.

Self-help and alternative therapies

•Meditation

• Relaxation and meditation techniques

•Good nutrition

•Alcohol and drug avoidance

• Exercise

•Yoga

References

• The icd-10classification of mentaland behaviouraldisorders, clinical descriptions anddiagnostic

guidelines, world health organization.Pdf

• Http://www.Blackdoginstitute.Org.Au/docs/treatmentsfordepression.Pdf

• Http://www.Macalester.Edu/psychology/whathap/ubnrp/depression05/history.Html

• Http://www.Who.Int/bulletin/archives/78%284%29439.Pdf [retrieved on 17 august 2013]

• Http://www.Psychologytoday.Com/blog/theory-knowledge/201201/what-is-depression

• Http://brainblogger.Com/

• Http://www.Who.Int/classifications/icd/en/bluebook.Pdf

• Http://www.Gpnotebook.Co.Uk/simplepage.Cfm?Id=x20091123152205182440

• Http://www.Health.Am/psy/more/prognosis_of_depression/#ixzz2crwybw1v

• Http://umm.Edu/health/medical/altmed/condition/depression

THANK YOU