Major

Depressive

DisorderKriti Lodh

Major Depressive Disorder

unipolar depression

lifetime prevalence:

◦ up to 21% in women

◦ 13% in men

typical age of onset:

◦ 20s, but can occur at any time

Major Depressive Episode

DSM-IV-TR criteria include

◦ 1 of 2 mood symptoms

◦ at least 5 symptoms total

◦ duration of at least 2 weeks

Major Depression in Women Twice as many woman as men

During extreme hormonal shifts

Early puberty

22% incidence in ages 20-45

Perimenopausal symptom

Pregnancy –especially around wk 32

Post partum ; 2wks- 3 months

Major Depression in Men Commonly occurs with attempts to self-

medicate with alcohol, drugs, food, gambling or sex;

Men often do not experience these behaviors as signs of depression and have more reluctance to ask for professional help.

Depression may be precipitated by loss of ability to function in an impt or especially valued area of life.

Depression & Life Changes

Even happy & eagerly anticipated events

(birth of a baby, retirement, new job, etc.)

can precipitate a mild depression;

The chronicity of other stressors can have a

profound impact on a at-risk individual

(caring for an aging parent, aftermath of

divorce, job lay-off, problematic family

issues)

Mood Symptoms of

Depression persistent sad, depressed mood

loss of interest or pleasure in

previously enjoyable activities

DSM-IV criteria specify that person

must have 1 of above plus 4 additional

sx for at least 2 weeks

Physical Symptoms of

Depression Sleep disturbance

◦ too much or too little

loss of energy, fatigue

appetite disturbance/weight change

◦ loss of appetite or increase in appetite

changes in activity level

◦ psychomotor retardation or agitation

Cognitive Symptoms of

Depression difficulty concentrating, thinking, and

making decisions

feelings of worthlessness, guilt, or

hopelessness

recurrent thoughts of death or suicide

Course of Depression

if untreated, average duration of first

episode is 6-9 months

often recur