Depression
Labels Depression
- Definition .
- Description .
- Demographics .
- Causes and Symptoms .
- Diagnosis .
- Treatment .
- Prognosis .
- Prevention .
- The Future .
Showing posts with label Depression. Show all posts
Showing posts with label Depression. Show all posts
Labels Depression
Definition
Depression, sometimes called major depression or depressive disorder, is
a mood disorder that has been called the “common cold of mental illness”
because it is so common in the general population. Unlike the
common cold, however, depression can have serious long-term effects
on a person’s quality of life.
Some types of depression are recognized as separate disorders:
a mood disorder that has been called the “common cold of mental illness”
because it is so common in the general population. Unlike the
common cold, however, depression can have serious long-term effects
on a person’s quality of life.
Some types of depression are recognized as separate disorders:
- Dysthymia. Also called dysthymic disorder, dysthymia is a condition
in which the person has milder symptoms of depression that
are less disabling than those of major depression over a period of
two years or longer. - Psychotic depression. Patients with this type of depression have
hallucinations, delusions, and other signs that they have lost contact
with reality. - Postpartum depression. This is a type of depression that affects
some women following the birth of a baby. - Seasonal affective disorder (SAD). SAD is a form of depression
related to changes in the seasons. Most people with SAD feel
depressed in the winter and better in summer, but there is also a
reverse form of SAD in which the person is depressed in summer
and feels better in winter.
Description
Depression is a mood disorder that does not affect everyone in the same
way. There is some evidence, for example, that women and men experience
depression differently; women are more likely to feel sad, worthless,
or guilty, while men are more likely to feel tired, irritable, and uninterested
in activities that they used to enjoy. Men appear more likely than
women to get angry and act abusively toward others, or to drive recklessly.
Depression in the elderly may take the form of memory problems or
slowed-down movement rather than crying or feeling sad. Depression in
children may have such symptoms as refusing to go to school, getting in
trouble, or sulking and being generally moody and hard to get along with.
Depression also has different patterns of recurrence in different
people. Some persons have one episode of depression, recover, and are
never troubled by recurrences. Others have a series of episodes at irregular
intervals. And as the definition of dysthymia indicates, some people
have a low-grade depression that may persist for years without turning
into an episode of major depression.
Depression often coexists with other mental and physical disorders,
which often makes it difficult to diagnose. Depression can occur before the
person gets sick; can occur as a result of the sickness; or exist alongside
other illness. Mental disorders that often coexist with depression include
alcoholism and substance abuse disorders, eating disorders, anxiety disorders,
posttraumatic stress disorder, and obsessive-compulsive disorder.
Physical disorders that commonly affect depressed patients include heart
disease, stroke, cancer, AIDS, diabetes, and Parkinson disease. Depression
can make the symptoms of these diseases worse and harder to treat.
way. There is some evidence, for example, that women and men experience
depression differently; women are more likely to feel sad, worthless,
or guilty, while men are more likely to feel tired, irritable, and uninterested
in activities that they used to enjoy. Men appear more likely than
women to get angry and act abusively toward others, or to drive recklessly.
Depression in the elderly may take the form of memory problems or
slowed-down movement rather than crying or feeling sad. Depression in
children may have such symptoms as refusing to go to school, getting in
trouble, or sulking and being generally moody and hard to get along with.
Depression also has different patterns of recurrence in different
people. Some persons have one episode of depression, recover, and are
never troubled by recurrences. Others have a series of episodes at irregular
intervals. And as the definition of dysthymia indicates, some people
have a low-grade depression that may persist for years without turning
into an episode of major depression.
Depression often coexists with other mental and physical disorders,
which often makes it difficult to diagnose. Depression can occur before the
person gets sick; can occur as a result of the sickness; or exist alongside
other illness. Mental disorders that often coexist with depression include
alcoholism and substance abuse disorders, eating disorders, anxiety disorders,
posttraumatic stress disorder, and obsessive-compulsive disorder.
Physical disorders that commonly affect depressed patients include heart
disease, stroke, cancer, AIDS, diabetes, and Parkinson disease. Depression
can make the symptoms of these diseases worse and harder to treat.
Demographics
Depression is one of the more common mood disorders in the United
States. According to the National Institutes of Health, one in every five
women and one in every eight men will have an episode of major depression
at some point in their lifetime. Depression is a major cause of time
lost from work, lost opportunities for education, and vulnerability to substance
abuse. It is a factor in 55 percent of all suicide attempts, or about
110,000 attempts annually. Depression adds to the cost of treating such
physical illnesses as diabetes, heart disease, high blood pressure, and cancer.
People can suffer from depression at any age; however, adults between
the ages of thirty and forty are most likely to be diagnosed withmajor depression.
There is a second but smaller peak in adults between fifty and sixty.
States. According to the National Institutes of Health, one in every five
women and one in every eight men will have an episode of major depression
at some point in their lifetime. Depression is a major cause of time
lost from work, lost opportunities for education, and vulnerability to substance
abuse. It is a factor in 55 percent of all suicide attempts, or about
110,000 attempts annually. Depression adds to the cost of treating such
physical illnesses as diabetes, heart disease, high blood pressure, and cancer.
People can suffer from depression at any age; however, adults between
the ages of thirty and forty are most likely to be diagnosed withmajor depression.
There is a second but smaller peak in adults between fifty and sixty.
- Major depression is diagnosed twice as often in women as inmen; however,
in children, boys are diagnosed with depression as often as girls. - Depression appears to be less common among African Americans
in the United States than among members of other racial groups.
- Death of a parent during one’s childhood
- A family history of depression
- A history of suicide in the family
- Long-term use of certain medications, particularly birth control
pills, drugs given to treat high blood pressure, and sleeping pills - Long-term alcohol or drug abuse
- Poverty and unemployment
- Recent bereavement or traumatic incident
Causes and Symptoms
The causes of depression have been debated for decades, with researchers
disagreeing as to whether biology, psychology, or a combination of the
two offers the best explanation. Most researchers now think that depression
is the end result of biological vulnerability to a mood disorder combined
with personal history and certain personality traits.
a depression. For a diagnosis of depression a personmust have five symptoms
from the following list for at least two weeks. The symptomsmust be severe
enough to interfere with the person’s daily activities and relationships:
disagreeing as to whether biology, psychology, or a combination of the
two offers the best explanation. Most researchers now think that depression
is the end result of biological vulnerability to a mood disorder combined
with personal history and certain personality traits.
- Genetic factors. No specific genes have been identified, although
the disorder is known to run in families. - Biochemical. Researchers have found that the brains of people
with depression have abnormal levels of certain brain chemicals
called neurotransmitters. Neurotransmitters relay impulses from
one nerve cell to the next. - Life history. Difficult circumstances early in life, too many traumatic
experiences too close together, or high stress levels over a long
period of time can all make people more likely to become depressed. - Personality factors. People who are pessimistic, easily discouraged,
or inclined to worry a lot are vulnerable to depression.
a depression. For a diagnosis of depression a personmust have five symptoms
from the following list for at least two weeks. The symptomsmust be severe
enough to interfere with the person’s daily activities and relationships:
- Depressed mood
- Loss of interest or pleasure in activities that the person used to
enjoy - Weight gain or loss
- Difficulty sleeping or sleeping much more than usual
- Slowed movement or extreme restlessness
- Lack of energy; difficulty getting things done
- Feeling worthless or hopeless
- Problems with concentrating or decision making
- Thoughts of death or suicide
Diagnosis
The diagnosis of depression is complicated and often missed, particularly
in the elderly. Diagnosis begins with a complete physical examination,
partly to see whether the patient has medical problems that may increase
his or her risk of depression, and partly to rule out physical reasons for
changes in mood. These include thyroid disorders, infectious diseases like
syphilis or Lyme disease, and prescription medications that are known to
affect mood. The doctor may order blood or urine tests as part of the
physical examination.
Another important part of the diagnosis is taking the patient’s personal
and family history. This part of the patient interview often includes
giving the patient the Beck Depression Inventory or another questionnaire
that can be completed in the doctor’s office in a few minutes. There
are special questionnaires of this sort for children and adolescents.
The doctor will also listen to the way the patient talks as well as the
content of what they are saying, because depressed people often talk
slowly and may sound sad. The patient’s facial expressions and the way
they are dressed may also provide clues; a patient who is usually neat and
tidy may come to the office looking poorly groomed.
Primary care doctors will usually refer their patients to psychiatrists
(mental health specialists) in order to distinguish major depression from
other mental illnesses, and to prescribe treatments for the depression.
in the elderly. Diagnosis begins with a complete physical examination,
partly to see whether the patient has medical problems that may increase
his or her risk of depression, and partly to rule out physical reasons for
changes in mood. These include thyroid disorders, infectious diseases like
syphilis or Lyme disease, and prescription medications that are known to
affect mood. The doctor may order blood or urine tests as part of the
physical examination.
Another important part of the diagnosis is taking the patient’s personal
and family history. This part of the patient interview often includes
giving the patient the Beck Depression Inventory or another questionnaire
that can be completed in the doctor’s office in a few minutes. There
are special questionnaires of this sort for children and adolescents.
The doctor will also listen to the way the patient talks as well as the
content of what they are saying, because depressed people often talk
slowly and may sound sad. The patient’s facial expressions and the way
they are dressed may also provide clues; a patient who is usually neat and
tidy may come to the office looking poorly groomed.
Primary care doctors will usually refer their patients to psychiatrists
(mental health specialists) in order to distinguish major depression from
other mental illnesses, and to prescribe treatments for the depression.
Treatment
Treatment for depression may consist of antidepressant medications, psychotherapy,
electroconvulsive therapy (ECT), or a combination of these
approaches.
for depression include various herbal remedies, such as St. John’s wort.
Those interested in herbal preparations should discuss these with their
doctor, however, as these preparations can interact with standard prescription
drugs and have side effects just like standard drugs. Other complementary
therapies include acupuncture, massage therapy, music therapy,
meditation, and stress reduction techniques. These are safe, and are
helpful to some patients with depression. Studies also indicate that regular
exercise can be helpful in controlling symptoms of depression and anxiety.
electroconvulsive therapy (ECT), or a combination of these
approaches.
- Antidepressant medications: These are drugs that work by
affecting the levels of neurotransmitters in the brain. There are several
different families of antidepressant medications, and the
doctor may have to try several different drugs before finding the
one that works best for the patient. The choice of antidepressant
also depends on whether the patient is taking prescription drugs
for other health conditions. It takes anywhere from two to eight
weeks for the patient to know whether the antidepressant is
working for them. Between a half and two-thirds of people with
depression are helped by medications. - Psychotherapy. There are several different approaches that are used
to treat depressed people. The most common ones are interpersonal
therapy and cognitive therapy. In interpersonal therapy, the
person learns about the causes of depression and the social triggers
in his or her life that set off depressive thoughts, together with strategies
for coping with their social situation. Cognitive therapy
works by teaching the patient to change his or her ways of
thinking. Many people have underlying negative assumptions that
affect the way they see their life, and these expectations can be
challenged and changed. - Electroconvulsive therapy (ECT). Sometimes called shock therapy,
ECT is a treatment in which seizures are induced in an anesthetized
patient to relieve the depression. It is thought to work by
changing the levels of neurotransmitters in the brain. ECT is generally
used only for depressed patients who have not been helped
by medications or psychotherapy.
for depression include various herbal remedies, such as St. John’s wort.
Those interested in herbal preparations should discuss these with their
doctor, however, as these preparations can interact with standard prescription
drugs and have side effects just like standard drugs. Other complementary
therapies include acupuncture, massage therapy, music therapy,
meditation, and stress reduction techniques. These are safe, and are
helpful to some patients with depression. Studies also indicate that regular
exercise can be helpful in controlling symptoms of depression and anxiety.
Prognosis
The prognosis of depression varies considerably. People who are not
treated for depression often feel better within six to twenty-four months;
however, episodes of depression can be shortened considerably with
treatment. About two-thirds of patients treated for depression feel well
enough to return to their normal activities within a few weeks. About a
quarter of patients will continue to have symptoms of depression for
months to years after the first episode. About 50 percent of patients
treated for depression will have a second episode at some point in time;
these recurrences usually respond well to treatment, however.
People who are depressed are at increased risk of suicide. About 3.4
percent of patients diagnosed with major depression eventually succeed
in committing suicide.
treated for depression often feel better within six to twenty-four months;
however, episodes of depression can be shortened considerably with
treatment. About two-thirds of patients treated for depression feel well
enough to return to their normal activities within a few weeks. About a
quarter of patients will continue to have symptoms of depression for
months to years after the first episode. About 50 percent of patients
treated for depression will have a second episode at some point in time;
these recurrences usually respond well to treatment, however.
People who are depressed are at increased risk of suicide. About 3.4
percent of patients diagnosed with major depression eventually succeed
in committing suicide.
Prevention
People cannot change some risk factors for depression, such as their
family history or their sex, but they can lower their risk by taking good
care of their physical health, keeping up a strong family and friendship
network, learning to cope with normal life stressors, and talking to their
doctor if they are concerned about their moods.
family history or their sex, but they can lower their risk by taking good
care of their physical health, keeping up a strong family and friendship
network, learning to cope with normal life stressors, and talking to their
doctor if they are concerned about their moods.
The Future
Depression is one of the oldest known mental disorders, having been
described by physicians in ancient Egypt and China, and is likely to continue
to be a common problem around the world. Present research
includes trials of newer antidepressants, comparisons of standard treatments
with various alternative therapies, and studies of the ways in which
culture or ethnic background influences depression. Another important
area of research is looking for ways to predict how patients will respond
to specific antidepressant medications, so that the trial-and-error approach
to finding the best drug for each patient could be eliminated.
described by physicians in ancient Egypt and China, and is likely to continue
to be a common problem around the world. Present research
includes trials of newer antidepressants, comparisons of standard treatments
with various alternative therapies, and studies of the ways in which
culture or ethnic background influences depression. Another important
area of research is looking for ways to predict how patients will respond
to specific antidepressant medications, so that the trial-and-error approach
to finding the best drug for each patient could be eliminated.
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