Depression. SYMPTOMS. Depressed mood. Markedly diminished interest or pleasure in activities. Significant weight loss when not dieting or weight gain, or decrease or increase in appetite. Insomnia or hypersomnia . Psychomotor agitation or retardation. Fatigue or loss of energy.
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Negative emotionality is a common precursor. Adverse events and a person’s way of coping or reacting to them determines resilience which may help prevent depression.
Low self-esteem and self-defeating or distorted thinking are also related to depression.
Depression is less likely to occur among people who have a sense of religiosity
Certain social situations such as poverty, social isolation, and child abuse are associated with increased risk of developing depressive disorders.
Among children, disturbances in family functioning serve as risk factors for depression; among adults, stressful life events are strongly associated with onset of depression
Loss of pleasure in most or all activities, a failure of reactivity to pleasurable stimuli, worsening of symptoms during morning hours, psychomotor retardation, and excessive weight loss.
Mood reactivity, significant weight gain or increased appetite, excessive sleep or sleepiness, sensation of heaviness in limbs, and significant social impairment due to perceived interpersonal rejection.
Severe form of Depression involving disturbances of motor behavior. Patient may be mute, stuporous, immobile, or exhibit purposeless movements.
Intense and sustained depression experienced by women after giving birth, with an incidence rate of 10-15%.
Seasonal Affective Disorder
Form of depression in which symptoms come during winter or autumn. And disappear during spring. Diagnosis is made if at least two episodes occurred in colder months with none at other months, over a two year period.
Selective Serotonin Reuptake Inhibitors
Mechanism: SSRIs inhibit reuptake of serotonin, and make it stay in the synaptic cleft longer than usual, hence repeatedly stimulating the receptors of recipient cell.
Examples: Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Paxil), Escitalopram
Serotonin-Norepinephrine Reuptake Inhibitors
Mechanism: SNRIs have the same mechanism as SSRI.
Examples: Venlafaxine, Desvenlafaxine, Duloxetine
Electricity is seen through brain via two electrodes to induce seizure while patient is under anesthesia.
It is the treatment of choice in catatonic depression or when a person has severe anorexia or is suicidal.
Relapse rate is around 50%-84%, but is reduced with use of psychiatric medications or with further ECT.
Can occur anytime, but usually before age 40. Untreated Depression usually lasts 6-13 months, while treated cases last 3 months.
50% recover within first year.
25% recover within first six months.
50-75% relapse within next five years.
Good Prognostic Indicators
Mild episodes (lasting around month or two)
Absence of psychotic or other comorbid psychiatric symptoms.
Short hospital stay.
Solid family function, friends, and sociality.
Advanced age of onset.
Ataque de Nervios: uncontrollable shouting, attacks of crying, trembling, heat rising in chest, aggression.
Piblokto: hysteria, depression, coprophagia, insensitivity to cold, echolalia
Hikikomori: withdrawal from society, seeking isolation; sometimes can be violent.
Hwabyeong: depression, sleeplessness, anxiety, obsessive-compulsiveness, anorexia, paranoia, sleeplessness, irritability.
Shenjingshuairuo: elements of depression and anxiety disorder, such as fatigue, dizziness, sleepiness, irritability, and memory loss.