Major depressive disorder is a serious mood disorder characterized by depressed mood and/or loss of interest or pleasure in activities for at least two weeks. It affects up to 21% of women and 13% of men at some point in their lives, typically beginning in the 20s. Symptoms include changes in mood, physical symptoms like sleep and appetite changes, cognitive symptoms like difficulty concentrating, and thoughts of death or suicide. The disorder is more common and severe in women during times of hormonal changes or life changes and can be triggered by both positive and negative life events.
2. 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
3. Major Depressive Episode
DSM-IV-TR criteria include
◦ 1 of 2 mood symptoms
◦ at least 5 symptoms total
◦ duration of at least 2 weeks
4. 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
5. 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.
6. 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)
7. 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
8. 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
9. Cognitive Symptoms of
Depression
difficulty concentrating, thinking, and
making decisions
feelings of worthlessness, guilt, or
hopelessness
recurrent thoughts of death or suicide
10. Course of Depression
if untreated, average duration of first
episode is 6-9 months
often recur
