What is Depression?Everyone occasionally feels blue or sad. But these feelings are usually short-lived and pass within a couple of days. When you have depression, it interferes with daily life and causes pain for both you and those who care about you. Depression is a common but serious illness.
DEFINITION• Depression is a common mental disorder that presents with depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration.
• Depression is the leading cause of disability as measured and the 4th leading contributor to the global burden of disease (DALYs) in 2000. By the year 2020, depression is projected to reach 2nd place of the ranking of DALYs calculated for all ages, both sexes. Today, depression is already the 2nd cause of DALYs in the age category 15-44 years for both sexes combined.
PREVALENECE• Depression occurs in persons of all genders, ages, and backgrounds.• Facts• Depression is common, affecting about 121 million people worldwide.• Depression is among the leading causes of disability worldwide.• Depression can be reliably diagnosed and treated in primary care.• Fewer than 25 % of those affected have access to effective treatments.•
What are the different forms of depression?There are several forms of depressive disorders.1. Major depressive disorder, or major depression2. Dysthymic disorder, or dysthymia3. Minor depression • Psychotic depression, • Postpartum depression • Seasonal affective disorder (SAD)4. Bipolar disorder
Signs And Symptoms Of Depression Persistent sad, anxious, or "empty" feelings Feelings of hopelessness or pessimism Feelings of guilt, worthlessness, or helplessness Irritability, restlessness Loss of interest in activities or hobbies once pleasurable, including sex Fatigue and decreased energy
S&S Cont…. Difficulty concentrating, remembering details, and making decisions Insomnia, early-morning wakefulness, or excessive sleeping Overeating, or appetite loss Thoughts of suicide, suicide attempts Aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment.
?Post-traumatic stress disorder (PTSD)Obsessive-compulsive disorderPanic disordersocial phobiaGeneralized anxiety disorderDepression also may occur with other serious medical illnesses such as heart disease, stroke, cancer, HIV/AIDS, diabetes, and Parkinsons disease
CAUSES OF DEPRESSION1. Genetic or Hereditary2. Biological / Biochemical / Medication3. Dietary4. Environmental5. Socio Cultural Factors / Situations / Relationships / Personality
DIAGNOSIS•History Collection•Mental Status Examination•ICD – 10 Criteria
Management• Antidepressants primarily work on brain chemicals called neurotransmitters, especially serotonin and norepinephrine. Other antidepressants work on the neurotransmitter dopamine.
ANTI DEPRESSANTS• Selective serotonin reuptake inhibitors (SSRIs). Fluoxetine (Prozac), sertraline (Zoloft), escitalopram (Lexapro), paroxetine (Paxil), and citalopram (Celexa) are some of the most commonly prescribed SSRIs for depression.
ANTI DEPRESSANTS• Tricyclics are older antidepressants. Tricyclics are powerful, but they are not used as much today because their potential side effects are more serious.Examples: Imipramine and Nortriptyline
ANTI DEPRESSANTS• Monoamine oxidase inhibitors (MAOIs) are the oldest class of antidepressant medications. They can be especially effective in cases of “atypical" depression.• People who take MAOIs must avoid certain foods and beverages (including cheese and red wine) that contain a substance called tyramine.
PSYCHOTHERAPY• Cognitive - behavioral therapy (CBT)CBT helps people with depression restructure negative thought patterns.• Interpersonal therapy (IPT)IPT helps people understand and work through troubled relationships that may cause their depression
ELECTROCONVULSIVE THERAPY• For cases in which medication and/or psychotherapy does not help relieve a persons treatment- resistant depression, electroconvulsive therapy (ECT) may be useful.