This ppt will provide a complete information on the topic Depression. It Will also provide the types of depression, pathophysiology involved, causes, drugs used in Depression and its management.
This document provides an overview of obsessive compulsive disorder (OCD), including its definition, symptoms, causes, diagnosis and treatment. OCD is characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions) performed to reduce associated anxiety. It has been linked to imbalances in serotonin and dopamine levels in the brain. Treatment involves cognitive behavioral therapy and medication, primarily selective serotonin reuptake inhibitors. The goals of treatment are to reduce symptoms and restore optimal functioning.
This document provides an overview of depression, including its definition, types, epidemiology, etiology, pathophysiology, clinical manifestations, diagnosis, investigations, and treatment. Depression is defined as a common mental disorder characterized by depressed mood, loss of interest, feelings of guilt, sleep disturbances, low energy, and poor concentration. Major types include major depressive disorder, bipolar disorder, dysthymic disorder, and situational depression. Depression affects over 350 million people globally and is a leading cause of disability. Causes may include genetic, environmental, biochemical and neurological factors. Treatment involves antidepressant medications like SSRIs, TCAs, and MAOIs as well as psychotherapy and other non-pharmacological approaches.
Schizophrenia is a group of severe brain disorders in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and disordered thinking and behaviour.
Contrary to some popular belief, schizophrenia is not split personality or multiple personality. The word “schizophrenia” does mean “split mind,” but it refers to a disruption of the usual balance of emotions and thinking (Mayo, 2013).
Schizophrenia is a chronic condition, requiring lifelong treatment.
Alzheimer's disease is a progressive brain disorder that destroys memory and thinking skills. It is the most common cause of dementia among older adults. The main risk factors are age, family history, and head trauma. Currently, there is no cure and symptoms gradually worsen over time, becoming severe enough to impact daily life. Management focuses on treatment of symptoms and increasing quality of life.
This document discusses delirium, including its causes, symptoms, types, risk factors, tests, diagnosis, treatments, and nursing interventions. Delirium is characterized by impaired consciousness, disorientation, and cognitive impairment. It has various causes like medical conditions, medications, and substance withdrawal. Symptoms fluctuate and include confusion, emotional disturbances, and behavioral changes. Treatment focuses on addressing underlying causes and providing a calm environment. Nursing aims to ensure patient safety, reduce fear and anxiety, meet physical needs, and facilitate orientation.
hii guys this is my ongoing presentation from my speciality class i hope u guys lije that please so i hope it is been useful for u in ur specialities by getting little help with that
Depression is the leading cause of disability world wide and is a major contributor to the overall global burden of diseases .At its worst depression can cause suicide .
There are effective psychological and pharmacological treatments for depression
This document discusses mood stabilizers used to treat bipolar disorder. It describes the symptoms of mania and depression in bipolar disorder. Lithium, valproic acid, carbamazepine, lamotrigine and various antipsychotics are described as first-line mood stabilizing agents. The mechanisms of action of these drugs involve inhibition of inositol monophosphatase and other enzymes, decreasing intracellular inositol levels. Novel targets for treating bipolar disorder discussed include inhibition of glycogen synthase kinase-3, protein kinase C, modulation of brain-derived neurotrophic factor, enhanced Bcl2 expression, effects on oxidative stress, and modulation of glutamatergic transmission.
This document provides an overview of obsessive compulsive disorder (OCD), including its definition, symptoms, causes, diagnosis and treatment. OCD is characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions) performed to reduce associated anxiety. It has been linked to imbalances in serotonin and dopamine levels in the brain. Treatment involves cognitive behavioral therapy and medication, primarily selective serotonin reuptake inhibitors. The goals of treatment are to reduce symptoms and restore optimal functioning.
This document provides an overview of depression, including its definition, types, epidemiology, etiology, pathophysiology, clinical manifestations, diagnosis, investigations, and treatment. Depression is defined as a common mental disorder characterized by depressed mood, loss of interest, feelings of guilt, sleep disturbances, low energy, and poor concentration. Major types include major depressive disorder, bipolar disorder, dysthymic disorder, and situational depression. Depression affects over 350 million people globally and is a leading cause of disability. Causes may include genetic, environmental, biochemical and neurological factors. Treatment involves antidepressant medications like SSRIs, TCAs, and MAOIs as well as psychotherapy and other non-pharmacological approaches.
Schizophrenia is a group of severe brain disorders in which people interpret reality abnormally. Schizophrenia may result in some combination of hallucinations, delusions, and disordered thinking and behaviour.
Contrary to some popular belief, schizophrenia is not split personality or multiple personality. The word “schizophrenia” does mean “split mind,” but it refers to a disruption of the usual balance of emotions and thinking (Mayo, 2013).
Schizophrenia is a chronic condition, requiring lifelong treatment.
Alzheimer's disease is a progressive brain disorder that destroys memory and thinking skills. It is the most common cause of dementia among older adults. The main risk factors are age, family history, and head trauma. Currently, there is no cure and symptoms gradually worsen over time, becoming severe enough to impact daily life. Management focuses on treatment of symptoms and increasing quality of life.
This document discusses delirium, including its causes, symptoms, types, risk factors, tests, diagnosis, treatments, and nursing interventions. Delirium is characterized by impaired consciousness, disorientation, and cognitive impairment. It has various causes like medical conditions, medications, and substance withdrawal. Symptoms fluctuate and include confusion, emotional disturbances, and behavioral changes. Treatment focuses on addressing underlying causes and providing a calm environment. Nursing aims to ensure patient safety, reduce fear and anxiety, meet physical needs, and facilitate orientation.
hii guys this is my ongoing presentation from my speciality class i hope u guys lije that please so i hope it is been useful for u in ur specialities by getting little help with that
Depression is the leading cause of disability world wide and is a major contributor to the overall global burden of diseases .At its worst depression can cause suicide .
There are effective psychological and pharmacological treatments for depression
This document discusses mood stabilizers used to treat bipolar disorder. It describes the symptoms of mania and depression in bipolar disorder. Lithium, valproic acid, carbamazepine, lamotrigine and various antipsychotics are described as first-line mood stabilizing agents. The mechanisms of action of these drugs involve inhibition of inositol monophosphatase and other enzymes, decreasing intracellular inositol levels. Novel targets for treating bipolar disorder discussed include inhibition of glycogen synthase kinase-3, protein kinase C, modulation of brain-derived neurotrophic factor, enhanced Bcl2 expression, effects on oxidative stress, and modulation of glutamatergic transmission.
Mania is defined as a distinct period of abnormally and persistently elevated or irritable mood lasting at least one week. It can be classified as mixed states with both manic and depressive features, hypomania with less sleep needs and increased goal-motivated behavior, or associated with bipolar disorder. Causes may include genetic, biochemical, seasonal, or stressful life influences. Signs include inflated self-esteem, decreased sleep needs, pressured speech, distractibility, and risky behaviors. Treatment involves psychological therapies and organic treatments like mood stabilizers, antipsychotics, or benzodiazepines to control symptoms.
The document defines psychosis as a loss of contact with reality and discusses its causes, types, signs and symptoms, diagnosis, treatment, and nursing management. Psychosis can be caused by genetic and medical factors as well as substance use and can involve hallucinations, delusions, and thought disorders. Diagnosis involves medical testing and evaluations to determine if underlying medical or substance conditions are present. Treatment includes antipsychotic medications, therapy, and rehabilitation services. Nursing care focuses on safety, communication, maintaining health, and addressing low self-esteem.
Depression is a state of low mood and loss of interest in activities. It affects thoughts, behavior, motivation, feelings, and well-being. Core symptoms include sadness, difficulty concentrating, changes in appetite and sleep, feelings of dejection and hopelessness, and sometimes suicidal thoughts. Depression can be short or long term. Causes include life events, personality traits, medical treatments, substance use, and psychiatric syndromes. Symptoms include mood disturbances and cognitive changes.
Generalized anxiety disorder (GAD) is characterized by excessive, uncontrollable worry about everyday things for at least six months. It is a common chronic disorder not focused on any single object or situation. Women are two to three times more likely than men to suffer from GAD, which typically develops between childhood and late adulthood, with median onset at age 31. Causes include genetics, abnormal brain chemistry, trauma, stressful life events, and environmental factors. Diagnosis requires excessive anxiety and worry for over six months that is difficult to control and associated with restlessness, fatigue, irritability, muscle tension, sleep issues, or difficulty concentrating. Treatment involves medication like benzodiazepines or antidepressants as well as cognitive
Bipolar disorder is characterized by recurrent episodes of mania and depression. It is classified into Bipolar I and II based on the severity of manic episodes. The exact causes are unknown but genetic and biochemical factors are thought to play a role. Clinical features include changes in mood, energy, sleep patterns, and risk-taking behavior. Treatment involves mood stabilizers like lithium, antipsychotics, and antidepressants to control symptoms and prevent future episodes. Prognosis depends on factors like comorbidities, stress levels, and medication compliance.
The document provides an overview of mood stabilizers, including their definition, classification, mechanisms of action, and side effects. It defines mood stabilizers as medications that decrease vulnerability to manic or depressive episodes without exacerbating current symptoms. Common mood stabilizers are lithium, anticonvulsants like valproate and carbamazepine, and atypical antipsychotics. These medications impact neurotransmitter systems and signaling pathways in the brain to achieve their mood stabilizing effects, but can also cause side effects like tremors, weight gain, thyroid and kidney issues.
obsessive-compulsive disorder is a mental disorder whose main symptoms include obsessions and compulsions, driving the person to engage in unwanted, often-times distress behaviors or thoughts. The obsessions are usually related to a sense of harm, risk or injury. The common Obsessions include concern about contamination, doubt, fear of loss or letting go, fear of physically injuring someone.It’s treatment is done through a combination of psychiatric medications and psychotherapy.
Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over.
An obsession is defined as an idea, impulse, or image which intrude into the conscious aware repeatedly.
Somatoform disorders are mental disorders characterized by physical symptoms that cannot be fully explained by a medical condition. They are caused by psychological factors and result in significant distress or impairment. One such disorder is somatization disorder, which involves multiple somatic complaints in various organ systems over several years. It has an onset before age 30 and is diagnosed when symptoms cannot be explained medically or are excessive given the medical findings. Common features include pain, gastrointestinal, sexual, and pseudoneurological symptoms. Somatization disorder is associated with conditions like depression and anxiety.
This document provides an overview of schizophrenia, including its symptoms, types, diagnosis, epidemiology, etiology, pathophysiology, imaging findings, treatment goals, and pharmacological management. Schizophrenia is a chronic psychotic disorder characterized by disorganized thinking and perceptions. It has several clinical subtypes and is generally treated through a combination of antipsychotic medications and psychotherapy, with goals of minimizing symptoms and improving functioning. The exact causes are unknown but involve genetic and environmental factors impacting brain neurochemistry.
This document discusses psychotropic drug categories and antipsychotic drugs. It summarizes that antipsychotic drugs work by blocking dopamine receptors and are used to treat symptoms of psychosis. It lists common antipsychotic drugs and their dosages and side effects, which include extrapyramidal symptoms like acute dystonia, pseudoparkinsonism, akathisia, and tardive dyskinesia. It provides information on treating side effects and educating clients on antipsychotic medication management.
This document discusses bipolar affective disorder, also known as manic-depressive disorder. It is characterized by cycles of abnormal high mood (mania) and low mood (depression). Bipolar disorder is classified into types I and II based on the severity and duration of manic or hypomanic episodes. Management includes pharmacotherapy with mood stabilizing drugs, electroconvulsive therapy, psychotherapy, and lifestyle changes. The causes are believed to involve genetic and environmental factors impacting cognitive and physiological functions.
Mood disorders are a category of mental illnesses that involve serious changes in mood. There are several types of mood disorders including major depressive disorder, dysthymic disorder, bipolar I, bipolar II, and cyclothymic disorder. Mood disorders are among the most common mental illnesses and have a lifetime prevalence of 5-20%. Females are twice as likely as males to experience a mood disorder. The highest incidence rates occur between the ages of 20-40 years old. Mood disorders are a major cause of disability and suicide worldwide. Biological, psychological, and environmental factors all contribute to the development of mood disorders.
mania is an alteration in mood that is characterized by extreme happiness, extreme irritability, hyperactivity, little or no need for sleep. the main etiological factors include biological factors, biochemical influences, physiological factors, and psycho social theories. mania is broadly classified into three categories- hypo mania, acute mania and delirious mania. there are three types of treatment for mania- pharmacological treatment, psycho-social treatment and ECT.
This document discusses dementia, including its definition, classification, causes, symptoms, stages, diagnosis and treatment. Dementia is defined as the acquired impairment of intellect, memory and personality without impaired consciousness. It is most common in the elderly. The main types discussed are Alzheimer's disease, vascular dementia and dementia caused by other diseases. Symptoms worsen over three stages from mild memory loss to severe impairment, eventually resulting in death. Diagnosis involves cognitive assessment and MRI or spinal fluid tests. Treatment focuses on medications to improve symptoms as well as managing behaviors and providing daily care and support.
obsessive compulsive and related disorders (OCD)mamtabisht10
This document provides information about obsessive compulsive disorder and related disorders. It discusses OCD, body dysmorphic disorder, hoarding disorder, trichotillomania, excoriation disorder and their symptoms. It also covers the etiology, clinical features, diagnosis and treatment of OCD, including psychotherapy, pharmacotherapy, ECT and self-help strategies. Nursing management focuses on reducing anxiety and compulsive behaviors, improving role performance and sleep disturbances. Related disorders like body dysmorphic disorder, hair pulling disorder and skin picking disorder are also summarized.
Epilepsy is a chronic neurological disorder characterized by recurrent seizures. It affects approximately 50 million people worldwide. Seizures occur due to abnormal electrical activity in the brain and can vary from brief lapses of awareness to severe and prolonged convulsions. Management involves anti-seizure medications and lifestyle modifications. Nurses play an important role in patient education and safety during seizures.
Dementia is a loss of mental skills that affects daily life and usually gets worse over time. It can be caused by neurodegenerative conditions like Alzheimer's disease, vascular diseases, head injuries, strokes, infections, and certain genetic disorders. Dementia is diagnosed through medical history, exams, and lab tests and stages progress from mild cognitive impairment to moderate and severe dementia. Treatment involves medications to address symptoms, care to support daily living, and management of behaviors.
Bipolar disorder causes extreme shifts in mood from mania to depression. It is a chronic illness often diagnosed in adolescence that has high rates of suicide. While the causes are unknown, genetic and environmental factors likely contribute. Diagnosis involves meeting DSM-5 criteria for manic or hypomanic episodes. Treatment includes medication, psychotherapy, and lifestyle changes. Lithium and anticonvulsants are commonly used to stabilize moods, while antidepressants may be used for depression but carry risk for inducing mania. Long-term management focuses on preventing recurrences through medication adherence and monitoring for risky behaviors.
The document provides information about mood disorders including major depressive disorder and bipolar disorder. It discusses the classification, signs and symptoms, epidemiology, etiology, differential diagnosis, and treatment options for mood disorders. Treatment involves risk assessment, hospitalization if needed, psychotherapy, pharmacotherapy, and addressing any medical causes.
Unipolar depression, also known as major depressive disorder, is characterized by at least two weeks of depressed mood or loss of interest accompanied by other cognitive and physical symptoms. It is a complex disorder that can manifest through emotional, physical, and cognitive symptoms due to involvement of many brain regions. Treatment goals include reducing symptoms, restoring function, and minimizing relapse risk. While SSRIs effectively treat emotional symptoms, dual-acting antidepressants that increase both serotonin and norepinephrine may better treat the full symptom spectrum due to the roles of these neurotransmitters in both the brain and spinal cord. Achieving full remission is important for improving long-term outcomes, as residual symptoms are associated with higher relapse risk.
Mania is defined as a distinct period of abnormally and persistently elevated or irritable mood lasting at least one week. It can be classified as mixed states with both manic and depressive features, hypomania with less sleep needs and increased goal-motivated behavior, or associated with bipolar disorder. Causes may include genetic, biochemical, seasonal, or stressful life influences. Signs include inflated self-esteem, decreased sleep needs, pressured speech, distractibility, and risky behaviors. Treatment involves psychological therapies and organic treatments like mood stabilizers, antipsychotics, or benzodiazepines to control symptoms.
The document defines psychosis as a loss of contact with reality and discusses its causes, types, signs and symptoms, diagnosis, treatment, and nursing management. Psychosis can be caused by genetic and medical factors as well as substance use and can involve hallucinations, delusions, and thought disorders. Diagnosis involves medical testing and evaluations to determine if underlying medical or substance conditions are present. Treatment includes antipsychotic medications, therapy, and rehabilitation services. Nursing care focuses on safety, communication, maintaining health, and addressing low self-esteem.
Depression is a state of low mood and loss of interest in activities. It affects thoughts, behavior, motivation, feelings, and well-being. Core symptoms include sadness, difficulty concentrating, changes in appetite and sleep, feelings of dejection and hopelessness, and sometimes suicidal thoughts. Depression can be short or long term. Causes include life events, personality traits, medical treatments, substance use, and psychiatric syndromes. Symptoms include mood disturbances and cognitive changes.
Generalized anxiety disorder (GAD) is characterized by excessive, uncontrollable worry about everyday things for at least six months. It is a common chronic disorder not focused on any single object or situation. Women are two to three times more likely than men to suffer from GAD, which typically develops between childhood and late adulthood, with median onset at age 31. Causes include genetics, abnormal brain chemistry, trauma, stressful life events, and environmental factors. Diagnosis requires excessive anxiety and worry for over six months that is difficult to control and associated with restlessness, fatigue, irritability, muscle tension, sleep issues, or difficulty concentrating. Treatment involves medication like benzodiazepines or antidepressants as well as cognitive
Bipolar disorder is characterized by recurrent episodes of mania and depression. It is classified into Bipolar I and II based on the severity of manic episodes. The exact causes are unknown but genetic and biochemical factors are thought to play a role. Clinical features include changes in mood, energy, sleep patterns, and risk-taking behavior. Treatment involves mood stabilizers like lithium, antipsychotics, and antidepressants to control symptoms and prevent future episodes. Prognosis depends on factors like comorbidities, stress levels, and medication compliance.
The document provides an overview of mood stabilizers, including their definition, classification, mechanisms of action, and side effects. It defines mood stabilizers as medications that decrease vulnerability to manic or depressive episodes without exacerbating current symptoms. Common mood stabilizers are lithium, anticonvulsants like valproate and carbamazepine, and atypical antipsychotics. These medications impact neurotransmitter systems and signaling pathways in the brain to achieve their mood stabilizing effects, but can also cause side effects like tremors, weight gain, thyroid and kidney issues.
obsessive-compulsive disorder is a mental disorder whose main symptoms include obsessions and compulsions, driving the person to engage in unwanted, often-times distress behaviors or thoughts. The obsessions are usually related to a sense of harm, risk or injury. The common Obsessions include concern about contamination, doubt, fear of loss or letting go, fear of physically injuring someone.It’s treatment is done through a combination of psychiatric medications and psychotherapy.
Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over.
An obsession is defined as an idea, impulse, or image which intrude into the conscious aware repeatedly.
Somatoform disorders are mental disorders characterized by physical symptoms that cannot be fully explained by a medical condition. They are caused by psychological factors and result in significant distress or impairment. One such disorder is somatization disorder, which involves multiple somatic complaints in various organ systems over several years. It has an onset before age 30 and is diagnosed when symptoms cannot be explained medically or are excessive given the medical findings. Common features include pain, gastrointestinal, sexual, and pseudoneurological symptoms. Somatization disorder is associated with conditions like depression and anxiety.
This document provides an overview of schizophrenia, including its symptoms, types, diagnosis, epidemiology, etiology, pathophysiology, imaging findings, treatment goals, and pharmacological management. Schizophrenia is a chronic psychotic disorder characterized by disorganized thinking and perceptions. It has several clinical subtypes and is generally treated through a combination of antipsychotic medications and psychotherapy, with goals of minimizing symptoms and improving functioning. The exact causes are unknown but involve genetic and environmental factors impacting brain neurochemistry.
This document discusses psychotropic drug categories and antipsychotic drugs. It summarizes that antipsychotic drugs work by blocking dopamine receptors and are used to treat symptoms of psychosis. It lists common antipsychotic drugs and their dosages and side effects, which include extrapyramidal symptoms like acute dystonia, pseudoparkinsonism, akathisia, and tardive dyskinesia. It provides information on treating side effects and educating clients on antipsychotic medication management.
This document discusses bipolar affective disorder, also known as manic-depressive disorder. It is characterized by cycles of abnormal high mood (mania) and low mood (depression). Bipolar disorder is classified into types I and II based on the severity and duration of manic or hypomanic episodes. Management includes pharmacotherapy with mood stabilizing drugs, electroconvulsive therapy, psychotherapy, and lifestyle changes. The causes are believed to involve genetic and environmental factors impacting cognitive and physiological functions.
Mood disorders are a category of mental illnesses that involve serious changes in mood. There are several types of mood disorders including major depressive disorder, dysthymic disorder, bipolar I, bipolar II, and cyclothymic disorder. Mood disorders are among the most common mental illnesses and have a lifetime prevalence of 5-20%. Females are twice as likely as males to experience a mood disorder. The highest incidence rates occur between the ages of 20-40 years old. Mood disorders are a major cause of disability and suicide worldwide. Biological, psychological, and environmental factors all contribute to the development of mood disorders.
mania is an alteration in mood that is characterized by extreme happiness, extreme irritability, hyperactivity, little or no need for sleep. the main etiological factors include biological factors, biochemical influences, physiological factors, and psycho social theories. mania is broadly classified into three categories- hypo mania, acute mania and delirious mania. there are three types of treatment for mania- pharmacological treatment, psycho-social treatment and ECT.
This document discusses dementia, including its definition, classification, causes, symptoms, stages, diagnosis and treatment. Dementia is defined as the acquired impairment of intellect, memory and personality without impaired consciousness. It is most common in the elderly. The main types discussed are Alzheimer's disease, vascular dementia and dementia caused by other diseases. Symptoms worsen over three stages from mild memory loss to severe impairment, eventually resulting in death. Diagnosis involves cognitive assessment and MRI or spinal fluid tests. Treatment focuses on medications to improve symptoms as well as managing behaviors and providing daily care and support.
obsessive compulsive and related disorders (OCD)mamtabisht10
This document provides information about obsessive compulsive disorder and related disorders. It discusses OCD, body dysmorphic disorder, hoarding disorder, trichotillomania, excoriation disorder and their symptoms. It also covers the etiology, clinical features, diagnosis and treatment of OCD, including psychotherapy, pharmacotherapy, ECT and self-help strategies. Nursing management focuses on reducing anxiety and compulsive behaviors, improving role performance and sleep disturbances. Related disorders like body dysmorphic disorder, hair pulling disorder and skin picking disorder are also summarized.
Epilepsy is a chronic neurological disorder characterized by recurrent seizures. It affects approximately 50 million people worldwide. Seizures occur due to abnormal electrical activity in the brain and can vary from brief lapses of awareness to severe and prolonged convulsions. Management involves anti-seizure medications and lifestyle modifications. Nurses play an important role in patient education and safety during seizures.
Dementia is a loss of mental skills that affects daily life and usually gets worse over time. It can be caused by neurodegenerative conditions like Alzheimer's disease, vascular diseases, head injuries, strokes, infections, and certain genetic disorders. Dementia is diagnosed through medical history, exams, and lab tests and stages progress from mild cognitive impairment to moderate and severe dementia. Treatment involves medications to address symptoms, care to support daily living, and management of behaviors.
Bipolar disorder causes extreme shifts in mood from mania to depression. It is a chronic illness often diagnosed in adolescence that has high rates of suicide. While the causes are unknown, genetic and environmental factors likely contribute. Diagnosis involves meeting DSM-5 criteria for manic or hypomanic episodes. Treatment includes medication, psychotherapy, and lifestyle changes. Lithium and anticonvulsants are commonly used to stabilize moods, while antidepressants may be used for depression but carry risk for inducing mania. Long-term management focuses on preventing recurrences through medication adherence and monitoring for risky behaviors.
The document provides information about mood disorders including major depressive disorder and bipolar disorder. It discusses the classification, signs and symptoms, epidemiology, etiology, differential diagnosis, and treatment options for mood disorders. Treatment involves risk assessment, hospitalization if needed, psychotherapy, pharmacotherapy, and addressing any medical causes.
Unipolar depression, also known as major depressive disorder, is characterized by at least two weeks of depressed mood or loss of interest accompanied by other cognitive and physical symptoms. It is a complex disorder that can manifest through emotional, physical, and cognitive symptoms due to involvement of many brain regions. Treatment goals include reducing symptoms, restoring function, and minimizing relapse risk. While SSRIs effectively treat emotional symptoms, dual-acting antidepressants that increase both serotonin and norepinephrine may better treat the full symptom spectrum due to the roles of these neurotransmitters in both the brain and spinal cord. Achieving full remission is important for improving long-term outcomes, as residual symptoms are associated with higher relapse risk.
This document provides an overview of mood disorders, including bipolar disorder and major depressive disorder. It discusses the classification, symptoms, diagnostic criteria, epidemiology, pathophysiology, etiology, presentation, differential diagnoses, screening tests, and management of mood disorders. The learning objectives are to describe mood and affect, classify mood disorders, identify the sources of mood disorders, determine the diagnostic criteria for depression, and describe proper management of depressive disorders.
Depression
Background
Pathophysiology
• The monoamine theory of depression is that it results from a central deficit in the monoamine neurotransmitters serotonin (5-HT) and norepinephrine.
• Other reported physiological features include ↑cortisol and a blunted TSH response.
• However, there is no widely accepted and definitively proven biological model of depression.
Epidemiology
• Time course: for most it is an episodic illness, but for other it follows a more chronic course.
• Incidence: 5% annual risk, 20% lifetime risk.
Presentation
DSM and NICE criteria
These are based on DSM-4, though DSM-5 does not significantly differ.
Major depressive disorder is ≥2 weeks of low mood and/or anhedonia, and at least 4 symptoms out of:
• ↓Energy or fatigue.
• ↓Concentration
• ↓Weight/appetite.
• Disturbed sleep, which commonly includes early waking. Diurnal pattern to symptoms also seen, with symptoms often worse in the morning.
• Slowing of thought and movements (psychomotor slowing) or agitation.
• Ideas of worthlessness or guilt.
• Recurrent thoughts of death or suicide.
• All but the last 2 are considered 'biological' symptoms.
The document lists the 10 leading causes of disability worldwide according to cost in disability-adjusted life years (DALYs). Unipolar major depression is the leading cause, accounting for 10.3% of total cost. The top 3 causes are unipolar major depression, tuberculosis, and road traffic accidents. Together the top 10 causes account for over 40% of the total cost of disability worldwide.
Diagnosis and management of major depressive disorderNeurologyKota
This document provides information on major depressive disorder and dysthymic disorder, including their symptoms, classifications, prevalence, risk factors, pathophysiology, diagnostic criteria, sleep abnormalities seen in depression, and treatment options. It discusses antidepressant medications like TCAs, MAOIs, SSRIs, SNRIs, augmentation therapies, psychosocial therapies, and ECT in the treatment of depressive disorders.
Depression is a mood disorder characterized by persistent feelings of sadness and loss of interest. It can be caused by genetic, biological, environmental, and psychological factors. Common symptoms include changes in appetite, sleep, and energy levels. Treatment involves therapy, medication, and lifestyle changes. There are several types of depressive disorders defined in the DSM-5, including major depressive disorder, persistent depressive disorder, and postpartum depression. Substance-induced depressive disorder occurs when depressive symptoms are directly caused by substance or medication use.
Mood disorder characterized by disturbance of mood. it includes mania or depressive syndrome. it includes definition, causes, sign and symptoms, treatment and nursing diagnosis etc.
Major depressive disorder is one of the most common psychiatric disorders, affecting nearly 17% of the population. It is characterized by depressed mood or loss of interest/pleasure for at least two weeks, along with other symptoms such as changes in appetite, sleep, energy levels, concentration, feelings of worthlessness and thoughts of death or suicide. Biological factors like abnormalities in neurotransmitter systems, hormones, and sleep patterns are implicated in its etiology. Treatment involves medications and psychotherapy.
Major depression is characterized by depressed mood and loss of interest or pleasure that lasts at least two weeks. About 15% of people experience major depression in their lifetime. Females experience depression twice as often as males. Depression has genetic, biological, psychological, and social causes. Treatment involves psychotherapy, antidepressant medication, electroconvulsive therapy, or light therapy. Nursing care focuses on safety, support, and education to prevent suicide and promote recovery.
This document discusses the treatment of depression in children and adolescents. It covers symptoms of depression, diagnostic criteria, course of illness, common comorbidities, treatment options including psychotherapy and medication management. Psychoeducation is recommended for all patients, while mild cases may only require supportive care. Moderate to severe depression is often treated with evidence-based therapies such as CBT or medication in addition to psychoeducation. The goals of treatment are response, remission, and recovery from depressive symptoms.
Major Depressive Disorder is characterized by at least five symptoms of depression lasting at least two weeks. The document discusses the various types of depression like major depression, dysthymia, seasonal affective disorder, atypical depression, bipolar disorder, and others. It also discusses the causes of depression including genetic, environmental, medical factors. Treatment involves medication, psychotherapy, and social support depending on the severity and type of depression.
This was a lecture in the course "Significant Medical Conditions in Seniors" presented at Peer Learning in Chapel Hill, NC, USA in 2016 by Michael C. Joseph, MD, MPH.
Mental illness refers to medical conditions that disrupt thinking, mood, and behavior. Some common mental illnesses include anxiety disorders, depression, bipolar disorder, schizophrenia, and others. Mental illnesses are treatable medical conditions that can affect people of any age, race, or background. Signs and symptoms vary depending on the illness but may include changes in mood, sleep, appetite, concentration, and social withdrawal. Treatment involves medication, therapy, support groups, and lifestyle changes tailored to the individual. Recovery is promoted through awareness, seeking help, and maintaining treatment.
This document discusses mood disorders and their treatment. It defines mood as a sustained emotional state, versus affect which is the external display of emotions. Mood disorders involve disturbances in mood that impair functioning, and include magnified states of mania and depression. There are several types of mood disorders including major depressive disorder, bipolar disorder, and dysthymic disorder. Treatment involves risk assessment, psychosocial therapies like CBT and IPT, pharmacotherapy with antidepressants, and other options like ECT for severe cases.
This document provides information on mood disorders including depression and bipolar disorder. It discusses the characteristics and prevalence of depression, including symptoms such as lowered mood, sleep disturbances, and weight loss. Mania is described as involving overactivity, mood changes, and self-important ideas. The document outlines various classifications of depressive and bipolar disorders. It also discusses the epidemiology, causes, assessment, and management of depression and bipolar disorder.
About Different Mood Disorders - PsychologyAnshAntil2
This document summarizes several mood disorders as defined in the proposed DSM-5, including major depressive disorder, chronic depressive disorder (dysthymia), premenstrual dysphoric disorder, and disruptive mood dysregulation disorder. It also covers bipolar disorders such as bipolar I, bipolar II, and cyclothymic disorder. Key details include diagnostic criteria for each disorder, descriptions of depressive and manic symptoms, epidemiology of depressive disorders, and comorbidity between mood disorders and anxiety disorders.
Major Depressive Disorder (MDD), also known as clinical depression, is a mood disorder characterized by persistent feelings of sadness that impact a person's mood, cognition, and behavior. There are several types of MDD with varying symptoms. Globally over 264 million people suffer from depression. Treatment involves medications like SSRIs and SNRIs as well as psychotherapy through approaches like cognitive behavioral therapy. The goal is to effectively manage symptoms and improve mood.
A 42-year-old man is experiencing a recurrent major depressive episode. He had previously responded well to treatment with imipramine but did not tolerate the anticholinergic side effects. Given his history of responding well to antidepressants and preference to avoid side effects, an SSRI with fewer anticholinergic effects would be a suitable first-line treatment option for this episode. Close monitoring would also be important given his risk of recurrence.
Hypertension and it's role of physiotherapy in it.Vishal kr Thakur
This particular slides consist of- what is hypertension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is summary of hypertension -
Hypertension, also known as high blood pressure, is a serious medical condition that occurs when blood pressure in the body's arteries is consistently too high. Blood pressure is the force of blood pushing against the walls of blood vessels as the heart pumps it. Hypertension can increase the risk of heart disease, brain disease, kidney disease, and premature death.
Joker Wigs has been a one-stop-shop for hair products for over 26 years. We provide high-quality hair wigs, hair extensions, hair toppers, hair patch, and more for both men and women.
We are one of the top Massage Spa Ajman Our highly skilled, experienced, and certified massage therapists from different corners of the world are committed to serving you with a soothing and relaxing experience. Luxuriate yourself at our spas in Sharjah and Ajman, which are indeed enriched with an ambiance of relaxation and tranquility. We could confidently claim that we are one of the most affordable Spa Ajman and Sharjah as well, where you can book the massage session of your choice for just 99 AED at any time as we are open 24 hours a day, 7 days a week.
Visit : https://massagespaajman.com/
Call : 052 987 1315
As Mumbai's premier kidney transplant and donation center, L H Hiranandani Hospital Powai is not just a medical facility; it's a beacon of hope where cutting-edge science meets compassionate care, transforming lives and redefining the standards of kidney health in India.
This particular slides consist of- what is Pneumothorax,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is a summary of Pneumothorax:
Pneumothorax, also known as a collapsed lung, is a condition that occurs when air leaks into the space between the lung and chest wall. This air buildup puts pressure on the lung, preventing it from expanding fully when you breathe. A pneumothorax can cause a complete or partial collapse of the lung.
About this webinar: This talk will introduce what cancer rehabilitation is, where it fits into the cancer trajectory, and who can benefit from it. In addition, the current landscape of cancer rehabilitation in Canada will be discussed and the need for advocacy to increase access to this essential component of cancer care.
MYASTHENIA GRAVIS POWER POINT PRESENTATIONblessyjannu21
Myasthenia gravis is a neurological disease. It affects the grave muscles in our body. Myasthenia gravis affects how the nerves communicate with the muscles. Drooping eyelids and/or double vision are often the first noticeable sign. It is involving the muscles controlling the eyes movement, facial expression, chewing and swallowing. It also effects the muscles neck and lip movement and respiration.
It is a neuromuscular disease characterized by abnormal weakness of voluntary muscles that improved with rest and the administration of anti-cholinesterase drugs.
The person may find difficult to stand, lift objects and speak or swallow. Medications and surgery can help the patient to relieve the symptoms of this lifelong illness.
Letter to MREC - application to conduct studyAzreen Aj
Application to conduct study on research title 'Awareness and knowledge of oral cancer and precancer among dental outpatient in Klinik Pergigian Merlimau, Melaka'
2024 HIPAA Compliance Training Guide to the Compliance OfficersConference Panel
Join us for a comprehensive 90-minute lesson designed specifically for Compliance Officers and Practice/Business Managers. This 2024 HIPAA Training session will guide you through the critical steps needed to ensure your practice is fully prepared for upcoming audits. Key updates and significant changes under the Omnibus Rule will be covered, along with the latest applicable updates for 2024.
Key Areas Covered:
Texting and Email Communication: Understand the compliance requirements for electronic communication.
Encryption Standards: Learn what is necessary and what is overhyped.
Medical Messaging and Voice Data: Ensure secure handling of sensitive information.
IT Risk Factors: Identify and mitigate risks related to your IT infrastructure.
Why Attend:
Expert Instructor: Brian Tuttle, with over 20 years in Health IT and Compliance Consulting, brings invaluable experience and knowledge, including insights from over 1000 risk assessments and direct dealings with Office of Civil Rights HIPAA auditors.
Actionable Insights: Receive practical advice on preparing for audits and avoiding common mistakes.
Clarity on Compliance: Clear up misconceptions and understand the reality of HIPAA regulations.
Ensure your compliance strategy is up-to-date and effective. Enroll now and be prepared for the 2024 HIPAA audits.
Enroll Now to secure your spot in this crucial training session and ensure your HIPAA compliance is robust and audit-ready.
https://conferencepanel.com/conference/hipaa-training-for-the-compliance-officer-2024-updates
DECODING THE RISKS - ALCOHOL, TOBACCO & DRUGS.pdfDr Rachana Gujar
Introduction: Substance use education is crucial due to its prevalence and societal impact.
Alcohol Use: Immediate and long-term risks include impaired judgment, health issues, and social consequences.
Tobacco Use: Immediate effects include increased heart rate, while long-term risks encompass cancer and heart disease.
Drug Use: Risks vary depending on the drug type, including health and psychological implications.
Prevention Strategies: Education, healthy coping mechanisms, community support, and policies are vital in preventing substance use.
Harm Reduction Strategies: Safe use practices, medication-assisted treatment, and naloxone availability aim to reduce harm.
Seeking Help for Addiction: Recognizing signs, available treatments, support systems, and resources are essential for recovery.
Personal Stories: Real stories of recovery emphasize hope and resilience.
Interactive Q&A: Engage the audience and encourage discussion.
Conclusion: Recap key points and emphasize the importance of awareness, prevention, and seeking help.
Resources: Provide contact information and links for further support.
Get Covid Testing at Fit to Fly PCR TestNX Healthcare
A Fit-to-Fly PCR Test is a crucial service for travelers needing to meet the entry requirements of various countries or airlines. This test involves a polymerase chain reaction (PCR) test for COVID-19, which is considered the gold standard for detecting active infections. At our travel clinic in Leeds, we offer fast and reliable Fit to Fly PCR testing, providing you with an official certificate verifying your negative COVID-19 status. Our process is designed for convenience and accuracy, with quick turnaround times to ensure you receive your results and certificate in time for your departure. Trust our professional and experienced medical team to help you travel safely and compliantly, giving you peace of mind for your journey.
2. Points of discussion.
History
Introduction & definition
Different types of depression
Epidemiology or prevalence of the disease
Etiology or causes
Pathophysiology
Clinical manifestations (Signs and
symptoms)
Diagnosis and Investigative tests
Treatment approaches
2
3. History
3
Hippocrates Galen Emil
Kraepelin
Four Humors
or Internal
fluids--Blood
-Black bile
-Yellow bile
-Phlegm
Excess of
black bile-
Melancholic
state
Distinguished
Melancholia into:
-Manic
Depression
-Dementia
Praecox
Melancholic
person
=Depressed
7. Introduction & definition
According to oxford dictionary- Depression is feeling of
severe despondency, or dejection and the disorder of
mood.
Leading cause of disability.
More than 264 million people suffer from depression
worldwide.
Clinical depression and just feeling sad both are
different.
Is persistent alteration in one's mood, persistent –ve
mental state more focused on the past.
Anxiety and depression both are different.
Anxiety more focused to the future.
Anxiety= “What if”, “Sense of uncertainty”
Depression- more focused on the past 7
8. Introduction & definition (continued)
Can also disturb sleep and appetite. Poor
concentration and tiredness are common.
Definition(WHO)- A common mental disorder that
presents with depressed mood, loss of interest or
pleasure (anhedonia), feeling of guilt, low self
worth, disturbed sleep or appetite, low energy or
poor concentration.
Another definition- State of low mood and
aversion(dislike), to activity that can affect a
person’s thoughts, behavior, feelings and sense of
well being.
8
9. Introduction & definition (continued)
Some very common symptoms include-
S I G E C A P S
S- Sleep Disturbances (Insomnia or Hypersomnia)
I- Interest (reduced) (Anhedonia)
G- Guilt
E- Energy (reduced)
C- Concentration (reduced)
A- Appetite (reduced)
P- Psychomotor retardation (Decreased thinking and
movement)
S- Suicidal thoughts
9
10. Introduction & definition (continued)
According to psychiatric guidelines- Diagnosis of
depression is mandatory if at least 5 of the
symptoms seen in the individual.
According to National Institute of Mental Health- It
takes a depressed person, 10 yrs for asking of
help.
Depression can be : Major(depression for very long
time) and Bipolar
10
Hippocampu
s
12. 1. Major Depressive Disorder
(MDD)
Very common type of depression.
Aka- Clinical depression or Unipolar depression.
According to APA for MDD diagnosis- at least 5
symptoms (S I G E C A P S) persisting for 2 weeks
or more.
One episode can occur or more often several.
People show dysphoria, anhedonia, physical
changes(altered weight, appetite, sleep, energy)
Impaired social life and distress.
12
13. 2. Treatment Resistant Depression
Those MDD patients who don’t respond to the
treatment.
One after the other antidepressants are tried but
depression stubbornly hangs on.
According to some researchers- 4 different
treatments should be tried.
How to overcome?
- Proper diagnosis
- Counseling on proper dosage and duration
- Switching to different class of the drugs.
- Antipsychotics are also sometimes beneficial
13
14. 3. Sub-syndromal Depression
(SSD)
Patients do not meet all the criteria of MDD
diagnosis.
Symptoms similar to clinical depression (MDD)
DSM-5 (Diagnostic & Statistic Manual of mental
Disorders) classify it in “other specified depressive
disorder”
At least 3 or 4 symptoms (S I G E C A P S)
persisting for 1 week- patient is sub-syndromally
depressed.
SSD can worsen to MDD if untreated.
Treatments include
14
Cognitive
behavioral
therapy
Transcranial
Magnetic
Stimulation
18. 4. Persistent Depressive Disorder
(PDD)
Aka- Dysthymia
Long term form of depression
Symptoms lasts for 2 yrs or more
Depressed mood, sadness last for a whole day for
2 yrs or more.
Children/Teens- irritability symptoms lasts for 1
year
2 of the symptoms should be there- sleep
problems, poor appetite or overeating, fatigue, low
self esteem or concentration, hopelessness.
Intensity of symptoms changes time to time
18
19. 5. Premenstrual Dysphoric Disorder
(PMDD)
10% of childbearing age women experience PMDD
Hormone based mood disorder.
Severe form of PMS
Trigger depression, sadness, anxiety, irritability in
the week before a woman’s period.
These women are sensitive to change of hormone
levels.
Estrogen affects dopamine, serotonin,
norepinephrine.
SSRI before 2 weeks of menstruation start or
during menstruation- found effective.
Light therapy improves sleep quality and mood.
19
20. 6. Bipolar Depression (Manic
Depression)
Extreme mood fluctuations.
Feelings changes from suicidal thoughts to feeling
of euphoria and endless energy.
Extreme mood swings occur frequently.
Young adulthood
Worsen without the treatment.
Effective treatments- mood stabilizers(Li), light
therapy, talk therapy, atypical antipsychotics (FDA-
approved cariprazine, lurasidone, olanzapine-
fluoxetine combination and quetiapine)
20
21. 7. Disruptive mood dysregulation
disorder (DMDD)
Screaming and temper tantrums(anger followed by
crying) are typical features
Diagnosis generally in children
Struggle with regulating their emotions
Angry mood, irritable mood most of the day, every
day
Kids have strong emotional outbursts.
Unable to contain their emotions.
Chronic or persistent irritability is common
DSM-5 classify- children who can not regulate
emotion in age- appropriate way
Current treatments- Psychotherapy, Parent training
to deal with irritable child
21
22. 8. Postpartum (or perinatal)
depression
One in 4 women & one in 8 men affected with
postpartum depression
In women- hormonal shift, fatigue
In men- environmental, shifting roles, lifestyle
changes with parenting
“Baby blues”(sad feelings after childbirth)(mild
mood disturbances in new mothers), subsides
within a week or two
If “Baby blues” condition last for several weeks or
more- Postpartum depression
According to DSM-5- mood swings, anxiety
symptoms, “baby blues” during pregnancy increase
risk of postpartum depression
22
23. Extreme cases of postpartum
depression
Two cases recent cases of Kerala (MONDAY,
JANUARY 11, 2021) : Thiruvananthapuram &
Kasaragod
Kasaragod-
- 23-year-old women arrested- strangled her infant in
earphone wires, killed him, covered him with a
cloth, put infant under her bed.
- Investigating officials- she had a first child,
disappointed that she’s pregnant soon. Experts-
Post partum depression.
Thiruvananthapuram
- 29-year-old woman arrested- women killed her
infant, buried the body behind her house.
23
24. 9. Seasonal Affective Disorder
(SAD)
Comes and goes with seasons
Start- late autumn and early winter
Ends- Spring and summer
Increased craving for foods rich in carbohydrates
therefore weight gain
Patients- overreact, oversleep, withdrawal from
social interaction, feeling of heaviness in legs and
arms
Women & young children are at higher risk
Diagnosis- After at least 2 years of recurring
seasonal symptoms
Possible causes- imbalance of serotonin,
overabundance of melatonin, insufficiency of vit. D
24
25. 10. Substance-induced mood
disorder
Sedating drugs causes change in mood.
Substances such as alcohol(too much), opioid
painkillers, benzodiazepines are responsible for
mood changes.
Depression, loss of interest, anxiety are symptoms
Sedating drugs causes substance induce mood
disorder.
Diagnosis- Doctor may rule out the causes of
depression.
25
26. 11. Psychotic Depression
Severe depression with psychosis.
Symptoms include hallucinations(to see and to
hear things that aren’t present) & delusions (false
belief of happenings)
Disturbing fixed false beliefs are present
Antidepressants + Antipsychotic, electroconvulsive
therapy(ECT)
26
27. 12. Depression due to illness
Disease such as HIV, cancer, multiple sclerosis,
heart disease can be cause of depression itself.
Inflammation also plays an important role in
causing depression
Inflammation
Chemicals cross brain, triggering depression
27
Chemicals
released by
immune system
28. 13. Situational Depression
(Reactive Depression/Adjustment
Disorder)
Short term, stress related type depression.
Develop after a traumatic event or changes
everyday life
Examples include- divorce, retirement, loss of a
friend, illness, relationship problems
Within 90 days of triggering event- situational
depression begins to occur.
28
29. 14. Atypical and Melancholic
Depression
Are subtypes of Major Depressive Disorder
Atypical Depression
- Patient eats and sleeps lots
- Seen in young adults
- Emotionally reactive and very anxious
Melancholic Depression
- Trouble in sleep
- Deeply think over guilt
- Seen more often in older adults
29
30. Epidemiology
Statistics of India
- Every year 10th of October- celebrated as World
Mental Health Day to spread awareness.
- This year theme- “Mental Health for all due to
Covid-19”
- Causes of depression in covid 19 pandemic-
increased anxiety, fear, isolation, social distancing,
emotional distress.
- Acc. to WHO- Mental Health workforce – not at all
up to the mark in India
- Huge shortage of Psychiatrist and Psychologists
- WHO estimated- 7.5% Indians suffer from mental
disorder. 20% of Indians will suffer by the end of
2020
- India accounts 36.6% of global suicides
30
31. Statistics of the globe
- More than 264 million people suffer from
depression (WHO 2020)
- 63.8% of adult and 70.77% adolescent- have
severe impairment (NMIH 2017)
- Severe depression among colleges students- rose
from 9.4% to 21.1% (2018)
- 70-80% woman- experience baby blues
- 10-20% woman suffer from PDD
- 2/3rd of those who commit suicide struggle with
depression.
- Suicide is the leading cause for death for 15-19yr
olds
- From 2013-2018- suicide attempts increased from
0.7 to 1.8%
31
32. Etiology or causes
32
Genetic Causes
- Genes play important role in depression.
- 80 genes linked to depression
- Genetic variation- affects nerve connections in parts of brain, control
decision making.
- Increased variation, increased risk of developing depression.
Environmental Causes
- Synthetic chemicals, food additives, preservatives, pesticides,
hormones, GM foods, industrial by products
- Nonchemical sources- noise pollution, electrical pollution, natural
disasters, catastrophic events
- Acc. to some researchers- childhood abuse, long term stress at home or
work, coping with loss of loved ones.
- “Sick building syndrome (SBS)”(Being in a building with poor air quality)
- Electrical pollution- EM waves are generated by modern appliances-
thus promotes depression.
34. Biochemical Factors
- Traumatic events, blood sugar imbalances, medical
illness- neurotransmitter imbalances
- The Biogenic Monoamine Hypothesis- deficiency of
neurotransmitters (serotonin, NA, DA)
Endocrine Factors
- Addison’s disease, Acromegaly- brings depressed
mood, anxiety, agitation
- Endocrine- Nervous system work together-
Hypothalamic Pituitary System- homeostatis
- Eg- T3 & T4 hormone produced by thyroid gland
- T3 has major role in mental health
- T3 receptors- more concentrated in the brain
- If thyroid underperforming- T3 &T4 not in enough
quantity
- T3 not gets into the brain, thus increased depression.
- Another eg- Adrenal gland (help regulate internal stress
response. If stress present- adrenal not function
properly), cortisol (uncontrolled stress- cortisol not
produced)
34
41. Diagnosis and Investigative
tests
DSM-5 Diagnostic Criteria for Depression
1. Depressed mood most of the day, nearly every day.
2. Markedly diminished interest or pleasure in all, or
almost all, activities most of the day, nearly every day.
3. Significant weight loss when not dieting or weight gain,
or decrease or increase in appetite nearly every day.
4. A slowing down of thought and a reduction of physical
movement (observable by others, not merely
subjective feelings of restlessness or being slowed
down).
5. Fatigue or loss of energy nearly every day.
6. Feelings of worthlessness or excessive or
inappropriate guilt nearly every day.
7. Diminished ability to think or concentrate, or
indecisiveness, nearly every day.
8. Recurrent thoughts of death, recurrent suicidal
ideation without a specific plan, or a suicide attempt or
a specific plan for committing suicide. 41
42. Investigative tests or Screening
tools
Hamilton Depression Rating Scale (HDRS)
Beck Depression Inventory (BDI)
Patient Health Questionnaire (PHQ)
Major Depression Inventory (MDI)
Center for Epidemiologic Studies Depression Scale
(CES-D)
Zung Self-Rating Depression Scale
Geriatric Depression Scale (GDS)
42
46. Current Classification
Class A: Monoaminergic modulators
I A : Monoaminooxidase inhibitors (MAOIs)
a: Irreversible non-selective: Tranylcypromine, Phenelzine,
Isocarboxazid
b: Irreversible selective MAO-B inhibitor: Selegiline
c: Reversible selective MAO-A inhibitor: Moclobemide
II A : Neuronal reuptake inhibitors
a: Selective serotonin reuptake inhibitors (SSRIs):
Fluoxetine, Sertraline, Paroxetine, Citalopram, Escitalopram,
Fluvoxamine
b: Serotonin-noradrenaline reuptake inhibitors (SNRI):
Venlafaxine,
Desvenlafaxine, Duloxetine, Milnacipran, Levomilnacipran
c: Noradrenaline and dopamine reuptake inhibitor (NDRI):
46
47. Class III A : Alpha-2 (α2) receptor antagonists
Noradrenergic and specific serotonergic
antidepressant (NaSSA): Mirtazapine
Class IV A : Multimodals
a: Serotonergics: Vortioxetine, Vilazodone,
Trazodone
b: Noradrenergics: Mianserine, Maprotiline
c: Noradrenergic and serotonergics (with significant
muscarinic antagonism): Imipramine, Clorimipramine,
Amitriptiline, Desipramine, Nortriptiline
Class B: Non-Monoaminergic modulators
Melatonine receptors (MT1 and MT2) agonists:
Agomelatine
Class C: Drugs in research and development
47
48. Mirtrazapine
- Tetracyclic antidepressant
- Alpha 2 adrenergic receptor antagonists
- Thus it increases release of serotonin and NE
- Oral Bioavailability- 50%
- Plasma protein binding- 85%
- Metabolism occurs by CYP1A2, CYP2D6, CYP3A4
- t1/2- 20 to 40 hrs
Bupropion
- Inhibit NE and DA reuptake
- Unicyclic aminoketone
- Stimulate release of NE and DA from neurons
48
49. Vortioxetin
- New serotonergic antidepressant
- Mechanism not fully understood
- Believed to bind with high affinity SERT
- Also bind to 5-HT3, 5-HT1A, 5-HT7
- Increase in dose increase causes more binding to
receptor
- Agonist activity at 5-HT 1A
- Partial agonist activity at 5-HT 1B
- Antagonist at 5-HT 1D, 7, 3
- Dose- 10mg/day
- Peak plasma conc. achieved after 7 to 11 hrs
- Bioavailability- 75%
- t1/2- 66 hrs
49
50. Vilazodone
- Similar action to vortioxetine
- Bioavailability- 72%
- t1/2- 25 hrs
- Plasma protein binding- 96%-99%
Trazodone
- Inhibit both SERT and Serotonin type 2 receptors
- Inhibit serotonin reuptake, blocks histamine and α-1
adrenergic receptor.
- Evening dose- 75mg to 150mg before bedtime
- Dose increased every 3rd day to about 300mg/day
- For elderly- 100mg/day
50
51. Mianserin
- Antagonist of serotonin and histamine receptor
- NE reuptake inhibitor
- H1 and α-1 blockade- sedation
- Bioavailability- 20 to 30%
- Plasma protein binding- 95%
- t1/2- 21 to 61hr
Maprotiline
- Blockade of NE reuptake
- PP binding- 80 to 90%
- Peak plasma conc. Reached after 6hrs
- t1/2- 51 hr
51
52. Agomelatine
- Melatonergic M1and M2 receptor agonist
- Selective serotonergic 5-HT 2B, 2C receptor
antagonist
- No effect on monoamine uptake
- Agomelatine resynchronizes circadian rhythm
- Antagonism of 5-HT 2C increase NA
and DA in frontal cortex
- Aka as “disinhibitor” of NE-DA
52
54. Non Pharmacological
Treatments
Food- Protein rich food (Rajasic foods)
Hobbies- Those which involve all the 5
senses (e.g.- outdoor games)
Routines- Walking, pranayamas,
asanas(backward bending asanas),
sufficient sleep (around 10 pm)
Motivate to think positively, write down 10
+ve points before going to bed which made
you happy during the whole day.
54
55. References
1. Joseph H. Porter, Todd M. Hillhouse, A brief
history of the development of antidepressant
drugs: From monoamines to glutamate
2. Sebastian A. Alvano, Luis M. Zieherb, An updated
classification of antidepressants: A proposal to
simplify treatment
3. Bianca Nogrady, Antidepressant Approvals Could
Herald New Era in Psychiatric Drugs
4. Etiology of Depression: Genetic and
Environmental Factors Radu V. Saveanu, MD,
Charles B. Nemeroff, MD, PhD
5. The Etiology of Depression - Depression in
Parents, Parenting, and Children - NCBI
Bookshelf
55
56. 6. The diagnosis of depression: current and emerging
methods, Katie M. Smitha, Perry F. Renshawb, and
John Bilelloa
7. Pathophysiology of depression and mechanisms of
treatment, Brigitta Bondy
8. The emergence of new antidepressants for clinical
use: Agomelatine paradox versus other novel agents
Olumuyiwa John Fasipe
9. https://emedicine.medscape.com/article/286759-
print
56