This slide is made for educational and academic purpose for Pharmacy, Medical and paramedical students. This slide is concerned with a Psychiatric disorder namley Depression. This slide contains full pathophysiology of Depression. This slide is prepared in accordance with D.pharm 2nd year syllabus in the subject named Pharmacotherapeutics. Topics included are Definition, etilogy, pathophysiology, etiopathogenesis, diagnosis, clinical manifestations, non pharmacological and pharmacological treatment of Depression . Various hypothesis given to explain depression are also included.

1. PSYCHIATRIC DISORDERS
DEPRESSION
A PRESENTATION BY:
AMAN KUMAR
LECTURER
GCRG COLLEGE OF PHARMACY

2. PSYCHIATRIC DISORDERS
Psyche = mind=mental processes.
Psychiatric disorders are also known as Mental disorders or Psychological
disorders.
“A psychiatric disorder, also called a mental illness or mental disorder, is a
behavioural or mental pattern that causes significant impairment
(disturbance) of personal functioning.”
• For example: Anxiety, depression, schizophrenia etc.
• [Schizophrenia usually involves delusions (false beliefs), hallucinations
(seeing or hearing things that don't exist), unusual physical behavior ].
• Such features may be persistent or short term.

4. DEPRESSION
“Depression is a state of intense sadness, low mood that can affect a person's thoughts,
behaviour, feelings, and sense of well-being”.
• Depression is a psychiatric disorder that causes a persistent feeling of sadness and loss of
interest in daily activities, causing significant impairment in daily life.
• It is also called major depressive disorder or clinical depression.
• Depression can be: Endogenous (due to imbalance in neurotransmitters in body) or
Exogenous (due to any sad events in the outside world).
According to WHO (world health organization)-
Depression is a common mental disorder that presents with depressed mood, loos of interest
or pleasure, feelings of guilt or low self worth, disturbed sleep or appetite, low energy and
poor concentration.

5. TYPES OF DEPRESSION

6. ETIOLOGY OF DEPRESSION
The exact cause of depression is not known.
A variety of factors may be involved, such as:
• Brain chemistry: Neurotransmitters are naturally occurring brain chemicals that likely play an important role in maintaining mood
stability. Abnormalities in brain chemical levels may lead to depression. For ex low levels of serotonin, nor epinephrine and dopamine
may cause depression.
• Genetics: Depression is more common in people whose blood relatives (family members) also have this condition.
• Hormonal changes: Changes in the body's balance of hormones may be involved in causing or triggering depression Hormone changes
may occur during pregnancy and during the weeks or months after delivery (postpartum) and from thyroid problems, menopause or a
number of other conditions. So, women have higher rates (about twice) of major depression compared to men.
• Personality: personality and thoughts of individual also plays important role in the development of depression. The persons having
negative thinking, negative speech, less confidence can easily get depressed.
• Life events: Some extremely bad memories of childhood such as physical or sexual abuse, mental abuse, unequal parental treatment, the
death of a loved one, upsetting events (trauma), stress, isolation and lack of support can cause depression in adulthood.
• Any serious medical condition or disease.
• Drug Abuse (intoxication) or alcoholism.

8. PATHOPHYSIOLOGY OF DEPRESSION
Various theories have been given to explain pathophysiology of depression.
1. Monoamine Hypothesis:
In 1950s, it was seen that patients prescribed with the drug reserpine to control hypertension,
Developed severe depression as a side effect.
Later, it was discovered that reserpine caused depletion (decrease) of a group of neurotransmitters called
Monoamines (e.g., Serotonin, nor drenaline, dopamine etc).
Thus, it was concluded that Monoamines depletion led to----
DEPRESSION

9. PATHOPHYSIOLOGY OF DEPRESSION
2. Permissive Hypothesis:
According to this hypothesis, the emotional behavior is controlled due to balance between Nor adrenaline and
Serotonin.
Any disturbance (increase or decrease) in the levels of Serotonin affects the levels of Nor adrenaline.
Increase in the levels of nor adrenaline leads to- Mania (excited state).
Decrease in the levels of nor adrenaline leads to- DEPRESSION.
Other hypothesis are:
• Serotonin-only hypothesis.
• Neurotrophic hypothesis.

10. CLINICAL MANIFESTATIONS OF
DEPRESSION

11. DIAGNOSIS OF DEPRESSION
1. Physical examination by Psychiatrist.
2. Psychiatric evaluation.

12. TREATMENT OF DEPRESSION
Non pharmacological treatment:
• Regular exercise and following a healthy lifestyle.
• Getting plenty of sleep.
• Reducing stress.
• Keeping oneself busy.
• Avoid alcohol and drug abuse.
• Taking part in social activities.

13. TREATMENT OF DEPRESSION
Pharmacological Treatment:
1. Selective serotonin reuptake Inhibitors (SSRIs):
Theses drugs blocks the uptake of serotonin from the CNS and maintains a necessary amount of serotonin in
CNS thus preventing depression. For example- Fluoxetine.
2. Tricyclic Antidepressants:
For example:
• Amitriptyline.
• Desipramine.
• Trazadone.
3. Psychotherapy or Counseling by a Psychiatrist: Treating depression by talking about your condition to a
psychiatrist.

14. THANK
YOU