Major depressive disorder is a serious mood disorder characterized by depressed mood or loss of interest lasting 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 depressed mood, loss of interest, changes in sleep, energy, appetite, concentration and thoughts of death or suicide. Major depression is more common in women during times of hormonal changes like puberty, pregnancy, and menopause. Men may be less likely to recognize signs of depression and seek help. Life changes and chronic stress can also trigger depressive episodes.

1. Major
Depressive
Disorder
Kriti Lodh

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