The document discusses depression, including its classification, symptoms, risk factors, assessment methods, and treatment. It classifies depression according to the ICD-10 as mild, moderate, or severe episodes, and as recurrent. Risk factors mentioned include women being twice as likely as men to experience depression. Assessment methods involve history taking, mental status examinations, and psychological tests. Treatment discussed includes lifestyle changes, building emotional skills, medication, and therapies like CBT and art therapy.

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Classification of mood disorders (kdf; NfhshW Nehapid tifg;gLj;jy;)
International Classification of Diseases (ICD-10) came into use in WHO Member
States as from 1994.
F32: Depressive episode. (Depression – extreme sadness )
F32.0 Mild depressive episode
F32.1 Moderate depressive episode
F32.2 Severe depressive episode without psychiatric symptoms
F32.3 Severe depressive episode with psychiatric symptoms
F32.8 Other depressive episode – Atypical depression
F32.9 Depressive episode, unspecified
F33. Recurrent depressive Episode
Stages
Mild, Moderate & severe

4. Risk factors of depression
 According to the World Health Organization (WHO), depression will be the second most
important medical disease worldwide by the year 2020.
 One in 5 people will experience an episode of depression during their lifetime, but only 1
in 3 will be diagnosed.
 Depression as an illness has been linked with high suicide rates and it can have a
devastating impact. (Dr. Nirosha Mendis, Consultant Psychiatrist.)
 While women are twice as more likely to experience depression than men, depression
can overcome anyone at anytime.
 In Sri Lanka depression is a leading disease.
According to the WHO in 2006 almost 400,000 Sri Lankans experienced a serious mental
disorder. In some areas depression was reported as high as a quarter of the population.
 Suicide rates in Sri Lanka are among the highest in the world according to a WHO report in
2008 (conservative estimate: 24 per 100,000).
 According to NIMH statistics, one out of five persons in Sri Lanka suffers from a mental
illness, and only 20% receive treatment. “We have failed because our services are still
centralised, and only available in the cities. Also, as our treatment is hospital based, only
those who come to hospitals get treated. Most mentally ill patients are reluctant to get
medication. Hence, only a fraction gets medical attention,” he said.

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12. Types of depression
Major depression.
The two main symptoms are that people have a depressed mood and
have no interest in activities for at least two weeks for most of the time
almost every day. Father more they must have at least three more
symptoms out of seven (for instance weight change, sleeping problems,
thinking about death or suicide).
Bipolar depression.
Some people have periods with depression as with manic periods
which are coloured by much activity and energy (hence the name
bipolar, two poles).
Post natal depression.
About 10 – 20% of the women after giving birth develop a depression.

13. mwpFwpfs; Symptoms

14. Depression
Symptoms:
Primary (key) symptoms
 Feeling sadness or low mood.
 Marked loss of interest or pleasure in activities.
secondary symptoms
 Disturbed sleep compared with your usual pattern.
 change in appetite (eating habits and weight).
 Tiredness (fatigue) or loss of energy
 Agitation or slowing moments.
 Poor concentration of inductiveness (simple task can seen difficult)
 Feelings of worthlessness, or exercise or inappropriate guilt, (Loss of self-esteem,
Withdrawal, feelings of helplessness, Worthlessness, Excessive crying)
 Recurrent thoughts of death (Suicidal tendency).

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A last note by Marilyn Monroe
Marilyn Monroe‘s drug addiction had become severe. Makeup was “applied while she was still
asleep under the influence.” Her films were gaining bad reviews. She spent four weeks in the
hospital for depression. Colleagues described her as unprofessional. Her mood swings were
unpredictable. And she was overdosing on barbiturates.
Monroe died in her bedroom in 1962. A “probable suicide” was declared by the coroner. Three
empty medicine bottles lay next to her bed. Her last words were,
“Say goodbye to Pat, say goodbye to the president, and say goodbye to yourself, because
you’re a nice guy.”
“I still am lost […] everything is pulling against my concentration […] My will is weak […] I
sound crazy, but I think I’m going crazy […] I get before a camera and my concentration and
everything I’m trying to learn leaves me. Then I feel like I’m not existing in the human race at
all.”

16. Story No: 2 (fij-2)
A last note by: Virginia Woolf
Virginia Woolf was a prominent “modernist” writer. Her most famous novel, “Mr.
Dalloway,” gained entry into a TIME magazine “100 Best” list. But since childhood, she
suffered severe bipolar disorder, possibly influenced by sexual abuse from her half-
brothers. After completing her last manuscript, World War II had come. Her home fell
during a bombing raid and she fell into depression. On March 28, 1941, Woolf filled
her overcoat with stones and walked into the River Ouse. She drowned there, at the
age of 59.
Her last note to her husband read,
“…I feel certain that I am going mad again […] I shan’t recover this time. I begin to
hear voices, and I can’t concentrate. So I am doing what seems the best thing to do.
[…] You see I can’t even write this properly […] What I want to say is I owe all the
happiness of my life to you…”
Sources: wikipedia.org; theguardian.com; time.com

19. Method of Assessment s
 History Taking
 MSE
 MMSE
 Investigation
 Psychological test

20. Treatment
Process

21. Ask for help and support
The key to depression recovery is to start small and ask for help. The simple act of talking
to someone face to face about how you feel can be an enormous help.
Make healthy lifestyle changes
Lifestyle changes are not always easy to make, but they can have a big impact on
depression.
 Cultivating Supportive relationships.
 Managing stress.
 Practicing relaxation techniques.
 Challenging negative thought patterns.
Build emotional skills.
Seek professional help.
Antidepressants .
Medication can help relieve the symptoms of depression.
Treatment

22.  Cognitive Behavioural Therapy : Imagination relaxation
 Art Therapy: ‘MY Life tree’
 Behavioural Therapy: (SR) Exercise, Yoga, Meditation,
Breathing exercise
 Occupational therapy: Task
 Rational Emotional Therapy: Life skills development
 Logo Therapy: Spiritual strength
 Person center therapy: Social changes or adjustment
 TA: Games
Treatment cont…

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25. Mrs. Thahir Noorul Isra (M.Phil PSW) Dip: Coun, HR.
Rehabilitation Counsellor
Psychiatric Social Worker
Palliative Care Activist
Email: israanas@gmail.com