Introduction to depression Flashcards
What is depression?
Depression is syndrome of clinical symptoms, mainly associated with an abnormally low mood for the individual
Often have a lack of interest or pleasure in activities
Decreased energy and increase fatigue.
To be clinically depressed a person must have at least one of these symptoms on most days most of the time for at least 2 weeks.
What is anhedonia?
Reduced ability to feel pleasure, often feel no joy in anyhting
What are some of the associated symptoms with depression?
Loss of confidence
Guilt or self blame
Suicidal acts or ideas
Poor concentration
Agitation or slowing of movements
Sleep distrubance (early hour waking)
Change in appetite (decrease or increase)
What are some psychological symptoms of depression?
Low self esteem
Guilt
Hopelessness
Worthlessness
Suicidal ideation
What are some of the biological or somatic symptoms of depression?
Loss of interest or pleasure
Loss of libido
Loss of appetite
Lack of emotional reactions “Flattened affect”
Depression is often worse in the morning
Psychomotor changes - slowed and increased pace of movements
What is psychotic depression?
As a clinical what is important to consider in this case
A severe form of depression characterised by either auditory hallucinations or delusional beliefs or both.
Delusions can be persecutory, nihilistic and recently lots of COVID-19 super spreaders
Always check for command hallucination - pressured into suicide attempts
What are nihilistic delusions?
Belief that they are dead, non-existing or dieing
Patients may beleive they have no internal organs or that they have lost body parts or that they have no future.
What is the spectrum of suicidal ideation?
- Thoughts that life is not worth living, tired, wouldn’t mind if they slept all day - no thoughts or plans for suicide
- Thoughts but no plans for suicide, want to die but have not decided how
- Have plans for suicide, actively sorting out their will and saying goodbye to relatives etc or have already tried to take their life and failed.
What are the statistics around the occurrence of depression?
Every year 5% of adults have an episode of depression
Is more common in women than men
1 in 4 women will get depression, 1 in 10 men will develop depression severe enough to require treatment in their lifetime.
Female increased risk - thought to be due to hormone fluctuations.
What are some of the biological risk factors for depression?
Medical illness - pain, COPD, cancer, hypothyroidism, anaemia
Family history - genetic link??
Drug misuse - alcohols, opiods and stimulants - depresse the nervous system
Prescribed medication - anticonvulsants, beta blockers, TB meds, opiods, some hormonal treatments.
What are some of the psychological risk factors for depression?
Chronic stress from bullying, abuse ACEs
Sudden changes to routine - pandemic loss of loved ones, fear of death etc
What are some of the social risk factors for depression?
Poverty
Housing problems
Unemployment
All contribute towards chronic stress
When does a patient with depression require inpatient treatment?
Risk of suicide
Profound self neglect - indirect risk of death
Risk of exploitation/ abuse from others
Risk to others - often with psychotic depression hallucinations and intentions
How do we classify between mild and severe depression?
Based on the number of and the severity of symptoms, not how long the symptoms last for.
How is mild depression commonly managed?
Most cases self resolve
Life style coahcing and information on self care
Medication is often not given but psychological therapy may be useful
