Depression Flashcards
Depression
• a common mental disorder characterized by sadness, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, feelings of tiredness and poor concentration
• Children: 1 year prevalence rate of 2%
• Adolescents: 1 year prevalence rate of 4% to 8%
• National Cormorbidity Survey: 6.1%, 15-24 years
• Lifetime prevalence (up to age 18) 15%-20%
• 65% of adolescents report some depressive symptoms
• 5% to 10% of youth with subsyndromal symptoms have
considerable psychosocial impairment, high family loading
for depression, and an increased risk for suicide and
developing MDD
Signs and Symptoms
- Tiredness and loss of energy.
- Sadness that doesn’t go away.
- Loss of self-confidence and self-esteem.
- Difficulty concentrating.
- Cannot enjoy things that are usually pleasurable or interesting.
- Feeling anxious all the time.
- Avoiding other people, sometimes even your close friends.
- Feelings of helplessness and hopelessness.
- Sleeping problems - difficulties in getting off to sleep or waking up much earlier than usual.
- Very strong feelings of guilt or worthlessness.
- Finding it hard to function at work/college/school.
- Loss of appetite.
- Loss of sex drive and/or sexual problems.
- Physical aches and pains.
- Thinking about suicide and death.
- Self-harm
Emotional Symptoms
Include:
- Sadness
- Loss of interest or pleasure
- Overwhelmed
- Anxiety
- Diminished ability to think or concentrate, indecisiveness
- Excessive or inappropriate guilt
Physical Symptoms
Include:
- Vague aches and pains
- Headache
- Sleep disturbances
- Fatigue
- Back pain
- Significant change in appetite resulting in weight loss or gain
Depression: Scope of the Problem
• Mean length of episodes: 7 to 9 months • 6% to 10% become protracted • Recurrence: 30 -50% • Approximately 20% develop bipolar disorder • Associated with significant: – comorbidity – functional impairment – risk for suicide – substance use
What leads to depression?
Depression can happen suddenly as a result of physical
illness, experiences dating back to childhood,
unemployment, bereavement, family problems or other
life-changing events;
Examples of chronic illnesses linked to depression
include heart disease, back pain and cancer. Pituitary
damage, a treatable condition which frequently follows
head injuries, may also lead to depression;
Sometimes, there may be no clear reason for your
depression but, whatever the original cause, identifying
what may affect how you feel and the things that are
likely to trigger depression is an important first step.
Mild depression
a limited negative effect on your daily life. For example, you may have difficulty concentrating at work or motivating yourself to do the things you normally enjoy.
Major depression
interferes with an individual’s daily life - with eating, sleeping and other everyday activities. It can lead to hospital admission, if the person is so unwell they are at risk of harm to themselves.
Bi-polar disorder
The mood swings in bi-polar disorder can be extreme - from highs, where the individual feels extremely elated and indestructible, to lows, where they may experience complete despair, lethargy and suicidal feelings.
Post-natal depression
is more intense and lasts longer. It can leave new mothers feeling completely overwhelmed, inadequate and unable to cope. They may have problems sleeping, panic attacks or an intense fear of dying. They may also experience negative feelings towards their child.
Seasonal Affective Disorder (SAD) “winter blues”
SAD is associated with the start of winter and can last until spring when longer days bring more daylight.
Cognitive behavioural therapy (CBT)
It addresses the way you think and how this can
cause depression;
Counseling can help many depressed people
understand, accept and feel better about
themselves. People also learn more effective ways
of coping with life’s adversities and difficulties.
– Interpersonal therapy works to change how people how
to accept self and relate to others that affects mood and
self-worth.
– Cognitive therapy helps people change negative
thinking, behavior patterns and attitudes that affect self
esteem and overall sense of well being.
– It teaches you skills to identify patterns of behaviour
and thinking that are causing you problems and change
them.
Psychotherapy
Psychotherapy often looks at how past experience may be affecting your life now, so it may involve delving deeply into early experiences and key relationships; Interpersonal therapy focuses on how you relate and behave towards others. It helps you to build a better self-image and communicate more effectively with other
Drug therapy- The Monoamine Hypothesis
The Monoamine Hypothesis (1965, by Schildkraut)
• A functional deficit of the monoamine neurotransmitters,
noradrenaline, serotonin (5HT) at certain sites in the brain;
– Norepinephrine may be related to alertness and energy
as well as anxiety, attention, and interest in life;
– Serotonergic pathways in the CNS mainly involved in
mood;
– Dopamine may be related to attention, motivation,
pleasure, and reward, as well as interest in life;
There are at least two sides to the neurotransmitter story
• Both serotonin and norepinephrine mediate a broad spectrum of depressive symptoms
