As summary of manic depressive disorder, formerly known as manic depression. Includes most likely causes, differentiation with bereavement depression, most common symptoms and how to help patients manage them, and treatment with medication and therapy
- Characterized by feelings of sadness/loss of interest in activities once enjoyed
- Symptoms of depression (according to DSM 5) include:
o Feeling sad/depressed mood
o Loss of interest/ pleasure in activities once enjoyed
o Changes in weight loss/ gain unrelated to dieting
o Trouble sleeping/ sleeping too much
o Loss of energy/ increased fatigue
o Increase in purposeless physical activity (inability to sit still, pacing, handwringing) or slowed
movement or speech (must be observable by others)
o Feeling of worthlessness or guiltiness
o Difficulty thinking, concentrating or making decisions
o Thoughts of death/suicide
- Certain medical conditions can mimic symptoms of depression
- Prevalence is around 6.7% of the population (~1 in 15 people). 1 in 6 people (16.6% of the
population) experience some kind of depression in their lifetime
- Depression occurs usually occurs in late teens to mid-20s. Women are more likely than men to
become depressed
Depression vs grief/bereavement
- Grief and bereavement are both natural emotional processes, and it is natural to experience these
feelings
- There are key differences between sadness/grief and depression:
o In grief, painful feelings come in waves, intermixed with happy memories. In major
depression, mood and/or pleasure are decreased for the majority of a two-week period
o In grief, self-esteem is usually maintained, however in depression, feelings of worthlessness
and self-loathing are common
o In grief, thoughts of death surface when thinking/fantasizing about joining a deceased loved
one. In depression, suicidal thoughts are due to feelings of worthlessness/ undeserving of
life or being unable to cope with impact of depression
- Grief and depression can indeed coexist and can occur after a major event. In this case, the grief is
more severe and lasts longer than grief without depression
Risk factors of Depression
- Biochemistry – differences in certain chemicals in the brain (neurotransmitters such as Dopamine
and Serotonin) may contribute to symptoms of depression
- Genetics – depression can run in families. If one identical twin has depression, there is a 70%
chance the other will also have depression
- Personality – people with a low self-esteem, those easily overwhelmed by stress and those who are
generally pessimistic tend to be more susceptible to depression
- Environment – continuous exposure to violence, neglect, abuse or poverty may make some more
likely to develop depression
Treatment
- Depression is one of the most treatable mental disorders, with 80-90% of patients eventually
responding well to treatment
- Before diagnosis or treatment, diagnostic evaluation (including interview and physical examination)
should be conducted. Blood tests are also used sometimes to rule out medical conditions such as
thyroid problems and vitamin deficiencies (these sometimes cause depression-like symptoms)
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