Depressive Disorders according to DSM-5

Depressive Disorders: Introduction

• Depressive disorders are a group of mental health conditions characterized by feelings of sadness, hopelessness, and a loss of interest in activities
• They are one of the most common mental health disorders, affecting millions of people worldwide

Etiology

Biological Theory

• Genetic factors: individuals with a family history of depression are more likely to develop the disorder
• Neurotransmitter imbalance: decreased levels of serotonin, dopamine, and norepinephrine contribute to depressive symptoms
• Hormonal changes: thyroid disorders, Cushing's syndrome, and hormonal fluctuations during pregnancy or menopause can contribute to depression

Psychodynamic Theory

• Unresolved unconscious conflicts and childhood experiences can contribute to depressive symptoms
• Defense mechanisms, such as repression and denial, can prevent individuals from coping with negative emotions

Cognitive Theory

• Negative thought patterns and cognitive distortions contribute to depressive symptoms
• Individuals with depression may have a negative self-image, distorted thinking, and a pessimistic outlook

Learned Helplessness

• Repeated exposure to uncontrollable and inescapable stressors can lead to feelings of hopelessness and powerlessness
• Individuals may develop a perception that they are unable to change their circumstances, leading to depressive symptoms

Stressful Life Events

• Significant life changes, such as the loss of a loved one, divorce, or job loss, can trigger depressive symptoms
• Traumatic events, such as abuse or neglect, can increase the risk of developing depression

Epidemiology

• Depression is a leading cause of disability worldwide, affecting approximately 322 million people
• Women are more likely to experience depression than men, with a lifetime prevalence of 1 in 5
• Depression can occur at any age, but the highest prevalence is among adults aged 25-44

Clinical Features

• Depressed mood: feelings of sadness, hopelessness, and emptiness
• Anhedonia: loss of interest in activities that were once enjoyable
• Appetite and sleep disturbances: changes in appetite and sleep patterns
• Fatigue: feeling tired or lacking energy
• Concentration difficulties: difficulty concentrating or making decisions

DSM-5 Criteria

• Five or more symptoms must be present for at least 2 weeks, with at least one of the symptoms being depressed mood or anhedonia
• Symptoms must cause significant distress or impairment in social, occupational, or other areas of functioning

Course and Prognosis

• Depression can be a recurrent disorder, with many individuals experiencing multiple episodes
• Early treatment can improve outcomes and reduce the risk of recurrence

Differential Diagnosis

• Dysthymia: a chronic, low-grade depressive disorder
• Bipolar disorder: a mood disorder characterized by alternating periods of mania and depression
• Anxiety disorders: disorders characterized by excessive worry, fear, or anxiety
• Substance use disorders: disorders characterized by the misuse of substances

Nursing Diagnosis

• Risk for suicide: individuals with depression are at an increased risk for suicide
• Impaired social interaction: depression can impair social relationships and daily functioning
• Disturbed sleep pattern: changes in sleep patterns can contribute to depressive symptoms

Treatment

• Pharmacological interventions: medications, such as antidepressants, can help manage depressive symptoms
• Psychotherapy: cognitive-behavioral therapy, psychodynamic therapy, and interpersonal therapy can help individuals cope with depression
• Lifestyle modifications: regular exercise, healthy diet, and stress management can help reduce symptoms of depression

Depressive Disorders according to DSM-5

Introduction

• Depressive disorders are a group of mental health conditions characterized by feelings of sadness, hopelessness, and loss of interest in activities
• Can affect anyone, regardless of age, gender, or background

Etiology

• Biological Theory: imbalance of neurotransmitters such as serotonin, dopamine, and norepinephrine
• Psychodynamic Theory: unconscious conflicts and feelings of guilt, anger, and low self-esteem
• Cognitive Theory: negative thought patterns and cognitive distortions
• Learned Helplessness: feeling of powerlessness due to past experiences
• Stressful Life Events: loss of a loved one, job change, or financial problems

Epidemiology

• Depressive disorders are common, affecting approximately 1 in 10 people
• Women are more likely to experience depression than men
• Depression can occur at any age, but most common in young adults

Clinical Features

• Persistently feeling sad, empty, or hopeless
• Loss of interest in activities, including those that were once enjoyable
• Changes in appetite, sleep patterns, or energy levels
• Difficulty concentrating, making decisions, or remembering things
• Feeling guilty, worthless, or suicidal

DSM-5 Criteria

• At least 5 symptoms of depression present nearly every day for 2 weeks
• Symptoms must be severe enough to cause significant distress or impairment
• Symptoms must not be due to a medical condition, substance abuse, or bereavement

Course and Prognosis

• Major depressive disorder (MDD) can be a chronic condition, with recurring episodes
• Episodes can last from weeks to months, or even years
• Recovery is possible, but relapse is common
• Treatment can improve symptoms and reduce the risk of relapse

Differential Diagnosis

• Distinguishing depression from other mental health conditions, such as anxiety, bipolar disorder, or dysthymia
• Ruling out other medical conditions that may cause similar symptoms

Nursing Diagnosis

• Identifying specific problems and needs of the individual with depression
• Developing a plan to address these problems and promote recovery

Treatment

• Medications, such as antidepressants, to help manage symptoms
• Psychotherapy, such as cognitive-behavioral therapy (CBT), to address underlying issues
• Lifestyle changes, such as regular exercise, healthy diet, and social support
• Combination of these approaches often most effective