Understanding Major Depression

Task 6 - Having the Blues

• Introduction:
  • Loss and failure are significant triggers for depressive episodes.
  • Some people quickly recover, while others experience persistent impairment.
  • Depression can affect emotional, motivational, behavioral, physical, and cognitive aspects of life.
  • Depression can occur without a specific life event.
  • Depression involves negative emotions, loss of interest, reduced energy, and difficulties in thinking and concentration.
  • Recurring suicidal thoughts are a serious symptom of depression.
  • Two types of clinical depression exist:
    • Major depression (or unipolar depression)
    • Bipolar disorder

Major Depression

• Diagnostic Criteria:
  • Five (or more) of the following symptoms for 2 weeks, representing a change from prior functioning:
    • Depressed mood most of the day
    • Markedly diminished interest or pleasure
    • Significant weight change or appetite change
    • Insomnia or hypersomnia
    • Psychomotor agitation or retardation
    • Fatigue or loss of energy
    • Feelings of worthlessness or guilt
    • Diminished ability to think or concentrate
    • Recurrent suicidal thoughts or attempts
  • Symptoms cause significant distress or impairment
  • Symptoms are not due to a medical condition or substance use

Persistent Depressive Disorder (Dysthymia)

• Diagnostic Criteria:
  • Depressed mood for most of the day, for more days than not, for at least 2 years.
    • In children and adolescents, this period is 1 year.
  • Presence of two or more of these symptoms during the depressed period:
    • Poor appetite or overeating
    • Insomnia or hypersomnia
    • Low energy or fatigue
    • Low self-esteem
    • Poor concentration or difficulty making decisions
    • Feelings of hopelessness
  • Symptoms must not have been absent for over 2 months at any time.
  • No instances of a manic episode were present.
  • Not better explained by schizoaffective disorder, schizophrenia, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder.
• Diagnosis, Prevalence, and Comorbidity:
  • Depression is a common feature of many other conditions, such as anxiety and substance abuse.
  • Depression is a contributing factor to 12% of global nonfatal maladies.
  • Lifetime prevalence of depression is 20% in men and 30% in women.

Subtypes of Depression

• Seasonal Affective Disorder (SAD):
  • Recurring winter depression with remission in spring/summer.
  • Often attributed to increased melatonin secretion in winter.
• Atypical Depression:
  • Mood reactivity to events
  • Significant weight increase or increase in appetite
  • Oversleeping (hypersomnia)
  • Feeling of heaviness in limbs
  • Increased sensitivity to interpersonal rejection
• Peripartum Onset:
  • Onset of major depression during pregnancy and/or postpartum.
• Premenstrual Dysphoric Disorder (PMDD):
  • Severe depressive symptoms are linked to premenstrual phase.
  • Symptoms improve following menstruation's start.
• Chronic Fatigue Syndrome:
  • Combination of extreme fatigue, muscle pain, and other physical and mood symptoms.
• Other subtypes include anxious distress, melancholic features, psychotic features, and catatonic features.

Other Information

• Comorbidity:
  • Depression frequently co-occurs with other mental disorders.
  • Substance use disorders, anxiety disorders, and eating disorders are common comorbidities.
  • Depression can either cause or be caused by comorbid conditions.