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The words above belong to author William The words above belong to author William Styron, and they describe his first episode Styron, and they describe his first episode of major depressionof major depression
This experience belongs to millionsThis experience belongs to millions
Definition of Definition of MAJOR DEPRESSIVE DISORDERMAJOR DEPRESSIVE DISORDER
MMental disorder characterized by an all-ental disorder characterized by an all-encompassing low mood accompanied by encompassing low mood accompanied by low self-esteem, and loss of interest or low self-esteem, and loss of interest or pleasure in normally enjoyable activitiespleasure in normally enjoyable activities
Depressed mood persists for at least Depressed mood persists for at least two two weeks weeks
SubtypesSubtypes
Melancholic depressionMelancholic depression
Atypical depressionAtypical depression
Catatonic depressionCatatonic depression
Postpartum depressionPostpartum depression
Seasonal affective depressionSeasonal affective depression
Symptoms and signsSymptoms and signs
Feelings of helplessness and hopelessnessFeelings of helplessness and hopelessness Loss of interest in daily activitiesLoss of interest in daily activities Appetite or weight changesAppetite or weight changes Sleep changesSleep changes Irritability or restlessnessIrritability or restlessness Loss of energyLoss of energy Self-loathingSelf-loathing Concentration problemsConcentration problems Unexplained aches and painsUnexplained aches and pains
Depression and suicide!!!Depression and suicide!!!
3.4% of people with major depression commit 3.4% of people with major depression commit suicidesuicide
60% of people who commit suicide have 60% of people who commit suicide have depression or another mood disorder depression or another mood disorder
Causes and risk factors for Causes and risk factors for depressiondepression
LonelinessLoneliness Lack of social supportLack of social support Recent stressful life experiencesRecent stressful life experiences Family history of depressionFamily history of depression Marital or relationship problemsMarital or relationship problems Financial strainFinancial strain Early childhood trauma or abuseEarly childhood trauma or abuse Alcohol or drug abuseAlcohol or drug abuse Unemployment or underemploymentUnemployment or underemployment Health problems or chronic painHealth problems or chronic pain
Biological theoriesBiological theories
Dysregulation of monoamine chemicals Dysregulation of monoamine chemicals serotoninserotonin, , norepinephrinenorepinephrine and and dopaminedopamine in the brain in the brain
Most antidepressants increase the levels Most antidepressants increase the levels of one or more of the monoamines of one or more of the monoamines
DiagnosisDiagnosis
Patient's self-reported experiences Patient's self-reported experiences Behavior reported by relatives or friends Behavior reported by relatives or friends Mental status exam Mental status exam
No laboratory testNo laboratory test for major depression for major depression
Differential diagnosesDifferential diagnoses
Dysthymia Dysthymia Adjustment disorder with depressed moodAdjustment disorder with depressed mood Bipolar disorderBipolar disorder
ManagementManagement
Antidepressant medicationAntidepressant medication
(MAOIs, TCAs, SSRIs) – delayed onset of (MAOIs, TCAs, SSRIs) – delayed onset of action (2-6 weeks)!!!action (2-6 weeks)!!!
Psychotherapy or counsellingPsychotherapy or counselling
HospitalizationHospitalization Electroconvulsive therapy (ECT)Electroconvulsive therapy (ECT)
Prevention - Lifestyle changes!Prevention - Lifestyle changes! Cultivating supportive Cultivating supportive
relationshipsrelationships Getting regular exercise and Getting regular exercise and
sleepsleep Eating a healthy, mood-boosting Eating a healthy, mood-boosting
dietdiet Managing stressManaging stress Practicing relaxation techniquesPracticing relaxation techniques Challenging negative thought Challenging negative thought
patternspatterns
SMILE SMILE