Depression:

• What is depression?

  A mental disorder characterised by low mood and low energy levels
• What are the DSM-5 categories of depression?

  • Major depressive disorder
  • Persistant depressive disorder
  • Disruptive mood dysregulation disorder
  • Premenstrual dysphoric disorder
• What is major depressive disorder?

  Severe but often short-term depression
• What is persistent depressive disorder?

  Long-term or recurring depression, including sustained major depression and what used to be called dysthymia
• What is Disruptive mood dysregulation disorder?

  Childhood temper tantrums
• What is premenstrual dysphoric disorder?

  Disruption to mood prior to and/or during menstruation
• What are the behavioural characteristics of depression?

  1. Activity levels
  2. Disruption to sleep and eating behaviour
  3. Aggression and self-harm
• Activity levels:

  Typically people with depression have reduced levels of energy, making them lethargic. This has a knock-on effect, with people tending to withdraw from work, education and social life. In extreme cases this can be so severe that the person cannot get out of bed.

  In some cases depression can lead to the opposite effect- known as psychomotor agitation. Agitated individuals struggle to relax and may end up pacing up and down a room.
• Disruption to sleep and eating behaviour:

  Depression is associated with changes in sleeping behaviour. A person may experience reduced sleep, particularly premature waking, or an increased need for sleep. Similarly, appetite and eating may increase or decrease, leading to weight gain or loss. The key point is that such behaviours are disrupted by depression.
• Aggression and self-harm:

  People with depression are often irritable, and in some cases they can become verbally or physically aggressive. This can have serious knock-on effects on a number of aspects of their life. For example, someone experiencing depression might display verbal aggression by ending a relationship or quitting a job.

  Depression can also lead to physical aggression directed against the self. This includes self-harm, often in the form of cutting or suicide attempts.
• What are the emotional characteristics of depression?

  1. lowered mood
  2. anger
  3. lowered self-esteem
• Lowered mood:

  Lowered mood is still a defining emotional element of depression but it is more pronounced than in the daily kind of experience of feeling lethargic and sad. People with depression often describe themselves as 'worthless' and 'empty'.
• Anger:

  People with depression also frequently experience anger, sometimes extreme anger. This can be directed at the self or others. On occasion such emotions lead to aggressive or self-harming behaviour- which is why this characteristic appears under behavioural characteristics as well.
• Lowered self-esteem:

  Self-esteem is the emotional experience of how much we like ourselves. People with depression tend to report reduced self-esteem, in other words they like themselves less than usual. This can be quite extreme, with some people with depression describing a sense of self-loathing
• What are the cognitive characteristics of depression?

  1. poor concentration
  2. attending to and dwelling on the negative
  3. absolutist thinking
• Poor concentration:

  Depression is associated with poor levels of concentration. The person may find themselves unable to stick with a task as they usually would, or they might find it hard to make decisions. Poor concentration and poor decision-making are likely to interfere with the individual's work.
• Attending to and dwelling on the negative:

  When experiencing a depressive episode people are inclined to pay more attention to negative aspects of a situation and ignore the positives.

  People with depression also have a bias towards recalling unhappy events rather than happy ones- the opposite bias that most people have when not depressed.
• Absolutist thinking:

  Most situations are not all-good or all-bad, but when a person is depressed they tend to think in these terms. This is sometimes called 'black and white thinking'. This means that when a situation is unfortunate they tend to see it as an absolute disaster.