depressive disorders

• Depressive Disorder is characterized by sadness severe enough or persistent enough to interfere with function and often by decreased interest or pleasure in activities.
• Depression is often used to describe the low or discouraged mood that results from disappointments.
• Depression often occurs in waves that tend to be tied to thoughts and reminders of the inciting event.
• Depression resolves when circumstances or events improve.
• Depression may be interspersed with periods of positive emotion and humor.
• Depression is not accompanied by pervasive feelings of worthlessness and self loathing.
• The exact cause of Depression is unknown, but genetic and environmental factors contribute.
• Both Cognitive Behavioral therapy and Interpersonal therapy are used to treat acute symptoms of depression.
• Cognitive Behavioral therapy and Interpersonal therapy are effective in treating patients with major depressive disorder.
• Cognitive Behavioral therapy and Interpersonal therapy have been shown to decrease the likelihood of relapse in patients with major depressive disorder.
• Initial support for depression may involve seeing the patient weekly or biweekly to provide support and education and to monitor progress.
• Explaining that depression is a serious medical disorder can help the clinician in providing support.
• Telling patients that the path to recovery often fluctuates can provide encouragement.
• Encouraging patients to gradually increase simple activities and social interactions must be balanced.
• Reassuring patients and loved ones that depression does not reflect a character flaw can be an important part of support.
• Suggesting that patients avoid self blame and explaining that dark thoughts are part of the disorder and will go away can be helpful in support.
• Depression is more common among first degree relatives of depressed patients and concordance between identical twin is high.
• Genetic factors probably influence the development of depressive responsive to adverse events.
• Focus on changes in neurotransmitters levels.
• Major life stresses, especially separations and losses, commonly precede episodes of major depression.
• People predisposed to mood disorders are at higher risk of subsequent episodes.
• People who have had an episode or major depression are at higher risk of subsequent episodes.
• People who are less resilient and who have tendencies may be more likely to develop a depressive disorder.
• Treatment for depressive disorders may include support, psychotherapy, drugs, or a combination of these.
• PREMENSTRUAL DYSPHORIC DISORDER involves mood and anxiety symptoms that are clearly related to menstrual cycle with onset during the premenstrual phase and a symptoms-free interval after menstruation.
• The manifestations of PMDD are similar to those of premenstrual syndrome but are more severe, causing clinically significant distress and occupational functioning.
• OTHER DEPRESSIVE DISORDER clusters of symptoms with characteristics of a depressive disorder that do not meet the full criteria for other depressive disorder but that cause clinically significant distress or impairment of functioning.
• Specifiers for Major depression and persistent depressive disorder may include one or more specifies that describe additional manifestations during a depressive episodes: anxious distress, mixed features, melancholic features, atypical features, psychotic features, catatonic features, peripartum onset, seasonal pattern, or any combination of these.
• Diagnosis of depressive disorders is based on identification of the symptoms and signs and the clinical criteria described.
• To diagnose PMDD, patients must have 5 symptoms during the week before menstruation.
• In addition to the 5 symptoms, 1 of the following must be present in PMDD: decreased interest in usual activities, difficulty concentrating, low energy or fatigue, marked change of appetite, overeating or specific food cravings, hypersomia or insomnia, feeling overwhelmed or out of control, or physical symptoms such as breast tenderness or swelling, joint or muscle pain, a feeling of being bloated and weight gain.
• One of the symptoms of PMDD must be marked mood swings, marked irritability or anger or increased interpersonal conflicts, marked depressed mood, feelings of hopelessness or self-deprecating thoughts, or marked anxiety, tension or on-edge feeling.
• Symptoms of PMDD must be present during most menstrual cycles during the past years.
• Symptoms of PMDD must begin to remit within a few days after onset of menses and become minimal or absent in the week after menstruation.
• People with other mental disorders are at higher risk of developing a depressive disorder.
• Women are at higher risk of developing a depressive disorder, but no theory explaining why.
• Possible factors contributing to depression include greater exposure, heightened response to daily stresses, higher levels of monoamine oxidase, higher rates of thyroid dysfunction, and endocrine changes that occur with menstruation and menopause.
• Depression causes cognitive, psychomotor and other types of dysfunction as well as a depressed mood.
• People with depression frequently have thoughts of suicide and may attempt suicide.
• Other mental symptoms or disorders, such as anxiety and panic attacks, often occur with depression.