Clinical depression overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Major depressive disorder a psychiatric disorder characterized by a pervasive low mood, loss of interest in usual activities, and a diminished ability to experience pleasure (anhedonia).
Although the term "depression" is commonly used to describe a temporary depressed mood (i.e., "feeling blue"), major depressive disorder is a serious and often disabling condition that can significantly affect a person's work, family, and school life; sleeping and eating habits; general health; and ability to enjoy life.[1] The course of major depressive disorder varies widely: depression can be a once-in-a-lifetime event or have multiple recurrences, it can appear either gradually or suddenly, and it can either last for a few months or be a life-long disorder. Major depressive disorder is a major risk factor for suicide. In addition, people with depression suffer from higher mortality from other causes.[2]
When specific treatment is indicated, it usually consists of psychotherapy and antidepressants.
The impact of depression on the quality of an individual's life is more than that of having a recent myocardial infarction but less than tha of having heart failure.[3].
Diagnosis
History and Symptoms
Before a diagnosis of depression can be made, a physician should perform a complete medical exam to rule out any possible physical cause for the suspected depression. If no such cause is found, a psychological evaluation should be done by the physician or by referral to a psychiatristor psychologist. The evaluation will include a complete history of symptoms, a discussion of alcohol and drug use, and whether the patient has had or is having suicidal thoughts or thinking about death. The evaluation will also include a family medical history to see if other family members suffer from any form of depression or similar mood disorder.
Treatment
Medical Therapy
The treatment of depression is highly individualized to the patient, based on the patient's unique combination of biological, psychological and social health factors and the severity of their condition.[4] The three most conventional treatments for depression include medication, psychotherapy, and electroconvulsive therapy. New treatments and less conventional options are also available, including self help, life style changes, and vagus nerve stimulation.[4] If there is an imminent threat of suicide or the patient is a danger to others, hospitalization is employed as an intervention method to keep at-risk individuals safe until they cease to be a danger to themselves or others. At-risk individuals may also be placed in a partial hospitalization therapy, in which the patient sleeps at home but spends most of the day in a psychiatric hospital setting. This intensive treatment usually involves group therapy, individual therapy, medication management, and is used often in the case of children and adolescents.
References
- ↑ Mayo Clinic Staff (2006-03-06). "Depression" (PDF). National Institute of Mental Health (NIMH). Retrieved 2007-10-20.
- ↑ Rush AJ (2007). "The varied clinical presentations of major depressive disorder". The Journal of clinical psychiatry. 68 Suppl 8: 4–10. PMID 17640152.
- ↑ Hays RD, Wells KB, Sherbourne CD, Rogers W, Spritzer K (1995). "Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses". Arch Gen Psychiatry. 52 (1): 11–9. PMID 7811158.
- ↑ 4.0 4.1 Mayo Clinic Staff (2006-03-06). "Depression Treatment Guide". Mayo Clinic. Retrieved 2007-10-20.