Clinical depression is a psychiatric disorder characterized by pervasive and persistent low mood, resulting in low self-esteem, anhedonia (loss of interest of pleasure), and pleasure.
Causes
Combination of hereditary and psychosocial factors
Also linked w/ substance abuse
Causes decreased levels of monoamines (esp serotonin, norepinephrine and dopamine), which are required for communication between neurons
Classification
Endogenous depression, is Tx-resistant, non-psychotic, clinical depression, involving abnormal behavior of the endogenous opioid system, but NOT the monoaminergic system
Sx
It is a disabling condition, affecting the Pt's:
Family
Work/school
Sleeping/eating habits
General health
Dx
The Dx is based on the patient’s self-reported experiences, behavior reported by relatives or friends, and a mental status examination
There is no lab test for major depression, although doctors generally request tests for physical conditions that may cause similar Sx
This is not the same as description by the Pt of being depressed, which is advising of an internal state of low mood and loss of interest in activity
It can be a normal reaction to certain life events, or a side effect of certain drugs
Tx
Psychotherapy/counseling, and antidepressant medication, although its effectiveness is questionable for mild to moderate cases (and may also be linked w/ suicide risk). For those of significant risk of harm to self or others, hospitalization and even ECT may be required
Prognosis
3.4% of Pt's will commit suicide
Up to 60% of people who die by suicide had depression or another mood disorder
Pt's have shorter life expectancy due to greater susceptibility to illnesses and suicide
Epidemiology
The most common time of onset is between 20-30yo, with a later peak between 30-40yo
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