Major depressive disorder
From the Simple English Wikipedia, the free encyclopedia that anyone can change
Depression (also called unipolar depression or clinical depression) is a type of mental illness or mood disorder. Someone with depression might have these symptoms: strong sad feelings or no strong feelings at all, feeling guilty, feeling helpless or hopeless, anxiety (worry), fear, low self-esteem or a loss of interest in life which lasts for a long time. Some people who are depressed think about suicide (killing themselves).
Many people feel sad, discouraged, or "down" once in a while, but for some people, this mood does not go away. When these problems last two weeks or more, and are so bad that they get in the way of daily living, this is depression.
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[change] How common depression is
Ten percent of people have depression at some time in their lives. Depression happens most often in people between the ages of 24 and 44 years. About two times as many women as men are diagnosed with depression.
[change] Signs and symptoms
The DSM-IV-TR (a book used to diagnose mental illness) says that the two main parts of depression are:
- depressed mood, or
- loss of interest or pleasure.
- feelings of much sadness, or no emotion
- less interest in things that are normally fun
- changing appetite (wanting to eat) and weight
- sleeping more, or less
- fatigue (feeling tired) of mind and body
- feelings of guilt, helplessness, anxiety (worry), and/or fear
- lowered self-esteem
- thinking about death or suicide
- drug or alcohol use.
Depression in children is harder to notice. Signs a child may have depression include:
- loss of appetite (not wanting to eat)
- sleep problems such as nightmares
- problems with behavior or grades at school where there were none before.
In older children and adolescents (teenagers), another sign may be the use of drugs and alcohol. Most people who have not had depression do not completely understand its effects. Instead, they see it as simply being sad. Since it is not understood, many people with depression are criticized by others for not helping themselves.
Depression is a syndrome of many symptoms that relate to each other, and is not just sad feeling. Medical measurements have shown that there are big changes in the chemicals in the brain, and that the whole brain slows down during depression. Depression that is not treated may get worse.
Good exercise helps deal with depression, since exercise releases chemicals that put a person in a better mood. Having a supportive group of friends and doing outside activities can also help prevent or ease depression.
[change] Types of depression
Major depressive disorder is also referred to as major, biochemical, clinical, endogenous, or biological depression. It may also be called unipolar affective disorder.
There are many subtypes of depression:
- Melancholia is very severe (bad), and has a number of major physical symptoms, like sleep and appetite changes, weight gain, and withdrawal.
- Psychotic depression is much like melancholia, with hallucinations or delusions.
- Atypical depression causes anxiety and panic attacks.
- Chronic dysthymic disorder is a long-term, mild depression that lasts for at least two years. It often begins in adolescence and lasts several decades.
- Seasonal affective disorder (SAD) usually starts in the autumn and goes away in the spring every year. It is common in Alaska, northern Canada, Scandinavia and Finland, but not in Iceland.
[change] Causes of depression
No one cause for depression has been found, but there are some things that can be involved.
These things can cause depression, or make it worse:
- Heredity (someone's genes): Depression is known to be inherited (meaning that someone whose parent or parents or a grandparent are depressed would be more likely to get it).
- Physiology: The amounts of some chemicals in the brain. Serotonin is the main chemical in the brain that has to do with happiness. Many antidepressant medication works to balance the amount of serotonin in the brain.
- Psychological factors: Low self-esteem and harmful thinking
- Early experiences: Events such as the death of a parent, abandonment or rejection, neglect, chronic illness, and severe physical, psychological, or sexual abuse
- Life experiences: Losing a job, problems with money, death of a loved one, or other life problems can cause depression.
- Medical conditions: Some illnesses such as hepatitis or mononucleosis may contribute to depression.
- Alcohol and other drugs: Alcohol can make one depressed. The abuse of alcohol, benzodiazepine-based tranquillizers, sleeping medications, or narcotics can influence the duration and harshness of depression. Some medicines like birth control pills and steroids may also contribute to depression.
[change] Treatment
Depression is usually treated with a combination of medication and other therapy.
[change] Medication
Medications which can help the symptoms of depression have existed for several decades.
Tricyclic antidepressants are the oldest kind of medicine for depression. They are not used much now, because they do not work well, and they have many bad side-effects. An example is Nortriptiline (Allegron).
Monoamine oxidase inhibitors (MAOIs) may be used if other antidepressant medications do not work well. This kind of medicine can cause problems with many kinds of food and drugs. An example is Tranylcypramine.
Selective serotonin reuptake inhibitors (SSRIs) are now the most commonly used family of antidepressant medicine. These drugs work by allowing the brain to have more serotonin. There are fewer side-effects with this kind of drug. An example is Fluoxetine (Prozac).
Sometimes, antidepressant medicine works better when it is used together with another drug that is not an antidepressant. These "augmentor" drugs are:
Tranquillizers and sedatives may be used to ease anxiety (worries) and help sleep.
Antipsychotics are used to keep mood from changing and to reduce or get rid of hallucinations.
Lithium is often used for bipolar disorder, but also can help people with depression.
If people with depression do not take their medicine the right way, the depression can get worse. A doctor must help when depression patients want to change to another medication, or to take a different amount of a medication than before.
[change] Psychotherapy
In psychotherapy, someone with depression is helped to understand and solve problems which cause depression.
Psychotherapy can help a person make changes in thought, help with relationship problems, find and fix relapses, and understand what makes depression worse. The most effective psychotherapy for depression is Cognitive Behavioral Therapy (CBT). In CBT the depressed patient is taught how to think in a more rational, positive, realistic manner.
Probably the most effective single treatment for the vast majority of depressed patients of all ages is physical exercise. (See, Dunn, A., Exercise for Depression Rivals Drugs, Therapy. American Journal of Preventive Medicine, January 2005; vol 28: pp 1-8. National Institutes for Mental Health, "Depression." News release, University of Texas Southwestern Medical Center at Dallas.)
[change] Electroconvulsive therapy
Electroconvulsive therapy (ECT), also called electroshock therapy or shock therapy is used to treat a small percentage of severely depressed people. ECT uses a small amount of electricity to cause an epileptic seizure while the patient is under anesthesia. This may cause some memory loss, amnesia.
[change] See also
- Cyclothymia
- dysthymia
- mania
- bipolar disorder, the newer name for Manic/Depressive
[change] Other websites
- Clinical-Depression
- Internet Mental Health: Major Depressive Disorder
- Depression Alliance website (UK charity) [useful information]
- Depression Fact Sheets [Facts about the causes, symptoms, and treatment of depressive disorders.]
- Detailed information [concerning Emil Kraepelin, who identified Manic Depression]
[change] Books
- Books by psychologists/psychiatrists:
- Beck, A. T., Rush, A. J., Shaw, B. F., Emery, G. (1987). Cognitive therapy of depression. New York: Guilford.
- Klein, D. F., & Wender, P. H. (1993). Understanding depression: A complete guide to its diagnosis and treatment. New York: Oxford University Press.
- Weissman, M. M., Markowitz, J. C., & Klerman, G. L. (2000). Comprehensive guide to interpersonal psychotherapy. New York: Basic Books.
- Books by persons suffering or having suffered from depression:
- Smith, Jeffery (2001). Where the roots reach for water: A personal and natural history of melancholia. New York: North Point Press.
- Solomon, Andrew (2001). The noonday demon: An atlas of depression. New York: Sribner.
- Styron, William (1992). Darkness visible: A memoir of madness. New York: Vintage Books/Random House.
- Wolpert, Lewis (2001). Malignant sadness: The anatomy of depression. London: Faber and Faber.
- Self-help (bibliotherapeutic) books:
- Lewinsohn, P. M., Munoz, R. F, Youngren, M. A., Zeiss, A. M. (1992). Control your depression. New York: Fireside/Simon&Schuster.
