Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behavior, feelings, and sense of well-being. A depressed mood is a normal temporary reaction to life events such as loss of a loved one. It is also a symptom of some physical diseases and a side effect of some drugs and medical treatments. Depressed mood is also a symptom of some mood disorders such as major depressive disorder or dysthymia.
|Lithograph of a man diagnosed as suffering from melancholia with strong suicidal tendency (1892)|
|Classification and external resources|
People with a depressed mood may be notably sad, anxious, or empty; they may also feel notably hopeless, helpless, dejected, or worthless. Other symptoms expressed may include senses of guilt, irritability, or anger. Further feelings expressed by these individuals may include feeling ashamed or an expressed restlessness. These individuals may notably lose interest in activities that they once considered pleasurable or experience either loss of appetite or overeating. Experiencing problems concentrating, remembering general facts or details, otherwise making decisions or experiencing relationship difficulties may also be notable factors in these individuals' depression and may also lead to their attempting or actually dying by suicide.
The difference between a depressed mood and Major Depressive Disorder is length of time, ranging from very temporary such as a day to a month, and Major Depressive Disorder which is long-term and life-impacting. The depressive mood can be overcome by lifestyle changes or conversations, whereas Major Depressive Disorder generally requires major intervention with a combination of SSRIs or Dopamine therapy and long-term psychiatric treatments.
Depression is one of the major causes or risk factors of suicide among adolescents, and more than half of the suicide victims in this age group are diagnosed with depressive orders before their demise. Depression among teenagers is also a leading cause of educational and social impairments, substance abuse, obesity, and increased risk of smoking. Expressed insomnia, excessive sleeping, fatigue, and vocalizing general aches, pains, and digestive problems and a reduced energy may also be present in individuals experiencing depression.
Adversity in childhood, such as bereavement, neglect, mental abuse, physical abuse, sexual abuse, and unequal parental treatment of siblings can contribute to depression in adulthood. Childhood physical or sexual abuse in particular significantly correlates with the likelihood of experiencing depression over the life course.
Life events and changes that may precipitate depressed mood include (but are not limited to): childbirth, menopause, financial difficulties, unemployment, stress (such as from work, education, family, living conditions etc.), a medical diagnosis (cancer, HIV, etc.), bullying, loss of a loved one, natural disasters, social isolation, rape, relationship troubles, jealousy, separation, and catastrophic injury. Adolescents may be especially prone to experiencing depressed mood following social rejection, peer pressure and bullying. In addition, culture shock and homesickness are one of the main factors influencing international students. To be more precise, students who experience homesickness might feel alienation from their surroundings, anxiety and depression, especially when they face problems. This can be coupled with low self-esteem, which may make them less confident in public and in social situations.
High scores on the personality domain neuroticism make the development of depressive symptoms as well as all kinds of depression diagnoses more likely, and depression is associated with low extraversion. Other personality indicators could be: temporary but rapid mood changes, short term hopelessness, loss of interest in activities that used to be of a part of one's life, sleep disruption, withdrawal from previous social life, appetite changes, and difficulty concentrating,
Gender identity and sexualityEdit
Depression may also be iatrogenic (the result of healthcare), such as drug induced depression. Therapies associated with depression include interferon therapy, beta-blockers, Isotretinoin, contraceptives, cardiac agents, anticonvulsants, antimigraine drugs, antipsychotics, and hormonal agents such as gonadotropin-releasing hormone agonist.
Several drugs of abuse can cause or exacerbate depression, whether in intoxication, withdrawal, and from chronic use. These include alcohol, sedatives (including prescription benzodiazepines), opioids (including prescription pain killers and illicit drugs such as heroin), stimulants (such as cocaine and amphetamines), hallucinogens, and inhalants.
Depressed mood can be the result of a number of infectious diseases, nutritional deficiencies, neurological conditions and physiological problems, including hypoandrogenism (in men), Addison's disease, Cushing's syndrome, hypothyroidism, Lyme disease, multiple sclerosis, Parkinson's disease, chronic pain, stroke, diabetes, and cancer.
A number of psychiatric syndromes feature depressed mood as a main symptom. The mood disorders are a group of disorders considered to be primary disturbances of mood. These include major depressive disorder (MDD; commonly called major depression or clinical depression) where a person has at least two weeks of depressed mood or a loss of interest or pleasure in nearly all activities; and dysthymia, a state of chronic depressed mood, the symptoms of which do not meet the severity of a major depressive episode. Another mood disorder, bipolar disorder, features one or more episodes of abnormally elevated mood, cognition and energy levels, but may also involve one or more episodes of depression. When the course of depressive episodes follows a seasonal pattern, the disorder (major depressive disorder, bipolar disorder, etc.) may be described as a seasonal affective disorder. Outside the mood disorders: borderline personality disorder often features an extremely intense depressive mood; adjustment disorder with depressed mood is a mood disturbance appearing as a psychological response to an identifiable event or stressor, in which the resulting emotional or behavioral symptoms are significant but do not meet the criteria for a major depressive episode;:355 and posttraumatic stress disorder, a mental disorder that sometimes follows trauma, is commonly accompanied by depressed mood. Depression is sometimes associated with substance use disorders. Both legal and illegal drugs can cause a substance use disorder.[unreliable medical source?]
Combination of many factorsEdit
The depressed mood can be a combination of many things. A significant life event could possibly trigger onset while other factors are still present. The brain could be lacking optimal stimulation of dopamine or serotonin, and an individual could be abusing alcohol in order to relax after a stressful day of work. All of these factors could total to a depressed mood, while just one of them alone may not cause the mood adjustment. The root cause of depression generally does not have one single factor, but rather a combination of many.
Questionnaires and checklists such as the Beck Depression Inventory or the Children's Depression Inventory can be used by a mental health provider to help detect, and assess the severity of depression. The Seasonal Pattern Assessment Questionnaire can be used to screen for seasonal affective disorder. Semi structured interviews such as the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS) and the Structured Clinical Interview for DSM-IV (SCID) are used for diagnostic confirmation of depression. A major indicator in diagnosis is time, or how long one has been exhibiting signs of depression for, and if it is impacting their life negatively, or cause disruption. For depressed moods, the feelings could be present for days or even weeks, yet for Major Depressive Disorder, there would be a lasting history of symptoms.
Depressed mood may not require professional treatment, and may be a normal temporary reaction to life events, a symptom of some medical condition, or a side effect of some drugs or medical treatments. A prolonged depressed mood, especially in combination with other symptoms, may lead to a diagnosis of a psychiatric or medical condition which may benefit from treatment.[unreliable medical source?] Different sub-divisions of depression have different treatment approaches. In the United States, it has been estimated that two thirds of people with depression do not actively seek treatment. The World Health Organisation (WHO) has predicted that by 2030, depression will account for the highest level of disability accorded any physical or mental disorder in the world (WHO, 2008).
The UK National Institute for Health and Care Excellence (NICE) 2009 guidelines indicate that antidepressants should not be routinely used for the initial treatment of mild depression, because the risk-benefit ratio is poor. A recent meta-analysis also indicated that most antidepressants, besides fluoxetine, do not seem to offer a clear advantage for children and adolescents in the acute treatment of major depressive disorder.
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