DEPRESSION Antonija Jukić Mentor: A. Žmegač Horvat

 The words above belong to author William Styron, and they describe his first episode of major depression  This experience belongs to millions

Definition of MAJOR DEPRESSIVE DISORDER  Mental disorder characterized by an all- encompassing low mood accompanied by low self-esteem, and loss of interest or pleasure in normally enjoyable activities  Depressed mood persists for at least two weeks

Subtypes  Melancholic depression  Atypical depression  Catatonic depression  Postpartum depression  Seasonal affective depression

Symptoms and signs  Feelings of helplessness and hopelessness  Loss of interest in daily activities  Appetite or weight changes  Sleep changes  Irritability or restlessness  Loss of energy  Self-loathing  Concentration problems  Unexplained aches and pains

Depression and suicide!!!  3.4% of people with major depression commit suicide  60% of people who commit suicide have depression or another mood disorder

Causes and risk factors for depression  Loneliness  Lack of social support  Recent stressful life experiences  Family history of depression  Marital or relationship problems  Financial strain  Early childhood trauma or abuse  Alcohol or drug abuse  Unemployment or underemployment  Health problems or chronic pain

Biological theories  Dysregulation of monoamine chemicals serotonin, norepinephrine and dopamine in the brain  Most antidepressants increase the levels of one or more of the monoamines

Diagnosis  Patient's self-reported experiences  Behavior reported by relatives or friends  Mental status exam  No laboratory test for major depression

Differential diagnoses  Dysthymia  Adjustment disorder with depressed mood  Bipolar disorder

Management  Antidepressant medication (MAOIs, TCAs, SSRIs) – delayed onset of action (2-6 weeks)!!! (MAOIs, TCAs, SSRIs) – delayed onset of action (2-6 weeks)!!!  Psychotherapy or counselling  Hospitalization  Electroconvulsive therapy (ECT)

Prevention - Lifestyle changes!  Cultivating supportive relationships  Getting regular exercise and sleep  Eating a healthy, mood-boosting diet  Managing stress  Practicing relaxation techniques  Challenging negative thought patterns  SMILE  SMILE

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