Lecture on Depression

Importance of Addressing Depression

• Depression is a significant global issue, impacting 10% of all death and disability worldwide.
• Recognizing and treating depression with evidence-based practices is crucial.

Understanding Depression

• Depression may encompass various conditions but is often referred to as episodic unipolar major depressive disorder.
• Knowing textbook depression helps identify non-typical cases needing different approaches.

Diagnosing Depression

• Key Feature: Depressed mood, described as sad, empty, hopeless, etc.
• Additional Features: Use the mnemonic SIGECAPS:
  • Sleep: Impaired sleep, difficulty falling asleep, early awakenings.
  • Interest: Anhedonia, reduced enjoyment from activities.
  • Guilt: Feelings of guilt, worthlessness, hopelessness, ruminative thoughts.
  • Energy: Decreased energy and activity, challenging to perform daily tasks.
  • Concentration: Difficulty concentrating, impacting work, school, relationships.
  • Appetite: Decreased appetite, weight loss, food unappetizing.
  • Psychomotor: Retardation, slowing of speech and movements.
  • Suicidal thoughts: High link between depression and suicide.
• At least five of these symptoms for two weeks indicate major depressive episode.

Epidemiology of Depression

• Most common psychiatric disorder; 20% experience at least one episode in their lifetime.
• Occurs at any age, often starts in early adulthood, median age 32.
• Women are twice as likely to be diagnosed as men.
• Episodes last 6-12 months untreated; risk of recurrence increases with each episode.
• Depression can be linked to life events but may occur spontaneously in recurrent cases.

Treating Depression

• Therapy and Medications: Both effective; combination preferable.
• Cognitive Behavioral Therapy (CBT): Focuses on thoughts, feelings, and behaviors.
• Antidepressants: Increase neurotransmitters like serotonin, dopamine, norepinephrine.
• Treatment Response: Rule of thirds - 1/3 recover, 1/3 improve partially, 1/3 no change.
• Severe cases: Electroconvulsive Therapy (ECT) is effective.

Subtypes of Depression

• Melancholic Depression: Severe, non-reactive, neurovegetative symptoms.
• Atypical Depression: Mood reactivity, increased appetite, sleep, leaden paralysis.
• Postpartum Depression: Occurs post childbirth, requires special considerations.
• Seasonal Depression: Linked to seasons, treatable with light therapy.
• Psychotic Depression: Includes paranoia, delusions, hallucinations.

Related Disorder: Dysthymia (Persistent Depressive Disorder)

• Chronic, mild form of depression lasting at least two years.
• Symptoms: Avoid severe symptoms like psychomotor retardation, suicide thoughts.
• Treatment similar to major depression.
• "Double Depression": Co-occurrence of dysthymia and major depressive episodes.

Conclusion

• Understanding and treating major depressive disorder is crucial.
• Next lecture will cover bipolar disorder.
• Further resources and practice questions are available in the accompanying book.