Clinical depression
From ArticleWorld
Clinical depression is a state of sadness or melancholia, advanced to a point where it is disruptive to one's social activities and functions, lasting for a longer period of time (at least 2 weeks). The diagnosis can be applied in a person meets enough symptomatic criteria, but clinical depression involves a biological cause or agent as well.
Clinical depression is not just a mood lasting more than two weeks. A person may be suffering of clinical depressioneven though he does not fully meet the criteria.
Clinical depression affects approximately 16% of the population at least once during their lifetime. Most occurrences are during the late 20s, predominantly in females.
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Signs and symptoms
According to the DSM-IV-TR criteria of diagnosis, clinical depression may be present if the individual presents a depressed mood, or a loss of interest and pleasure in most activities, associated with at least four of the following conditions:
- Feelings of great sadness, fear, or an apparent inability of feeling emotion
- A considerable decrease of pleasure associated with previously interesting or pleasurable activities.
- Changed appetite, serious weight gain or loss
- Disturbance of sleep patterns
- Restlessness or slowing of movement and other changes in activity levels.
- Mental and physical fatigue
- Decreasing of self-esteem
- Difficulties in concentration or decision making
- Self-harm, attempts or thoughts of self-harm, including suicide.
Many of these signs do not appear in children, which makes depression more difficult to diagnose in their case.
Depression by itself is not dangerous, but should be treated as a medical emergency because, untreated, it may lead to injury or death due to self-harm, or to a severe social ineptitude.
There are several types of depression, with different symptoms
Causes
Specialists are mostly speculating on the causes of clinical depression, especially because the biological mechanism behind it has not yet been fully elucidated. However, there are proofs that clinical depression has hereditary causes, including predisposition to physiological causes like changes in neurotransmitters. In fact, many modern antidepressants try to stimulate production of certain neurotransmitter, usually associated with pleasure or calm.
Psychological causes have a major contribution, either because of the person's thinking patterns, but also due to early experience like death of a parent, rejection or neglection, physical, psychological or sexual abuse during early life. Post traumatic stress disorder includes depression in its symptoms.
Treatment
There are two main models of treatment: medication and psychotherapy. Some alternatives do exist, including use of nutritional supplements and electroconvulsive therapy. The success rate of the treatment depends of the patient's psychological state. In extreme cases like suicide attempts, psychiatric hospitalization is an option, in order to keep the person safe from any self-harm attempts.
Despite the treatment, a danger of relapse does exist if the treatment has not resulted in the full remission of symptoms. Most medical guidelines suggest continued administration of antidepressant for at least 4 months after resolving, in order to prevent relapse.
Codes
Depressive episode
- ICD-10 code: F32, F33 Recurrent depressive disorder
- ICD-9 code: 296.2 Single episode, 296.3 Recurrent, 296.5 Bipolar I disorder most recent episode depressed