A major depressive episode ( MDE ) is a period characterized by symptoms of major depressive disorder. They primarily have depression moods for two weeks or more, and lose interest or pleasure in daily activities, accompanied by other symptoms such as feeling empty, desperate, anxious, worthless, guilt and/or irritability, appetite changes , concentrating problems, remembering details or making decisions, and thinking or trying to commit suicide. Insomnia or hypersomnia, pain, pain, or digestive problems that are resistant to treatment can also occur. Descriptions have been formalized in psychiatric diagnostic criteria such as DSM-5 and ICD-10.
Emotional pain and significant economic costs are associated with depression. In the United States and Canada, the costs associated with severe depression are comparable to those associated with heart disease, diabetes, and back problems and are greater than the cost of hypertension. According to the Nordic Journal of Psychiatry, there is a direct correlation between major depressive episodes and unemployment.
Treatments for major episodes of depression include exercise, psychotherapy and antidepressants, although in more serious cases, hospital care or intensive outpatient care may be necessary. There are many theories about how depression occurs. One interpretation is that the neurotransmitters in the brain are out of balance, and this produces feelings of worthlessness and despair. Magnetic resonance imaging shows that the depressed person's brain looks different than that of a person who shows no signs of depression. A history of depression in the family increases the likelihood of being diagnosed.
Video Major depressive episode
Symptoms
The following criteria are based on formal DSM-IV criteria for major depressive episodes. The diagnosis of a major depressive episode requires that the patient has - for a period of two weeks - experience five or more of the following symptoms, and this should be beyond the patient's normal behavior. Either a feeling of depression or a decrease in interest or pleasure should be one of five (though both are often present).
Mood, anhedonia and loss of interest
A person who has episodes of major depression may report depressed feelings or may appear depressed to others. Often, interest or pleasure in daily activities decreases; this is called anhedonia. These feelings should be present daily for two weeks or more to meet DSM-IV criteria for major depressive episodes. In addition, the person may experience one or more of the following emotions: sadness, emptiness, despair, guilt, indifference, anxiety, distress, pessimism, or irritability. Children and adolescents in particular may feel annoyed. There may be a loss of interest or desire for sex. Friends and relatives of the depressed person may notice that he or she has withdrawn from a friend, or has ignored or stopped doing activities that were once a source of pleasure.
People who are depressed may have feelings of guilt that go beyond normal or delusional levels. Depressed people may think of themselves in a very negative and unrealistic way, such as manifesting preoccupation with past failures, personalizing trivial events, or believing that minor faults prove their inadequacy. They may also have an unrealistic sense of personal responsibility and see things beyond their control as their fault. In addition, self-loathing often occurs in clinical depression, and can lead to a spiral when combined with other symptoms.
Sleep
Almost every day, people can sleep excessively, known as hypersomnia, or not enough, known as insomnia. Insomnia is the most common type of sleep disorder for people who are clinically depressed and often associated with a type of melancholy depression. Symptoms of insomnia include difficulty falling asleep, difficulty sleeping, and/or waking up too early. Hypersomnia is a less common type of sleep disorder. This may include sleeping for a long time at night or improving sleep during the day. Sleep may not sound well, and the person may feel sluggish despite many hours of sleep. This has an impact on their daily activities and abilities to focus at home or work. According to the National Library of Medicine of the United States, people with seasonal affective disorder (SAD) may sleep longer during the winter months. Hypersomnia is often associated with atypical depression. Hypersomnia is not as common as insomnia and up to 40% of people show hypersomnia from time to time.
Motor activity
Almost everyday, others may notice that a person's activity level is not normal. People who suffer from depression may be overactive (psychomotor agitation) or become very lethargic (psychomotor retardation). If someone is anxious, they may find it difficult to sit still, be able to pace around the room, squeeze their hands, or move with clothes or objects. Someone with psychomotor retardation tends to move slowly, can move across the room very slowly, diverting their eyes, sitting down in a chair and talking slowly, saying a little. They may say that their arms and legs are heavy. To meet the diagnostic criteria, changes in motor activity must be highly abnormal so that it can be observed by others. Personal reports feel uncomfortable or feel slowly not taken into account diagnostic criteria.
Fatigue and concentration
Almost every day, the person will experience extreme fatigue, fatigue, or loss of energy. A person may feel tired without engaging in any physical activity, and daily tasks become increasingly difficult. Job tasks or household chores become exhausting, and patients find that their work begins to suffer. The person may be hesitant or difficult to think or concentrate. Problems with memory and interruptions are common. These problems cause significant difficulties in functioning for those engaged in intellectual demanding activities, such as school and work, especially in difficult areas.
Thoughts about death and suicide
The person may have recurrent thoughts about death (other than fear of death) or suicide (with or without a plan), or may have committed suicide. The frequency and intensity of thoughts about suicide can range from believing that friends and family would be better off if someone dies, often thinking about committing suicide (usually related to the desire to stop emotional pain), until a detailed plan of how suicide will be done. Those who are more suicidal may have made a special plan and decide on days and locations for suicide attempts.
Maps Major depressive episode
Diagnosis
Healthcare providers can check patients for depression using screening tools, such as Patient Healthcare Questionnaire-2 (PHQ-2).
To diagnose major depressive episodes, trained healthcare providers should ensure that:
- Symptoms do not meet the criteria for mixed episodes.
- Symptoms should cause considerable pressure or impair function at work, in a social setting or in other important areas to qualify as episodes.
- Symptoms are not due to the direct physiological effects of a substance (eg drug or drug abuse) or a general medical condition (eg, hypothyroidism).
- Other than in case of severe symptoms (severe dysfunction, severe preoccupation, suicidal ideation, delusions or hallucinations or psychomotor retardation).
Treatment
Depression is a treatable disease. Treatment for major depressive episodes may be obtained in one or more of the following settings: mental health specialists (ie psychologists, psychiatrists, social workers, counselors, etc.), mental health centers or organizations, hospitals, outpatient clinics, social service agencies, private clinics, peer support groups, pastors, and employee assistance programs. Treatment plans may include psychotherapy alone, antidepressants alone, or a combination of drugs and psychotherapy.
For severe episodes of severe depression (some symptoms, minimal mood reactivity, severe dysfunction), the combination of psychotherapy and antidepressant medications is more effective than psychotherapy alone. Patients with severe symptoms may require outpatient care or hospitalization.
Psychotherapy, also known as speech therapy, counseling, or psychosocial therapy, is characterized by patients who talk about their condition and mental health issues with a trained therapist. Different types of psychotherapy can be effective for depression. These include cognitive behavioral therapy, interpersonal therapy, dialectical behavior therapy, acceptance and commitment therapy, and awareness techniques.
Drugs used to treat depression include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRI), norepinephrine-dopamine (NDRI) reuptake inhibitors, tricyclic antidepressants, monoamine oxidase inhibitors (MAOIs), and atypical antidepressants such as mirtazapine, which does not fit into any of the other categories. Different antidepressants work better for different individuals. It is often necessary to try a few before finding the most appropriate for a particular patient. Some people may find it necessary to combine drugs, which can mean two antidepressants or antipsychotic medications other than antidepressants. If a person's close relatives have responded well to a particular drug, then the treatment is likely to work for him.
Sometimes, people stop taking antidepressant drugs because of side effects, although side effects often become less severe over time. Suddenly stopping treatment or eliminating multiple doses can cause withdrawal-like symptoms. Several studies have shown that antidepressants may increase short-term suicidal thoughts or acts, especially in children, adolescents, and young adults. However, antidepressants are more likely to reduce a person's risk of suicide over the long term.
If left untreated, major major depressive episodes may last for about six months. About 20% of these episodes can last for two years or more. About half of the depressive episodes end spontaneously. However, even after the episode of major depression ends, 20% to 30% of patients have residual symptoms, which can be troublesome and related to disability.
Demographics
Estimates of the number of people suffering from major depressive episodes and Major Depression Disorder (MDD) vary significantly. In their lifetime, 10% to 25% of women, and 5% to 12% of men will suffer from major depressive episodes. Fewer people, between 5% and 9% of women and between 2% and 3% of men, will have MDD, or full depression. The biggest difference in the number of men and women diagnosed was found in the United States and Europe. The peak of development is between the ages of 25 and 44 years. The onset of episodes of major depression or MDD is common in people in their mid-20s, and less often in those over 65 years of age. Preteen and boy teens are affected equally. The symptoms of depression are similar in children and adolescents although there is evidence that their expression in individuals may change with age.
In a National Institute of Mental Health study, researchers found that more than 40 percent of people with post-traumatic stress disorder suffered depression 4 months after the traumatic event they experienced.
Cultural factors can affect the symptoms displayed by a person who has episodes of major depression. Certain cultural values ​​can also influence which phenomena concerns the person or his or her friends and family. It is important that a trained professional knows not to ignore certain symptoms only as a "norm" of a culture.
Women who have just given birth may be at high risk for major depressive episodes. This is called postpartum depression and is a different health condition than baby blues, a low mood that disappears within 10 days after delivery.
comorbid disorder
The episodes of major depression may indicate comorbidity (association) with other physical and mental health problems. Approximately 20-25% of individuals with chronic general medical conditions will experience severe depression. Common comorbid disorders include: eating disorders, substance-related disorders, panic disorder, and obsessive-compulsive disorder. Up to 25% of people who experience major episodes of depression have pre-existing dysthymic disorders.
Some people who have a fatal illness or are at the end of their life may be depressed, although this is not universal.
See also
- Depressive personality disorder
- Depression (differential diagnosis)
- Major depressive disorder
- Mentoring
Note
External links
- The Depression and Bipolar Support Alliance (DBSA) website of the Depression and Bipolar Support Alliance
- Depressed information from the National Institutes of Health
- The Truth About Depression
Source of the article : Wikipedia
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