Lesson 1: Clinical Disorders – Part B

PART B

Mood Disorders - DEPRESSION

Video: Ellie's Depression

Depression is known to have many causes, including a possible genetic link. From the loss of a loved one, losing a job, and financial difficulties, to thyroid problems and nutritional deficiencies, depression is a complicated condition and can be difficult to treat. Unfortunately, the number of individuals suffering from depression has steadily increased over the past decade, especially in teenagers and young adults. This disorder, the most common of all psychiatric disorders, affects more women than men. It is characterized by decreased interest or pleasure in most activities (if not all) and a depressed mood for most of the day, every day, for more than two weeks. In addition to these symptoms, a person must present five or more of the following for a diagnosis of depression to be made.

Table 5.1:
Symptoms of Depression

Symptom

Mood: Feeling "depressed"; "sad"; "unhappy" (or whatever the cultural equivalent of these descriptors is) Feelings of worthlessness, hopelessness or excessive and inappropriate guilt Feeling a loss of pleasure or marked disinterest in all or almost all activities.

Thinking: Diminished ability to think or concentrate or substantial indecisiveness Suicidal thoughts/plans or preoccupation with death and dying.

Body Sensations: Excessive fatigue or loss of energy. Significant sleep problems (difficulty falling asleep or sleeping excessively). Physical slowness or in some cases excessive restlessness. Significant decrease in appetite that may lead to noticeable weight loss

People with depression are at increased risk for suicide, especially if the depression is left untreated. Pay attention to your friend's/family's behavior and be aware of the warning signs that he or she may be contemplating suicide: Intense hopelessness or sadness Preoccupation with death Loss of interest in regular activities Withdrawal from family and friends Talking about what it will be like when he or she is gone Giving away valued possessions If you know someone that you think may be contemplating suicide, ask him or her about it and let him or her know you are concerned. Make sure they get professional help.

A unique form of depression, referred to as seasonal affective disorder (SAD), is associated with seasonal changes in the amount of available daylight. Treatment for this type of depression usually involves having the patient spend time under special lamps that use full-spectrum emission bulbs, for a prescribed period of time each day. Individuals with a predisposition to SAD and who live in parts of the world with little sunlight during certain times of the year (such as the northern hemisphere) or with much cloud cover for weeks on end (such as Vancouver) are more likely to develop this type of depression.

Regarding the more pervasive forms of depression, treatment often involves cognitive-behavioral therapy and/or interpersonal therapy combined with medication, the three major types of which are tricyclics, selective serotonin re-uptake inhibitors (SSRIs), and monoamine oxidase inhibitors. These medications help depressed people by preventing the re-uptake of the neurotransmitters norepinephrine and serotonin in the brain. Individuals must be careful with antidepressant drugs, however, because they each can have adverse side effects.

It is important to note that most antidepressant drugs have not been widely tested on children and teenagers. Therefore, they must be prescribed with caution. What is known is that careful monitoring of depressed individuals is required – especially when patients begin treatment or when their medication is increased or decreased.

Video: Caet's experience with depression

When traditional treatments (medication and therapy) are not effective, clinicians may try electroconvulsive therapy (ECT). ECT involves applying a small amount of electricity (not enough to hurt the individual) to the scalp. The electricity is believed to stimulate important neurotransmitters in the brain that act to alleviate depression. ECT, while highly controversial, can be potentially life-saving when other therapies fail or when a person is seriously ill (mentally or psychologically) and/or unable to take medication.

Once depression is recognized, help can make a difference for 80% of people who are affected, allowing them to get back to their regular activities.

Refer to the web site below to learn more about depression.

Teen Mental Health http://teenmentalhealth.org/learn/mental-disorders/depression/