Psychiatry RotationAttending Physician – Dr. Archibald

Presentation by:

OLADAPO SAMSON OLUWABUKOLA1ST AUGUST, 2012

A SIMPLIFIED APPROACH TO DEPRESSION

Windsor University School of Medicine

Overview

Telling someone with a depression & mood

disease things like 'Cheer up. Get over it. Move

forward', is like telling a blind person 'Just look

harder

What Is Depression?Depression is more than just a “down

mood.” It’s a condition that can be characterized by the persistence of several symptoms, including feelings of sadness, emptiness, and isolation. But the good news is that doctors are developing a better understanding of depression, which has led to new treatments to help people struggling with depression regain control of their lives.

What Is Depression?Depression is a state of low mood and

aversion to activity that can affect a person's thoughts, behavior, feelings and physical well-being. Depressed people may feel sad, anxious, empty, hopeless, worried, helpless, worthless, guilty, irritable, or restless. They may lose interest in activities that once were pleasurable; experience loss of appetite or overeating, have problems concentrating, remembering details, or making decisions; and may contemplate or attempt suicide. Insomnia, excessive sleeping, fatigue, loss of energy, or aches, pains or digestive problems that are resistant to treatment may be present.

It is commonly thought that about one in four women and one in six men will experience an episode of clinical depression over their lifetime. This of course depends on how you define clinical depression.Feeling down from time to time is a

natural part of life, but for almost 1 out of every 5 of us, this temporary

down moment turns to depression and it can last a long time.

Depression affects almost everything from our emotions to physical health and our relationships and work.

The good news is, today we have a better understanding of depression which has led to treatment and help people struggling with it get their lives back again.

What Causes Depression?There is no single cause for depression. Experts believe that a combination of three factors—genetics, the environment, and perhaps (although this has never been clearly proven) chemical imbalances in the brain—work together to cause depression.

Depression can strike anyone regardless of age, ethnic background, socioeconomic status, or gender; however, large-scale research studies have found that depression is about twice as common in women as in men.

What Causes Depression?A normal, functioning brain is a messaging system that controls all bodily functions. Communication within the brain is enabled through billions of cells called neurons. These cells send and receive messages from the rest of your body and with each other. To do this, they release chemicals called neurotransmitters, which communicate with other cells across a gap between them. This gap is called a synapse. When the brain is working normally, the neurons release the proper amount of functioning chemical messengers to communicate.

What Causes Depression?But, when a person has depression, the chemical messengers are speculated to perhaps either not function correctly, or not be present in normal quantities. However, it should be noted that there has never been clear substantiation of a definitive “chemical imbalance” that is responsible for depression. What causes this complex disorder of mood and somatic symptoms is still not fully understood.

Types of DepressionThere are a number of different types of depression:Major DepressionDysthymia Bipolar DisorderSeasonal Affective DisorderPostpartum Depression

Major DepressionAlso known as ‘Unipolar’ DepressionThis is the most common type of depression. It is considered severe and symptoms last for

weeks or months.

DysthymiaThis condition is less severe than major

depression, but each episode lasts for a longer period of time, often several years.

Bipolar DisorderUnlike the other types of depression, this condition

involves an “up” mood called “mania,” in addition to “down” moods. For this reason, this condition is sometimes called manic-depressive illness.

They have issues with relationship and work, sometimes coinciding.

Seasonal Affective Disorder (SAD)This condition occurs at a certain time of the year, usually

winter. It is also known as Winter Depression. It is a pattern of “down moods” caused by changes in the weather and decreased exposure to sunlight.

Postpartum DepressionThis is caused by hormonal changes after the

delivery of a baby. It is much more severe than the usual “baby blues,” which affects many women for a short period after giving birth.

Postpartum DepressionExtreme concern and worry about the

baby or a lack of interest or feelings for the baby  

Feeling unable to love the baby or your family  

Anger toward the baby, your partner, or other family members  

Anxiety or panic attacks  Fear of harming the baby; these thoughts

may be obsessive, and may be afraid to be left alone in the house with the baby.  

Sadness or excessive crying  Feelings of doubt, guilt, helplessness,

hopelessness, or restlessness  Lethargy or extreme fatigue  

Symptoms of DepressionThe following are the classic symptoms of

depression:Loss of interest in normal daily activitiesFeelings of helplessness, hopelessness, or

sadness, including crying spellsLoss of energy and the ability to concentrateProblems sleepingFeeling useless or inadequate for an

extended periodSignificant weight loss or gain, or extended

periods of indigestionFatigue or headaches for extending periodsDecrease in sexual activity for an extended

period of timeHarming oneself or thoughts of death or

suicide

ObservationsIf you have these several of these symptoms

for two or more weeks, seek medical care to determine if you are suffering from depression. If you have thoughts of harming yourself or thoughts of suicide, you should seek medical care immediately.

Of course, it is normal for a person to feel down after a period of major stress or loss such as the death of a loved one. The is considered the "grieving process". But, if the “down” mood does not improve after several months, or if it worsens, this may be a sign that the normal grieving process has turned into a clinical depression.

FINALLY…

This is the Heart Desire of every therapist, family members,

friends and the entire community – that the

depressed patient returns back to their

former state, and until then…