What is depression?

1. What is depression? • Depression is one of the most common mental illnesses. • People with depression experience feelings of unbearable sadness, despair, and hopelessness. • It effects all people of different ages, races, and socioeconomic groups. • Depression carries with it disturbances in emotional, cognitive, behavioral, somatic, and spiritual dimensions.

2. History of Depression • Depression was apparent back to the second millennium B.C., Mesopotamian. • Demonic possession • Greek physician Hippocrates believed it was an imbalance of humors. • Melancholia • During the Renaissance era in the 1600s, Robert Burton published, “Anatomy of Melancholy”. • In the 1600s depression was rooted from deprimere.

3. History of Depression • In the 1950s depression was divided depression into two groups: endogenous and neurotic. • Endogenous meaning genetic or physical • Neurotic meaning develop from environment • Clinical observations made in the 1960s led to formulation of the monoamine hypothesis of depression. • This states that depression is caused by functional insufficiency of neurotransmitters (norepinephrine, serotonin, or both). Today depression can be both physical and mental.

4. Prognosis • There are many prognostic factors that can affect depression, in particular, Major Depression Disorder (MDD). • This makes a depression prognosis highly individualized. • Prognostic factors can be demographics and may be physical and mental health treatment.

5. Prognosis • In the vast majority of cases the prognosis of depression is good. • This true only when someone is in treatment for depression. • Untreated depression usually does not go away by itself, and often gets worse with time. • Clinical depression tends to occur in episodes, most people who experience one such episode will eventually have another one.

6. Prognosis of Adolescence • A Major Depressive Disorder (MDD) episode for clinically referred youth typically lasts for 7 to 9 months. • Approximately 90% of major depressive episodes remit within 1 to 2 years from onset, however 6-10% of episodes become more persistent. • It is important to convey the message of “It gets better” to young people and their families with treatment.

7. Prognosis of Postpartum Depression • Most mothers with postpartum depression recover completely if the illness is diagnosed and treated early. • According to the World Health Organization (WHO) about 50% of women who recover from postpartum depression develop the illness again after future pregnancies. • Medication, counseling, and support from others usually cures even severe post partum depression which yields a good prognosis.

8. Prognosis of the Elderly • The prognosis for recovery is equal in young and old patients, although remission may take longer to achieve in older patients. • Most patients (54-84 %) recover. • 12-24 % relapse and 4-28 % remain ill or disabled. • In patients with psychotic depression, recovery rates are reduced by one half, and relapse and disability rates are twice those in patients with nonpsychotic depression

9. Signs and symptoms of depression • Suffering from depression can cause feelings of sadness or anxiety and can lasts for weeks at a time. • Symptoms include: • Feelings of hopelessness, guilt, and worthlessness • Persistent pessimism • Irritability, restlessness • Loss of interest in activities or hobbies once pleasurable • Fatigue and decreased energy • Insomnia, early-morning wakefulness, or excessive sleeping • Overeating, or appetite loss • Thoughts of suicide, suicide attempts

10. Treatment for depression • Numerous depression treatments are available. Medications and psychological counseling (psychotherapy) are very effective for most people. • Drugs are the primary therapy for major depression. • A number of antidepressant medications are available to treat depression. • There are several different types of antidepressants and are generally categorized by how they affect the naturally occurring chemicals in your brain to change your mood.

11. Treatment for depression Types of antidepressants include: • Selective serotonin reuptake inhibitors (SSRIs). • fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa) and escitalopram (Lexapro). • Many doctors start depression treatment by prescribing an SSRI because these medications are safer and generally cause fewer bothersome side effects than do other types of antidepressants. • Side effects include decreased sexual desire and delayed orgasm. Other side effects may go away as your body adjusts to the medication. They can include digestive problems, jitteriness, restlessness, headache and insomnia.

12. Treatment for depression • Serotonin and norepinephrine reuptake inhibitors (SNRIs): • These medications include duloxetine (Cymbalta), venlafaxine (Effexor XR) and desvenlafaxine (Pristiq). Side effects: • Similar to those caused by SSRIs. • These medications can cause increased sweating, dry mouth, fast heart rate and constipation. Norepinephrine and dopamine reuptake inhibitors (NDRIs). • In this category is Bupropion (Wellbutrin). • It's one of the few antidepressants that doesn't cause sexual side effects. At high doses, bupropion may increase your risk of having seizures.

13. Treatment for depression • Atypical antidepressants. • These medications are called atypical because they don't quite fit into another antidepressant category. • They include trazodone (Oleptro) and mirtazapine (Remeron). • Both of these are sedating and are usually taken in the evening.

14. Treatment for depression • Other forms of treatment include: • Psychotherapy--Psychological counseling • Electroconvulsive therapy (ECT):electrical currents are passed through the brain affecting levels of neurotransmitters in your brain. • Mind-body techniques that may be tried to ease depression symptoms include: • Acupuncture • Yoga • Meditation • Guided imagery • Massage therapy

15. Prevalence • Depression is considered to be the fourth leading cause of disability and disease worldwide • Depression affects up to 20% of Americans. • Women are more likely to develop depression than men. • 1.5 -2.5 time higher in women than in men from ages 18-64 years. • Depression is rising with age • 2.8% ages 18-24 • 4.6% ages 45-64 • 1.6% ages < 65 • 2.5 percent of children and up to 8.3 percent adolescent in the U.S suffer from depression

16. Incidence • Panic disorder: 1.7% of US adults annually • Obsessive-compulsive disorder: 2.3% adults annually • Post-traumatic stress disorder: 3.6% adults annually • Social phobia: 3.7% adults annually • Generalized anxiety disorder: 2.8% of the adults U.S. population

17. Incidence • The highest countries that experience depression is: • France 21% • The Netherlands 17.9% • New Zealand 16.0% • The U.S. 19.2 %

19. Don’t worry be Happy! Bobby McFerrin song

20. Depression