Major Depression: Category and symptoms

The category of Major Depression represents a superordinate class. Hence, within major depression are a number of sub-classifications.

Cases can be described as:
a. In partial or complete
b. Mild, moderate or severe
c. With melancholia (the American equivalent to endogenous)
d. With psychotic features

Psychotic features may be subdivided into mood congruent psychotic (e.g., delusions of guilt, poverty, disease) and mood incongruent psychotic features (e.g., persecutory, thought insertion).

There is a list of nine possible symptoms of which the patient should have at least five.

1. Depressed mood (or can be irritable mood in children and adolescents) most of the day, nearly every day, as indicated by subjective account or observation by others

2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either account or observation by other of apathy most of the time.)

3. Significant weight loss or weight gain when not dieting (e.g., more than 5% of body weight in a month), or decrease or increase in appetite nearly every day (in children, consider failure to make expected weight gains)

4. Insomnia or hypersomnia nearly every day

5. Psychomotor agitation or retardation nearly very day (observable by other, not merely subjective feelings of restless or being slowed down)

6. Fatigue or loss of energy nearly every day

7. Feelings or worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)

8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)

9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide
Major Depression: Category and symptoms

What is double depression?

Double depression is the concurrent presence of dysthymia and major depression, in which acute major depressive episodes appear to be ‘superimposed’ upon the underlying chronic depression.

Double depression is distinct from chronic major depression, in which an individual experiences the symptoms of a major depressive episode continuously for at least 2 years.

This type of depression has a poorer prognosis than either condition alone, and recurrences of major depressive episodes are common.

Patients with double depression seem to recover more rapidly from episodes of major depression than do patients with major depression alone.
What is double depression?

What is major depressive disorder?

It is a serious medical illness that disrupt a person; mood, behavior, thought process and physical health.

It is characterized by a persistent lowering of mood, loss of interest in usual activities and diminished ability to experience pleasure.

Major depressive disorder is a recurrent, episodic illness. This means that a person who has been depressed once and has recovered is likely to have one or more episodes of depression in future, often within 2 to 3 years.

Major depressive disorder has about a 50% chance of developing another episode at some later point. Once individual has two episodes, the odds of having a third increase to about 70%.

An episode of major depressive disorder may be classified as:
*mild
*moderate
*severe

Major depressive disorder may be accompanied by hallucination or delusions: these may be congruent or non congruent with the depressive mood.

Major depressive disorder can present with a variety of symptoms, however almost all patients display a marked change in mood, a deep feeling of sadness, and noticeable activities.
What is major depressive disorder?

Symptoms of a Major Depressive Episode

Symptoms of a Major Depressive Episode
Major depressive episode can be defined by the criteria listed below. At least five of the symptoms, including one or the other of the first two, must be present during the same two-week period for major depression to be diagnosed.

• Depressed mood (or can be irritable mood in children and adolescents) most of the day, nearly every day, as indicated either by the subjective account or observation by others.

• Markedly diminished interest or pleasure in all day, or almost all, activities most of the day, nearly every day (as indicated either by subjective account or observation by others of apathy most of the time)

• Significant weight loss or weight gain when no dieting (e.g. more than 5% of body weight in a month), or decrease or increase in appetite nearly every day (in children, consider failure to make expected weight gains).

• Insomnia or hypersomnia nearly every day

• Psychomotor agitation or retardation nearly every day (observation by others, not merely subjective feelings of restlessness or being showed down)

• Fatigue or loss of energy nearly every day

• Feelings of worthlessness or excessive of inappropriate guilt which may be delusional nearly every day (not merely self reproach or guilt about being sick)

• Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)

• Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

Symptoms of a Major Depressive Episode

Major Depression

The escalation in the problem, as well as the facts relating to recurring episodes of depression show that while the first line treatment of depression by antidepressants may sometimes control the symptoms, it usually does little to give sufferers depression-free lives.

More than ever, we need to look at alternatives to drugs that will equip us to deal effectively with the triggers that allow depression to take hold again and again. This is where drug treatments fail.

Facts on major depression
First and foremost, clinical or major depression is growing at an incredible rate.
· People of all ages, backgrounds, lifestyles, and nationalities suffer from major depression, with a few exceptions.
· Up to 20% of people experience symptoms of depression.
· 10 times more people suffer from major depression now than in 1945
· The average age of first onset of major depression is 25-29

A few key areas of society remain where major depression is not seen. Also, the huge increase in cases of major depression show that it can't be a disease.There is 10 times more major depression in people born after 1945 than in those born before. This clearly shows that the root cause of most depression is not a chemical imbalance.
Human genes do not change that fast.

Yet, it is estimated 35 to 40 million Americans living today will suffer from major depression at some time during their lives, with about half of this amount suffering from recurring depression symptoms.

This isn't due to more people telling their doctor. In fact, a major issue when considering the effect of major depression on society as a whole is the amount of misdiagnosis, or cases where major depression goes undiagnosed.

Major depression and suicide
* About a quarter of suicides in the US are felt to be due to undiagnosed, or misdiagnosed major depression.
* Up to 80% of suicide deaths are in sufferers of major depression.

Given that suicide is the 8th largest cause of death in the US, it's no wonder that major depression is classed as "the nation's leading mental health problem"
Even these horrific numbers may not reveal the true picture, given that many suicides will be disguised as accidental death.

Why the sudden increase?
Societies that breed depression and societies that don't
It is a fact that we all have basic emotional needs that must be met for us to thrive and enjoy life. After the primary human needs for food, water and shelter come commonly shared emotional and physical needs. Without exception we find depressed people are not getting these needs met.

Traditional communities naturally meet many 'basic needs' for emotional support. In the traditional Amish society in the US major depression is almost unknown, as it is in the equally traditional Kaluli tribe of New Guinea. In these societies individual concerns are group concerns and vise-versa. You know that if you have a problem other people will help you and you are expected to help out when others need support. We know we are meant to do these things but it's not a 'built in feature' of modern society in the same way.

These days we are much more 'self-focused'. The idea of considering the wider community to be more important than the self is almost impossible to understand for most people.Major depression is 4th most disabling condition in the world, and 2nd most in the developed world.

As well as the human cost, the burden on society is incredible. Much of the research on this site about effective treatments for depression has been controlled by the US government, in order to try and find the best way to overcome depression. The cost to society is real, and we need to find the best way at beating depression for good.
Depression