Depression is a state of low mood and aversion to activity. The Diagnostic and Statistical Manual of Mental Disorders The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders. It is used in the United States and in varying degrees around the world, by clinicians, researchers, psychiatric drug regulation agencies, defines a depressed person as experiencing feelings of sadness, helplessness and hopelessness. In traditional colloquy, feeling "depressed" is often synonymous with feeling "sad Sadness is an emotion characterized by feelings of disadvantage, loss, and helplessness. When sad, people often become quiet, less energetic, and withdrawn", but both clinical depression Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities. The term "major depressive disorder" was selected by the American Psychiatric Association to designate this symptom cluster as a mood disorder and non-clinical depression can also refer to a conglomeration of more than one feeling.

The precise number of individuals who have severe depression are not known but estimates indicate that about 12 million adults in the US have depression. Depression cuts across all barriers and affects all races The term race or racial group usually refers to the categorization of humans into populations or ancestral groups on the basis of various sets of heritable characteristics. The physical features commonly seen as indicating race are salient visual traits such as skin color, cranial or facial features and hair texture. Conceptions of race, as well, cultures and social classes Social classes are the arrangements of people in society in economic or cultural groups. Class is an essential object of analysis for sociologists, political scientists, economists, anthropologists and social historians. In the social sciences, social class is often discussed in terms of 'social stratification'. The disorder generally begins in early adulthood An adult is a human being or living organism that is of relatively mature age, typically associated with sexual maturity and the attainment of reproductive age. In human context, the term has other subordinate meanings associated to social and legal concepts, for example a legal adult is a legal concept for a person who has attained the age of but can occur at any age. While hospital data reveal that more women have depression, it is hypothesized that this is because men are less likely to seek treatment. Depression occurs in various grades and symptoms are likely to vary in intensity.

Slight depression is of minor consequence. One may become slightly depressed over a loss of a job; break up of a romantic relationship or divorce Divorce is the final termination of a marital union, cancelling the legal duties and responsibilities of marriage and dissolving the bonds of matrimony between the parties. In most countries divorce requires the sanction of a court or other authority in a legal process. The legal process for divorce may also involve issues of spousal support,. Other causes of slight depressions include loss of a parent, sibling, marital stress, job anxiety Anxiety is a psychological and physiological state characterized by cognitive, somatic, emotional, and behavioral components. These components combine to create an unpleasant feeling that is typically associated with uneasiness, apprehension, fear, or worry. Anxiety is a generalized mood condition that can often occur without an identifiable, moving or not having a great job. Slight depression may present with feelings of sadness Sadness is an emotion characterized by feelings of disadvantage, loss, and helplessness. When sad, people often become quiet, less energetic, and withdrawn, sleeping problems, irritability Irritability is an excessive response to stimuli. The term is used for both the physiological reaction to stimuli and for the pathological, abnormal or excessive sensitivity to stimuli; It is usually used to refer to anger or frustration, being easily annoyed and feeling tired. Slight depression is reversible and short term. Most people get over slight depression with time and supportive therapy Supportive psychotherapy is a psychotherapeutic approach that integrates psychodynamic, cognitive-behavioral, and interpersonal conceptual models and techniques. The objective of the therapist is to reinforce the patient's healthy and adaptive patterns of thought behaviors in order to reduce the intrapsychic conflicts that produce symptoms of.

There are some individuals whom may develop mild depression, which may start gradually for no reason. The individual may start to feel tired, restless, lonely Loneliness, the state of "feeling lonely," describes a human state or feeling involving isolation, or the feeling of disconnection with others, etc. Often accompanied by a sense of yearning for connection. Usually manifests through hopes of romantic redemption in the arms of another and have difficulty sleeping. In many cases, the individual loses interest in sex and wants to be left alone. One may be able to go to work but not have any enjoyment. Mild depression may last a lot longer than slight depression, but can be overcome with changes in lifestyle, psychotherapy Psychotherapy, or personal counselling with a psychotherapist, is an intentional interpersonal relationship used by trained psychotherapists to aid a client or patient in problems of living and social support Social support is the physical and emotional comfort given to us by our family, friends, co-workers and others. It is knowing that we are part of a community of people who love and care for us, and value and think well of us. Social support is a way of categorizing the rewards of communication in a particular circumstance. An important aspect of. ^[1]

However, some individuals develop severe depression Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities. The term "major depressive disorder" was selected by the American Psychiatric Association to designate this symptom cluster as a mood disorder, which may induce feelings of suicidal ideation Suicidal ideation is a common medical term for thoughts about suicide, which may be as detailed as a formulated plan, without the suicidal act itself. Although most people who undergo suicidal ideation do not commit suicide, some go on to make suicide attempts. The range of suicidal ideation varies greatly from fleeting to detailed planning, role as it is common in severe depression. In severe depression, one may feel sad constantly, cry for no apparent reason, have trouble sleeping and focusing , become fatigued Fatigue is a state of awareness. It can describe a range of afflictions, varying from a general state of lethargy to a specific work-induced burning sensation within one's muscles. It can be both physical and mental. Physical fatigue is the inability to continue functioning at the level of one's normal abilities. It is ubiquitous in everyday life,, feel worthless, have headaches A headache or cephalgia is pain anywhere in the region of the head or neck. It can be a symptom of a number of different conditions of the head and neck. The brain tissue itself is not sensitive to pain because it lacks pain receptors. Rather, the pain is caused by disturbance of the pain-sensitive structures around the brain. Several areas of the or even backache Back pain is pain felt in the back that usually originates from the muscles, nerves, bones, joints or other structures in the spine . ^[2] While slight depression has a cause, both mild and severe depression generally are complex disorders, which are not well understood. Mild depression may be related to the environment, such as being unable to cope with a certain job, unemployment, financial problems or loss of a loved one. No one understands why severe depression occurs. Even though many brain imaging Neuroimaging includes the use of various techniques to either directly or indirectly image the structure, function/pharmacology of the brain. It is a relatively new discipline within medicine and neuroscience/psychology studies have been done, the exact neurotransmitters Neurotransmitters are endogenous chemicals which transmit signals from a neuron to a target cell across the synapse. Neurotransmitters are packaged into synaptic vesicles that cluster beneath the membrane on the presynaptic side of a synapse, and are released into the synaptic cleft, where they bind to receptors in the membrane on the postsynaptic in the brain which play a role in depression are still in question. Some studies do show that severe depression may be more common in families. ^[3] Although the exact causes of depression are unknown, there are several risk factors that can trigger or increase the risk of depression. ^[4]

Symptoms

There are many symptoms that signify depression. The frequency, duration, and severity of these symptoms will vary depending on the individual. Some signs and symptoms that can occur include:^[5]

• Persistent sadness, anxiety or feelings of emptiness
• Feelings of hopelessness, helplessness and/or pessimism.
• Feelings of worthlessness or guilt
• Contemplating suicide or suicide attempt
• Problems concentrating, remembering details and making decisions
• Fatigue and loss of energy
• Persistent aches, pains or digestive problems that are resistant to treatment
• Irritability or restlessness
• Insomnia, waking early, or excessive sleeping
• Overeating, or appetite loss
• Loss of interest in activities that once were pleasurable (e.g., hobbies, sex, social activities, etc.)

Causes

It is estimated that about 1 out of 6 adults suffer from depression.^[6] Although depression does not have a single cause, many things contribute to the feeling of depression, such as family history, pessimistic personality, trauma and stress, physical conditions, and other psychological disorders. ^[7] Gender may additionally be a contributing factor. The ratio of depression in men and women is 1:2. ^[8]

Risk factors

• Having a family member or relative with depression.
• Having a family member who has committed suicide.
• Stressful events like losing a job, death of a loved one, financial difficulties.
• Having depression as a child or teenager.
• Having a chronic In medicine, a chronic disease is a disease that is long-lasting or recurrent. The term chronic describes the course of the disease, or its rate of onset and development. A chronic course is distinguished from a recurrent course; recurrent diseases relapse repeatedly, with periods of remission in between. As an adjective, chronic can refer to a illness like heart disease Heart disease or cardiopathy is an umbrella term for a variety of different diseases affecting the heart. As of 2007, it is the leading cause of death in the United States, England, Canada and Wales, killing one person every 34 seconds in the United States alone.[verification needed], Alzheimer's disease Alzheimer's disease , also called Alzheimer disease, Senile Dementia of the Alzheimer Type (SDAT) or simply Alzheimer's, is the most common form of dementia. This incurable, degenerative, and terminal disease was first described by German psychiatrist and neuropathologist Alois Alzheimer in 1906 and was named after him. Generally, it is diagnosed, AIDS Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus (HIV). This condition progressively reduces the effectiveness of the immune system and leaves individuals susceptible to opportunistic infections and tumors. HIV is transmitted through direct, or cancer Cancer /ˈkænsər/ (medical term: malignant neoplasm) is a class of diseases in which a group of cells display uncontrolled growth (division beyond the normal limits), invasion (intrusion on and destruction of adjacent tissues), and sometimes metastasis (spread to other locations in the body via lymph or blood). These three malignant properties.
• Having a personality where one has low self-esteem Self-esteem is a term used in psychology to reflect a person's overall evaluation or appraisal of his or her own worth. Self-esteem encompasses beliefs and emotions such as triumph, despair, pride and shame. A person's self-esteem may be reflected in their behaviour, such as in assertiveness, shyness, confidence or caution. Self-esteem can apply, no confidence, being dependent on others or being criticized Criticism is the judgement of the merits and faults of the actions or work of another individual. Criticism can mean merely to evaluate without necessarily finding fault; however, usually the word implies the expression of disapproval all the time.
• Having just delivered a baby (postpartum depression Postpartum depression , also called postnatal depression, is a form of clinical depression which can affect women, and less frequently men, after childbirth. Studies report prevalence rates among women from 5% to 25%, but methodological differences among the studies make the actual prevalence rate unclear. Among men, in particular new fathers, the).
• Having little or no money and being of a low socioeconomic status Socioeconomic status is an economic and sociological combined total measure of a person's work experience and of an individual's or family’s economic and social position relative to others, based on income, education, and occupation. When analyzing a family’s SES, the household income earners' education and occupation are examined, as well as. Cultural considerations are relevant to mixed episodes as well.

Slight and mild depression may not cause any complications. But severe depression can have an agonizing toll on the individual and the family. When severe depression is untreated it can quickly lead to disability The World Health Organization defines Disability as follows: "Disabilities is an umbrella term, covering impairments, activity limitations, and participation restrictions. An impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a and suicidal thinking. Severe depression can also cause deep emotional turmoil, changes in behavior, and legal and monetary problems. ^[9]

Biological influences of depression are varied, but may relate to malnutrition Malnutrition is the insufficient, excessive or imbalanced consumption of nutrients. A number of different nutrition disorders may arise, depending on which nutrients are under or overabundant in the diet, Fructose malabsorption Fructose malabsorption, formerly inappropriately named "dietary fructose intolerance", is a digestive disorder of the small intestine in which the fructose carrier in enterocytes is deficient. This problem results in the concentration of fructose in the entire intestine to be increased. Fructose malabsorption is found in approximately 30-^[10], heredity Heredity is the passing of traits to offspring . This is the process by which an offspring cell or organism acquires or becomes predisposed to the characteristics of its parent cell or organism. Through heredity, variations exhibited by individuals can accumulate and cause a species to evolve. The study of heredity in biology is called genetics,, hormones A hormone is a chemical released by a cell in one part of the body, that sends out messages that affect cells in other parts of the organism. Only a small amount of hormone is required to alter cell metabolism. It is essentially a chemical messenger that transports a signal from one cell to another. All multicellular organisms produce hormones;, seasons Seasonal Affective Disorder , also known as winter depression or winter blues, is a mood disorder in which people who have normal mental health throughout most of the year experience depressive symptoms in the winter or, less frequently, in the summer, spring or autumn, repeatedly, year after year. In the Diagnostic and Statistical Manual of, stress Stress is a term in psychology and biology, first coined in the 1930s, which has in more recent decades become a commonplace of popular parlance. It refers to the consequence of the failure of an organism – human or animal – to respond appropriately to emotional or physical threats, whether actual or imagined, illness Illness is a state of poor health. Illness is sometimes considered a synonym for disease. Others maintain that fine distinctions exist. Some have described illness as the subjective perception by a patient of an objectively defined disease, drug or alcohol use, neurotransmitter Neurotransmitters are endogenous chemicals which transmit signals from a neuron to a target cell across the synapse. Neurotransmitters are packaged into synaptic vesicles that cluster beneath the membrane on the presynaptic side of a synapse, and are released into the synaptic cleft, where they bind to receptors in the membrane on the postsynaptic malfunction, long-term exposure to dampness and mold,^[11] back injury, and to aerosol exposure.^[12][13] There are also correlations between long term sleep difficulties and depression. Up to 90% of patients with depression are found to have sleep difficulties.^[14]

Complications

When depression is neglected or severe, it can lead to:

• Suicide Suicide is the term used for the deliberate self-destruction by a living being, resulting in their own death. Such actions are typically characterised as being made out of despair, or attributed to some underlying mental disorder which includes depression, bipolar disorder, schizophrenia, alcoholism and drug abuse. Financial difficulties,.
• Substance abuse Substance abuse, also known as drug abuse, refers to a maladaptive pattern of use of a substance that is not considered dependent. The term "drug abuse" does not exclude dependency, but is otherwise used in a similar manner in nonmedical contexts. The terms have a huge range of definitions related to taking a psychoactive drug or.
• Alcoholism Alcoholism, also known as alcohol dependence, is a disabling addictive disorder. It is characterized by compulsive and uncontrolled consumption of alcohol despite its negative effects on the drinker's health, relationships, and social standing. Like other drug addictions, alcoholism is medically defined as a treatable disease. The term ".
• Anxiety Anxiety is a psychological and physiological state characterized by cognitive, somatic, emotional, and behavioral components. These components combine to create an unpleasant feeling that is typically associated with uneasiness, apprehension, fear, or worry. Anxiety is a generalized mood condition that can often occur without an identifiable.
• Heart problems.
• Weight problems.
• Work-related problems.
• Family conflicts.
• Interpersonal difficulties.
• Social isolation and loneliness.

Treatments

As a defense mechanism In Freudian psychoanalytic theory, defence mechanisms or defense mechanisms are unconscious psychological strategies brought into play by various entities to cope with reality and to maintain self-image. Healthy persons normally use different defences throughout life. An ego defence mechanism becomes pathological only when its persistent use leads

A number of authors have suggested that depression is an evolutionary adaptation Natural selection is the process by which certain heritable traits—those that make it more likely for an organism to survive and successfully reproduce —become more common in a population over successive generations. It is a key mechanism of evolution. A low or depressed mood can increase an individual's ability to cope with situations in which the effort to pursue a major goal could result in danger, loss, or wasted effort.^[15] In such situations, low motivation may give an advantage by inhibiting certain actions. This theory helps to explain why depression is so prevalent, and why it so often strikes people during their peak reproductive years. These characteristics would be difficult to understand if depression were a dysfunction, as many psychiatrists assume.^[15]

Depression is a predictable response to certain types of life occurrences, such as loss of status, divorce, or death of a child or spouse. These are events that signal a loss of reproductive ability or potential, or that did so in humans' ancestral environment. Depression can be seen as an adaptive response, in the sense that it causes an individual to turn away from the earlier (and reproductively unsuccessful) modes of behavior.

A depressed mood is common during illnesses, such as influenza Influenza, commonly referred to as the flu, is an infectious disease caused by RNA viruses of the family Orthomyxoviridae , that affects birds and mammals. The most common symptoms of the disease are chills, fever, sore throat, muscle pains, severe headache, coughing, weakness/fatigue and general discomfort. Sore throat, fever and coughs are the. It has been argued that this is an evolved mechanism that assists the individual in recovering by limiting his/her physical activity.^[16] The occurrence of low-level depression during the winter months, or seasonal affective disorder Seasonal Affective Disorder , also known as winter depression or winter blues, is a mood disorder in which people who have normal mental health throughout most of the year experience depressive symptoms in the winter or, less frequently, in the summer, spring or autumn, repeatedly, year after year. In the Diagnostic and Statistical Manual of, may have been adaptive in the past, by limiting physical activity at times when food was scarce.^[16] It is argued that humans have retained the instinct to experience low mood during the winter months, even if the availability of food is no longer determined by the weather.^[16]

An alternative theory ^[17] posits that depression is a plea for help. However this view is not widely credited by evolutionary biologists: depression is observed in other species that are not social, and depression in humans is often actively hidden from others; even when it is apparent, it often fails to elicit a positive response.^[18]

Milder depression has been associated with what has been called depressive realism, or the "sadder-but-wiser" effect, a view of the world that is relatively undistorted by positive biases.^[19]

Psychiatric disorders

Episodes of depressed mood are a core feature of the following psychological disorders, as specified by the DSM-IV The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders. It is used in the United States and in varying degrees around the world, by clinicians, researchers, psychiatric drug regulation agencies,:

• Adjustment disorder with depressed mood
• Anorexia Nervosa
• Bipolar disorder
• Bulimia Nervosa
• Cyclothymia
• Depressive Disorder Not Otherwise Specified
• Dysthymia
• Major depressive disorder
• Postnatal depression
• Schizoaffective disorder
• Seasonal affective disorder (SAD)

See also

• Catastrophization
• Grief
• Happiness
• Mood disorder
• Treatment for depression

References

1. ^ Depression and major depression definition Mayo Clinic. Retrieved on 2010-02-07
2. ^ Depression causes and treatment MedicineNet. Retrieved on 2010-02-07
3. ^ What is depression National institute of mental health. Retrieved on 2010-02-07
4. ^ Depression overview netDoctor Portal. Retrieved on 2010-02-07
5. ^ Depression, National Institute of Health, 23 September 2009.
6. ^ Add-on Depression treatment, Otsuko America Pharmaceutical, Inc., July 2009
7. ^ Understanding Depression, GlaxoSmithKline, 1997-2009.
8. ^ [Rao, U., & Chen, L. (n.d.). Characteristics, correlates, and outcomes of childhood and adolescent depressive disorders. National Center for Biotechnology Information. Retrieved February 24, 2010, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2766280/?tool=pubmed
9. ^ Depression Facts and Causes eMedicine Health Portal. Retrieved on 2010-02-07
10. ^ Ledochowski M, Widner B, Murr C, Sperner-Unterweger B, Fuchs D (2001). "Fructose malabsorption is associated with decreased plasma tryptophan". Scand. J. Gastroenterol. 36 (4): 367–71. doi:10.1080/003655201300051135. PMID 11336160.
11. ^ Edmond D. Shenassa, Constantine Daskalakis, Allison Liebhaber, Matthias Braubach, and MaryJean Brown (2007). "Dampness and Mold in the Home and Depression: An Examination of Mold-Related Illness and Perceived Control of One’s Home as Possible Depression Pathways". American Journal of Public Health 97 (10): 1893. doi:10.2105/AJPH.2006.093773. PMID 17761567. PMC 1994167. http://www.ajph.org/cgi/content/abstract/97/10/1893.
12. ^ Farrow, Alexandra (2003). "Symptoms of mothers and infants related to total volatile organic compounds in household products". Arch Environ Health 58 (10): 633–41. doi:10.3200/AEOH.58.10.633-641. PMID 15562635.
13. ^ Air fresheners can make mothers and babies ill, University of Bristol press release issued 19 October 2004
14. ^ Roth T (2005). "Prevalence, associated risks, and treatment patterns of insomnia". J Clin Psychiatry 66 Suppl 9: 10–3; quiz 42–3. PMID 16336036.
15. ^ ^{a b} Nesse R (2000). "Is Depression an Adaptation?". Arch. Gen. Psychiatry 57 (1): 14–20. doi:10.1001/archpsyc.57.1.14. PMID 10632228. http://www.google.com/url?sa=t&source=web&ct=res&cd=1&url=http%3A%2F%2Fwww-personal.umich.edu%2F%257Enesse%2FArticles%2FIsDepAdapt-ArchGenPsychiat-2000.pdf&ei=jk3MSovRNJ6qtgeY-6HtAQ&rct=j&q=%22is+depression+an+adaptation%22&usg=AFQjCNG_VSyM2WmMZebjLpzjgcj8CVluDQ.
16. ^ ^{a b c} Why We Get Sick: The New Science of Darwinian Medicine, Randolphe M. Nesse and George C. Williams | Vintage Books | 1994 | ISBN 0-8129-2224-7
17. ^ How Sadness Survived: The Evolutionary Basis of Depression, Paul Keedwell | Radcliffe Publishing | 2008 | ISBN 1846190134
18. ^ Hendrie C A (2009). "Depression as an evolutionary adaptation: implications for the development of preclinical models.". Med. Hypotheses 72 (3): 342–347. doi:10.1016/j.mehy.2008.09.053. PMID 19153014. PMID 19153014
19. ^ Taylor, SE (1991). Positive Illusions: Creative Self-deception and the Healthy Mind. New York, NY, USA: Basic Books. ISBN 0465060536.

External links

• Depression at the Open Directory Project
• Depression Research News at ScienceDaily
• National Alliance on Mental Illness – Depression support, advocacy, and education
• National Depressive and Manic Depressive Association - National Depressive and Manic Depressive Association
• Stanford Depression Research Clinic
• Substance Abuse and Mental Health Services (SAMHSA) – United States Department of Health and Human Services (HHS)
• Doing Well – Depression self-assessment and information from the UK National Health Service
• Depression information from mental health charity The Royal College of Psychiatrists
• Depression Alliance – Depression Alliance is a UK charity for people with clinical depression and anxiety

Categories: Emotion | Symptoms | Mental illness diagnosis by DSM and ICD | Psychology

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