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Depression

by Alike Medical Team ∙ Updated on June 13, 2023

Additional names

This group contains additional names: - Major depressive disorder (MDD) - Chronic Depression - Clinical Depression - Depressive Disorder

General

Major depression is a mood disorder that lasts at least two weeks and is characterized by a depressed mood, low self-esteem, and self-blame. Physiological symptoms such as changes in sleep and appetite and cognitive symptoms that interfere with day-to-day life. Depression is characterized by pessimistic thinking about the present, the self and the future. Depression is twice as common among women and the average age of onset is 40 years. In men, it is common to see comorbidity with substances use while in women, eating disorders and anxiety are common comorbidities.

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Signs & symptoms

The symptoms of depression are symptoms of a bad mood that include anhedonia, low self-esteem, self-blame, suicidal thoughts and distancing oneself from society. Also, physiologically, decreased, or increased appetite and weight gain, sleep disorders, decreased desire and sexual activity, constipation, and headaches. There are also cognitive symptoms in the disorder such as psychomotor agitation and concentration difficulties.

Diagnosis

major depression criteria by DSM-5: The DSM-5 outlines the following criterion to make a diagnosis of depression. The individual must be experiencing five or more symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure. 1. Depressed mood most of the day, nearly every day. 2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day. 3. Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day. 4. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down). 5. Fatigue or loss of energy nearly every day. 6. Feelings of worthlessness or excessive or inappropriate guilt nearly every day. 7. Diminished ability to think or concentrate, or indecisiveness, nearly every day. 8. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.B. A diagnosis of clinical / major depression will be given when the various symptoms lead to significant distress or impairment of social, occupational, or other significant areas of functioning. C. The episode is not related to physiological symptoms of substances or any other medical condition. Significant loss (bereavement, deep economic crisis, loss due to natural disaster, serious illness or disability) may include symptoms similar to major depression. It should be borne in mind that loss can lead to depression and therefore each case should be examined on its own merits, the person's history, social norms of distress at the time of loss should be examined and an in-depth clinical assessment performed. D. The onset of clinical / major depression is not better explained by: schizophrenia, schizophrenic disorder, schizophrenic disorder, delusional disorder, or other disorders of the schizophrenia spectrum and other psychotic disorders. E. There have never been manic or hypomanic episodes (if there was a manic or hypomanic episode caused by a physiological or medical condition, for example as a result of taking a drug, this is not considered a manic or hypomanic episode for the purposes of this section).

Treatment

The most common and effective drugs for the treating major depression are antidepressants from the SSRI class – selectiveserotonin reuptake inhibitors. There is also the SNRIs class that inhibit the reuptake of both serotonin and noradrenaline. Other drugs are NDRI, TCA and MAO INHIBITORS. Also, treatment-resistant depression can be treated with Electroconvulsive therapy (ECT) which is considered to be a very effective and very safe treatment with few side effects. Medication should be combined with psychological treatment.

Note

☝ We provide information on prescription and over-the-counter medicines, diagnosis, procedures and lab tests. This material is provided for educational purposes only and is not medical advice, diagnosis or treatment.

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I'm having a hard time at the moment, just needing someone to talk to! To explain further, I lost my dad in June of last year to cancer. Then my brother went missing in August of last year. His disappearance is under investigation, and they found his remains in July of this year. They are still trying to find out his cause of death. So many things do not add up. They believe foul play is at hand. Also, either between now and February 2nd, I will be having a total hip replacement. I am struggling to keep above water here. I can barely get out of bed some mornings and can not be on me feet for a long period of time or even walk very far.

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One suggestion from the replies is to force oneself outside of the house as staying inside all day can exacerbate feelings of depression. Finding genuine reasons to get out of bed and go somewhere, such as a yoga class, painting, a job, or even just driving around for fun can help. Another advice is to take some vitamin D supplements during winter as there is a strong link between vitamin D deficiency and anxiety as well as **depression**. Being outside as much as possible, even if it's cold, can also help as small amounts of vitamin D can be obtained even without direct sunlight.

I am on venlafaxine (Efexor is one of the more common name brands). It's usually used to treat **depression** and anxiety, but it suppresses REM sleep as well. I take that and usually Adderall for daytime sleepiness, but I'm currently breastfeeding so can't take my Adderall at the moment. I tried modaphinil, but it didn't work for me at all and I was also having heart palpitations with it.

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