Narrated- Depression

Category: Education

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Depressive Disorders:

Depressive Disorders LOSS AND GRIEF ISSUES


Epidemiology Approximately 10% of primary care patients experience significant depressive disorders Depression is the 4th most significant cause of global disability, projected to become the 2nd in 2020


Epidemiology MDD Lifetime Risks in community samples vary: 10-25% for women 5-12% for men MDD is 1.5-3 times more likely to occur in first-degree biological relatives than among the general population


Epidemiology Average onset late 20’s, may occur during Childhood, Adolescence, Adulthood or in Older Adulthood May have a Prodromal period May have a Sudden onset High prevalence of Comorbid Anxiety Mood Disorders due to Neurological Conditions e.g. Alzheimer’s & MS Mood Disorders due to Non-neurological Medical Conditions

Neurobiological Theories:

Neurobiological Theories Genetic Factors Neurotransmitter Dysregulation Neuroendocrine Dysfunction

Childhood Depression :

Childhood Depression Behavioral problems including: Aggression Apathy Sleep disturbances Weight loss Irritable versus sad or depressed mood Must be assessed for suicide

Adolescent Depression:

Adolescent Depression Prevalence increases with age and is more common in girls May express somatic complaints and have irritable mood Behavioral problems including: Poor academic and social performance Suicidal ideations Apathy Social withdrawal Rebelliousness Low self-esteem Aggressive behaviors Risky behaviors e.g. substance use, promiscuity

Older Adulthood Depression:

Older Adulthood Depression May present with atypical features such as low mood which may be masked: anxiety and cognitive impairments may be prominent features An estimated 10-15% of Older Adults have significant depressive sxs, although they might not meet the criteria for MDD Late onset variables include: biological, psychological and social factors

Major Depressive Disorder:

Major Depressive Disorder Criteria for Major Depressive Disorder includes a period of 2 weeks during which there are five of the following sxs that represent a change from previous functioning: at least one of the symptoms is either 1. depressed mood or 2. loss of interest or pleasure (anhedonia) Alterations in appetite or weight Sleep disturbance Fatigue Concentration disturbances Feelings of worthlessness, inadequacy, guilt Recurrent thoughts of death or suicidal ideations, plans or attempts


Dysthymia Depressed Mood for most of the day, more days than not, as indicated either by subjective account or observation by others, for at least 2 years . Presence, while depressed, of at least 2 Of the following: Poor appetite or overeating Insomnia or hypersomnia Low energy or fatigue Low self-esteem Poor concentration or difficulty making decisions Feelings of hopelessness

Treatment Modalities:

Treatment Modalities Psychotherapy Pharmacotherapy ECT Light Therapies

Loss and Grief Issues:

Loss and Grief Issues Bereavement Mourning Normal Grief Complicated Bereavement


4 TASKS OF MOURNING 1. Accept the reality of loss 2. Work through the pain of grief 3. Adjust to environment in which person is missing. 4. Emotionally relocate the deceased and move on with life


4 GRIEF REACTIONS 1. Chronic Grief 2. Delayed Grief 3. Exaggerated Grief Response 4. Masked Grief Reaction