From the Guidelines
Depression is a serious medical condition characterized by persistent feelings of sadness, hopelessness, and loss of interest in activities, significantly impacting daily functioning and quality of life. According to the American College of Physicians guideline 1, depressive disorders, including major depressive disorder (MDD), dysthymia, and subsyndromal depression, are major health care issues and among the foremost causes of disability in adults worldwide. The American Psychiatric Association defines MDD as depressed mood or loss of pleasure or interest along with other symptoms, such as significant changes in weight or appetite, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue, feelings of worthlessness, and recurrent thoughts of death or suicide, lasting for at least 2 weeks and affecting normal functioning 1.
Key Characteristics of Depression
- Persistent feelings of sadness, hopelessness, and loss of interest in activities
- Significant changes in weight or appetite
- Insomnia or hypersomnia
- Psychomotor agitation or retardation
- Fatigue or loss of energy
- Feelings of worthlessness or excessive guilt
- Indecisiveness or decreased ability to concentrate
- Recurrent thoughts of death or suicide
Treatment Approaches
The guideline recommends that clinicians select between either cognitive behavioral therapy or second-generation antidepressants to treat patients with major depressive disorder after discussing treatment effects, adverse effect profiles, cost, accessibility, and preferences with the patient 1. Treatment typically involves a combination of medication and psychotherapy, with lifestyle modifications such as regular exercise, adequate sleep, stress management, and social connection playing crucial roles in managing depression.
Importance of Seeking Help
Depression is not a sign of weakness or character flaw but a legitimate medical condition requiring proper treatment. Seeking help from healthcare providers is essential for developing an appropriate treatment plan, which can significantly improve symptoms, quality of life, and overall functioning. With the right treatment and support, individuals with depression can experience significant improvement and lead fulfilling lives.
From the FDA Drug Label
A major depressive episode implies a prominent and relatively persistent depressed or dysphoric mood that usually interferes with daily functioning (nearly every day for at least 2 weeks); it should include at least 4 of the following 8 symptoms: change in appetite, change in sleep, psychomotor agitation or retardation, loss of interest in usual activities or decrease in sexual drive, increased fatigue, feelings of guilt or worthlessness, slowed thinking or impaired concentration, and a suicide attempt or suicidal ideation. A major depressive episode (DSM–IV) implies a prominent and relatively persistent (nearly every day for at least 2 weeks) depressed or dysphoric mood that usually interferes with daily functioning, and includes at least 5 of the following 9 symptoms: depressed mood, loss of interest in usual activities, significant change in weight and/or appetite, insomnia or hypersomnia, psychomotor agitation or retardation, increased fatigue, feelings of guilt or worthlessness, slowed thinking or impaired concentration, a suicide attempt or suicidal ideation.
Depression is a medical condition characterized by a prominent and relatively persistent depressed or dysphoric mood that interferes with daily functioning. The symptoms of depression include:
- Change in appetite
- Change in sleep
- Psychomotor agitation or retardation
- Loss of interest in usual activities
- Increased fatigue
- Feelings of guilt or worthlessness
- Slowed thinking or impaired concentration
- Suicide attempt or suicidal ideation According to the DSM-IV, a major depressive episode must last for at least 2 weeks and include at least 5 of the above symptoms 2, 3, 4.
From the Research
Definition of Depression
- Depression, also known as major depressive disorder (MDD), is a complex medical condition characterized by persistent depressed mood, loss of interest or pleasure in previously enjoyable activities, recurrent thoughts of death, and physical and cognitive symptoms 5.
- It is a major affective disorder that involves feelings of loss, worthlessness, fatigue, and a general decrease in interest in the usual activities of daily living 6.
Symptoms of Depression
- Common symptoms of depression include marked sadness or a loss of interest or pleasure in daily activities, weight change, sleep disturbance, fatigue, difficulty concentrating, physical impairment, and a high suicide rate 7.
- Physical symptoms such as chronic joint pain, limb pain, back pain, gastrointestinal problems, tiredness, sleep disturbances, psychomotor activity changes, and appetite changes are also common in depression 8.
Causes of Depression
- Depression is caused by a combination of genetic, environmental, psychological, and biological factors, and cannot be fully explained by any one single established biological or environmental pathway 5.
- The neurotransmitters that influence both pain and mood, such as serotonin and norepinephrine, play a role in the development of depression, and dysregulation of these transmitters is linked to both depression and pain 8.
Treatment of Depression
- Treatment for depression commonly involves pharmacological therapy with antidepressant medications, psychotherapy, or a combination of both 5.
- Other biological therapies, such as electroconvulsive therapy, may also be offered in people with severe and/or treatment-resistant depression 5.
- Nursing care of hospitalized depressed persons involves careful monitoring of clients' status and the effectiveness of treatments, and focuses on three areas of need: immediate, short-term, and long-term needs 6.