Essay About Clinical Depressions And Depressive Episodes

Depression
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Everybodys mood varies according to events in the world around them.
People are happy when they achieve something or saddened when they fail a
test or lose something. When they are sad, some people say they are
depressed, but the clinical depressions that are seen by doctors differ
from the low mood brought on by everyday setbacks. Psychiatrists see a
range of more severe mood disturbances and so find it easier to
distinguish these from the normal variations of mood seen in the
community. General practitioners (GPs) need to be sensitive enough to
distinguish emotional reactions to setbacks in life from anxiety
syndromes, somatisation and clinical depressions. The general idea is
that anxiety disorders, depressive episodes, somatisation and adjustment
reactions are all different entities, but in practice it is not always
that clear-cut. Major depression, as defined by psychiatrists, is
unfortunately relatively common. What is depression? The term “affect”
refers to ones mood or “spirits.” “Affective disorder” refers to changes
in mood that occur during an episode of illness marked by extreme sadness
(depression) or excitement (mania) or both. Depression is a disorder of
affect. Affective disorders are predominantly disturbances of mood that
are severe in nature and persistent despite the influence of external
events. Depression is characterized by severe and persistent low mood,
which is often unresponsive to the efforts of friends and family to cheer
the sufferer up. Patients who suffer with repeated episodes of depression
have a Recurrent Depressive Disorder. Depressive episodes can be
classified into mild, moderate, and severe types, with or without
psychotic symptoms. To be classified as depression, an episode must last
more than two weeks. A condition where the mood is persistently low, but
does not quite fulfill all the criteria for a depressive episode, is
sometimes called “dysthymia.” Community studies have found that
depression is prevalent between 5 and 20% of all people. About 10% of
people over age 65 will have a major depressive episode. The incidence of
depression is higher in women and in urban settings rather than rural
settings. Clinical features of depression Mild depressive episodes
typically include features such as: ?Sadness and crying, ?Loss of
interest in and loss of enjoyment of life (anhedonia), ?Poor attention
and concentration, ?Low self-esteem and ideas of unworthiness, ?A bleak
view of the future and the world in general, ?Poor sleep and appetite.
People with mild depressive episodes find it difficult to continue with
their work and social lives, but usually continue to function, although
less than normal. Moderate depressive episodes have a wider range of
symptoms, which are present usually to a greater degree. Sufferers find it
very difficult to function normally at work or home. Severe depressive
episodes typically may also include features such as: ?Great distress and
agitation, ?Slowed thought and movement (psychomotor retardation),
?Ideas of guilt, ?Suicidal fantasies or plans which may be acted upon,
?Pronounced somatic symptoms, ?Psychotic symptoms. People with severe
depressive episodes find it impossible to continue with their work,
domestic and social lives, and usually cease to function in these areas.
Depression is often accompanied by slowing of thought processes and
biological features of everyday life which differ from a normal sense of
sadness. Crying is a frequent symptom, although some individuals are
reluctant to admit this, and others feel so depressed it that is as if
they have gone beyond crying. Suicidal ideas occur in most depressed
people, and asking about these is a crucial aspect of their assessment.
Depressed patients often find it a relief to talk about these ideas with
their doctor. Asking about suicidal ideas is a sequential process,
beginning with questions about the severity of the low mood. The doctor
can then ask if the patient has ever felt that life is not worth living.
A yes could be followed by inquiring whether the patient has ever felt
like ending their own life. Finally the doctor needs to assess if the
patient has any particular plans in mind. Case History: Janet Janet
Gordon was aged 35 when she lost her job as a manager of a department
store. At first she looked on her period of unemployment as an
opportunity to try out activities she had previously no time for. She
went hill-walking and painting every day. Two months later she had lost
interest