depression psych presentation

8/19/2019 Depression PSYCH Presentation

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Depression


2/16

What is depression ?

A continuum


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‘That’s the thing about depression: a human being cansurvive almost anything, as long as s/he sees the end insight. ut depression is so insidious and it compoundsdaily, that it’s impossible to ever see the end. Thelike a cage without a key.’

!li"abeth Wurt"el, #ro"ac $


4/16

%o& can &e tell?

• Motivation Apathy, loss o' energy and

interest: things seem pointless, hopeless• Emotional (o& mood, emptiness, anger or

resentment, an)iety, shame, guilt• Cognitive #oor concentration, negative

ideas about the sel', the &orld and the

'uture.• Behaviour (o&ered activity, social

&ithdra&al, agitation or retardation.• Biological +leep disturbance, loss o'

appetite, loss o' &eight, changes in circadianrhythms, hormones and brain chemicals.


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linical presentation

Emotional Symptoms Include:

Sadness

Loss of interest or pleasure

Overwhelmed

Anxiety

Diminished ability to think orconcentrate, indecisiveness

Excessive or inappropriate uilt

Physical Symptoms Include:

!a ue aches and pains

"eadache

Sleep disturbances

#ati ue

$ack pain

Si nificant chan e in appetiteresultin in wei ht loss or ain


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!tiology

• iological 'actors• +ocial 'actors• #sychological 'actors


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The neurotransmitter hypothesis

+e)

Appetite

Aggression

oncentration

-nterest

otivation

Depressedood

An)iety

-rritability

Thoughtprocess

$orepinephrine $!0

• Both serotonin and norepinephrine mediate a broadspectrum of depressive symptoms

+erotonin 12%T0

3ague Achesand pain


8/16

Diagnostic riteria 'or a4orDepressive Disorder and Depressive!pisodes

D M!"#• Depressed mood or a loss o' interest or pleasure in daily

activities 'or more than t&o &ee5s. 6 ood representing change 'rom the person7s baseline. 6 -mpaired 'unction: social, occupational, educational.

6 +peci8c symptoms, at least 1 o' 9, present nearly everyday


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A mnemonic to help remember theD+ criteria

+- ! A#+• leep disturbance: decreased or increased• "nterest or pleasure;: decreased• $ uilt or 'eeling &orthless• Energy loss or 'atigue• Concentration problems or problems &ith memory• %ppetite disturbance, &eight loss or gain• &sychomotor agitation or retardation• uicidal ideation, thoughts o' death


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ICD – 10

• Patient has low mood:

1)How bad is it and how long has it been going on?

2)Have you lost interest in things?

3)Are you more tired than usual?

If the answer is yes to these, then:


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- D < => ontinued0

)Have you lost !onfiden!e in yourself?") #o you feel guilty about things?

$)%on!entration diffi!ulties?

&)'lee(ing (roblems?

)%hange in a((etite or weight?

*)#o you feel that life is not worth living any more?


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- D < => ontinued0

♦ +ild-wo !riteria from 1.3 and 2 others♦ +oderate-wo !riteria from 1.3 and 3. others or a yes to /uestion "♦

'evere+ost of the !riteria in severe form es(e!ially /uestions " 0 *


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a4or subtypes o' Depression

• inor Depression• Atypical Depression subtype 0• Dysthymia• ipolar disorder•

+eason A ective disorder• #sychotic depression can include post partum0


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Associations

• en diagnosed &ith pancreatic cancer &ere more li5elyto develop a4or depressive disorder• ardiovascular disease and depression• Diabetes and depression• @besity and depression• Women entering perimenopause late vs early 0• %ot ushes associated &ith greater ris5 o' DD


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edical -nterventions

• edications• #sychotherapy• !lectro2convulsive therapy• 3agal $erve stimulation• ombination therapy


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#harmacotherapy

depression psych presentation

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