Hala Kerbage, M.D.LebMash

Kafa, January 9

What is depression?

Risk factors for depression

Specific issues in the female gender

When to consult for help

Treatment modalities in depression

Major depressive episode is a clinical disorder

Different from transient depressed mood

At least one of the following with significant impact for at least 2 weeks, most of the day, nearly every day:

Abnormal depressed mood Abnormal loss of all interest and pleasure

At least 5 of the following symptoms during the 2 weeks:

Appetite or weight disturbance Sleep disturbance Agitation or slowing Fatigue or loss of energy Abnormal inappropriate guilt Poor concentration Thoughts of death or suicide

Symptoms not due to another psychiatric disorder (psychosis, bipolar disorder)

Symptoms not due to physical illness, alcohol, medication or drugs

Symptoms not due to normal bereavement

Slow onset, long duration of prodrome

Episodes last several months

50 % will recur or have an unremitting course

Heavy burden and impact on social, familial and work

Frequent disorder (6.6% in Lebanon)

Twice more frequent in females

Peaks at the age of 30, decreases after 40 and peaks again after 55

Two major sources for depressive disorder:◦ Inheritance◦ Stress and environmental factors/Loss

Risk of depression in GBV

Impact on maternal depression on the children

Post-partum: Highly at-risk period

Role of life hygiene in preventing depression

Good response to medications (SSRIs)

If during more than 2 weeks:

◦ You feel sad all the time◦ You are losing interest in things you used to like◦ You feel “emotional numbness”◦ You have suicidal thoughts◦ You feel fatigue, loss of energy and concentration◦ You have changes in appetite and sleep pattern◦ You feel agitated or very slowed◦ You have excessive guilt or self-devaluation◦ You feel all this is impacting on your functioning

Pharmacological treatment

Psychotherapy

Physical exercise

Intensifying social support and resources