HomeForumDownloads
Friday, November 24, 2017

Menu
· Squad Rules
· Server Rules
· Roster


Map Downloads
Our Map Database

Nova HQ Map Database

Click here

To vote for our site

Topics
· Bootcamp
· Match Results
· NovaWorld
· RP: Admin
· RP: CD
· RP: Rules
· RP: SetUp Guides

Login
 



 


 Log in Problems?
 New User? Sign Up!
Inactive accounts will be deleted after 6 months of non usage.

  
Post new topic   Reply to topic
View previous topic Printable version View next topic
Author Message
DianeHaught
Post subject: Part #1 Serious Condition: Depression  PostPosted: Jul 17, 2005 - 11:35 PM





Sergeant
Part#1


Depression is a serious health condition affecting millions of people each year.

Medical Information
It is not the intention of Raptor-Pack to provide specific medical advice but rather to provide users with information to better understand their health and their diagnosed disorders. Specific medical advice will not be provided, and Raptor-Pack urges you to consult with a qualified physician for diagnosis and for answers to your personal questions and specific medical advice


source: National Institute of Health Publication No. NIH-99-3561
http://www.allaboutdepression.com/gen_01.html



Depression is a serious health condition affecting millions of people each year.

The total cost in human suffering is impossible to estimate. Depression often impairs many aspects of our everyday lives and affects not only those who are depressed, but also those who care about the depressed person. No one should have to endure the painful symptoms of depression since very effective treatments are available.

If you or someone you know has experienced five or more symptoms listed to the bottom for a period of two weeks or more, a thorough evaluation by a qualified mental health professional is recommended.





Symptoms of Major Depression

<Sadness, anxiety, or "empty" feelings
<Decreased energy, fatigue, being "slowed down"
<Loss of interest or pleasure in activities that were once enjoyed, including sex
<Insomnia, oversleeping, or waking much earlier than usual
<Loss of weight or appetite, or overeating and weight gain
<Feelings of hopelessness and pessimism
<Feelings of helplessness, guilt, and worthlessness
<Thoughts of death or suicide, or suicide attempts
<Difficulty concentrating, making decisions, or remembering
<Restlessness, irritability or excessive crying
<Chronic aches and pains or physical problems that do not respond to treatment

What is Depression?

Clinical depression is more than just the "blues," being "down in the dumps," or experiencing temporary feelings of sadness we all have from time to time in our lives. It is a serious condition that affects a person's mind and body. It impacts all aspects of everyday life including eating, sleeping, working, relationships, and how a person thinks about himself/herself. People who are

clinically depressed cannot simply will themselves to feel better or just "snap out of it." If they do not receive appropriate treatment their symptoms can continue for weeks, months, or years.

The good news is that very effective treatments are available to help those who are depressed. However, only about one-third of those who are depressed actually receive treatment. This is unfortunate since upwards of 80-90% of those who do seek treatment can feel better within just a few weeks. Many people do not seek treatment for depression for a variety of reasons. Some believe that depression is the result of a personal weakness or character flaw. This is simply not true. Like diabetes, heart disease, or any other medical condition, clinical depression is an illness that should be treated by a mental health professional or physician. Another reason why many people do not seek help for depression is that they simply do not recognize the signs or symptoms that something may be wrong.

Depression affects approximately 19 million Americans, or 9.5% of the population in any given one-year period. At some point in their lives, 10%-25% of women and 5%-12% of men will likely become clinically depressed. In fact, it affects so many people that it is often referred to as the "common cold" of mental illness. It is estimated that depression exacts an economic cost of over $30 billion each year, but the cost of human suffering cannot be measured. Depression not only causes suffering to those who are depressed, but it also causes great difficulty for their family and friends who often do not know how to help.


Types of Depression

<Major Depressive Disorder
This illness impairs a person's ability to work, sleep, eat, and function as he or she normally would. It keeps people from enjoying activities that were once pleasurable, and causes them to think about themselves and the world in negative ways. Major depression is often disabling and may occur several times in a person's lifetime.
(For more information go to Diagnosis: Major Depressive Disorder)

<Dysthymic Disorder
A milder yet more enduring type of major depression. People with dysthymia may appear to be chronically mildly depressed to the point that it seems to be a part of their personality. When a person finally seeks treatment for dysthymia, it is not uncommon that he/she has struggled with this condition for a number of years.
(For more information go to Diagnosis: Dysthymic Disorder)

<Bipolar Disorder
Also known as manic-depression or manic-depressive disorder. This condition is characterized by mood that alternates between periods of depression and periods of elation and excitable behavior known as mania (see symptoms below). For people who have bipolar disorder, the depressions can be severe and the mania can seriously impair one's normal judgment. When manic, a person is prone towards reckless and inappropriate behavior such as engaging in wild spending sprees or having promiscuous sex. He or she may not be able to realize the harm of his/her behavior and may even lose touch with reality.
(for more information go to Diagnosis: Bipolar Disorder)

<Cyclothymic Disorder
A milder yet more enduring type of bipolar disorder. A person's mood alternates between a less severe mania (known as hypomania) and a less severe depression.
(For more information go to Diagnosis: Cyclothymic Disorder)

<Mood Disorder Due to a General Medical Condition
Depression may be caused or precipitated by a known or unknown physical medical condition such as hypothyroidism.
(For more information go to Diagnosis: Mood Disorder Due to...

<Substance-Induced Mood Disorder
Depression may be caused or precipitated by the use or abuse of substances such as drugs, alcohol, medications, or toxins.
(For more information go to Diagnosis: Substance-Induced...)

<Seasonal Affective Disorder (SAD)
This condition affects people during specific times or seasons of the year. During the winter months individuals feel depressed and lethargic, but during other months their moods may be normal.
(For more information go to Diagnosis: Seasonal Affective Disorder)

<Postpartum Depression
A rare form of depression occurring in women within approximately one week to six months after giving birth to a child.
(For more information go to Diagnosis: Postpartum Depression)

<Premenstrual Dysphoric Disorder
This is an uncommon type of depression affecting a small percentage of menstruating women. It is a cyclical condition in which women may feel depressed and irritable for one or two weeks before their menstrual period each month.
(For more information go to Diagnosis: Premenstrual Dysphoric Disorder)




<Symptoms of Depression
People who are depressed or manic may not experience all of the following symptoms. Some will have many symptoms, others will have just a few. The severity of the symptoms may also be different for every person and even vary over time. If you are experiencing some of these symptoms or if you have questions about whether you may be depressed or manic, you should consult with your physician or a qualified mental health professional. If you or someone you know is considering suicide, or has made plans to do so, you should seek the help of a mental health professional or physician immediately.

<Sadness, anxiety, or "empty" feelings
<Decreased energy, fatigue, being "slowed down"
<Loss of interest or pleasure in activities that were once enjoyed, including sex
<Insomnia, oversleeping, or waking much earlier than usual
<Loss of weight or appetite, or overeating and weight gain
<Feelings of hopelessness and pessimism
<Feelings of helplessness, guilt, and worthlessness
<Thoughts of death or suicide, or suicide attempts
<Difficulty concentrating, making decisions, or remembering
<Restlessness, irritability or excessive crying
<Chronic aches and pains or physical problems that do not respond to treatment


Symptoms of Mania

<Abnormal or excessive elation
<Unusual irritability
<Decreased need for sleep
<Grandiose notions
<Increased talking
<Racing thoughts
<Increased sexual desire
<Markedly increased energy
<Poor judgment
<Inappropriate social behavior

source: National Institute of Health Publication No. 97-4266 and 99-3561







Additional Statistics and Information About Depression

<Major depression is the leading cause of disability in the United States
<Depression affects almost 10% of the population, or 19 million Americans, in a given year
<During their lifetime, 10%-25% of women and 5%-12% of men will become clinically depressed
<Women are affected by depression almost twice as often as men
<The economic cost of depression is estimated to be over $30 billion each year
<Two-thirds of those who are depressed never seek treatment and suffer needlessly
<80%-90% of those who seek treatment for depression can feel better within just a few weeks
<Research on twins suggests that there is a genetic component to the risk of developing depression
<Research has also shown that the stress of a loss, especially the death of a loved one, may lead to depression in some people

<How Depression Affects a Person's Life
Clinical depression affects all aspects of a person's life. It impairs our ability to sleep, eat, work, and get along with others. It damages our self-esteem, self-confidence, and our ability to accomplish everyday tasks. People who are depressed find daily tasks to be a significant struggle. They tire easily, yet cannot get a good night's sleep. They have no motivation and lose interest in activities that were once enjoyable. Depression puts a dark, gloomy cloud over how we see ourselves, the world, and our future. This cloud cannot be willed away, nor can we ignore it and have it magically disappear.

Read some first hand accounts of how people have experienced and managed their own depression.

<Brenda's story:
"It was really hard to get out of bed in the morning. I just wanted to hide under the covers and not talk to anyone. I didn't feel much like eating and I lost a lot of weight. Nothing seemed fun anymore. I was tired all the time, yet I wasn't sleeping well at night. But I knew that I had to keep going because I've got kids and a job. It just felt so impossible, like nothing was going to change or get better.

"I started missing days from work, and a friend noticed that something wasn't right. She talked to me about the time that she had been really depressed and had gotten help from her doctor.

"I called my doctor and talked about how I was feeling. She had me come in for a checkup and gave me the name of a psychiatrist, who is an expert in treating depression.

"Now, I'm seeing the psychiatrist once a month and taking medicine for depression. I'm also seeing someone else for "talk" therapy, which helps me learn ways to deal with this illness in my everyday life.

"Everything didn't get better overnight, but I find myself more able to enjoy life and my children."

<Rob's story:
"Things in my life were going all right. I had just gotten my GED and was starting a new job in a week. My family was really proud of me. But inside, I was feeling terrible.

"At first I was feeling sad all the time, even though I had no reason to be. Then the sadness turned into anger, and I started having fights with my family and friends. I felt really bad about myself, like I wasn't good enough for anyone. It got so bad that I wished I would go to bed and never wake up.

"My older brother, who I always looked up to, saw that I wasn't acting like my usual self. He told me straight out that I seemed depressed and that I should talk to a doctor about it. I hate going to the doctor. I thought, "No way am I going in for this."

"But after a few weeks, I started having problems at work too. Sometimes I wouldn't show up because I wasn't able to sleep the night before. When I got fired, I knew I had to listen to my brother and get help.

"I saw a doctor at the health clinic. He told me I had a common illness called depression and that treatment could help. So I started to see someone at the clinic each week for "talk" therapy. This treatment helps me learn to control depression in my everyday life. It has taken some time, but I'm finally feeling like myself again."

<Feelings of Hopelessness, Helplessness

Feelings of hopeless and/or helplessness are common in those who are clinically depressed. They are also some of the most frustrating feelings that depressed individuals experience. Research on the cognitive theory of depression has shown that people who are depressed struggle with feelings of hopelessness and helplessness more so than people who are not depressed (Sacco & Beck, 1995). A sense of hopelessness reflects a negative view of the future. This includes expectations of personal dissatisfaction, failure, and a continuation of pain and difficulty-- a belief that nothing will get better. Feelings of helplessness reflect a negative view of the self. Depressed individuals view themselves more negatively, their self-esteem suffers, and they have little or no self-confidence. They do not believe they have any control or that they can help themselves to feel better. They may have an urge to give up and think, "what's the use?"

Research has also indicated that severe hopelessness may be a predictor of suicide (Beck, 1987; Fawcett, 1990). Now, this does not mean that if a person feels hopeless that he or she will attempt to commit suicide. This is a common symptom of clinical depression. What it does tell us, however, is that depressed individuals who struggle with strong feelings of hopelessness may be at a higher risk for self-harm. They should receive treatment from a trained medical or mental health professional.

Cognitive therapy or Cognitive-Behavioral therapy often address feelings of hopelessness and helplessness in a direct manner. More about Cognitive-Behavioral therapy.



<Loss of Interest or Pleasure
At least one of two essential features of clinical depression must be present in order to suspect a diagnosis of major depressive disorder. One of these is loss of interest or pleasure, and the other is depressed mood. People who become depressed tend to lose interest in things they once found enjoyable. Activities such as going out to dinner or a movie, visiting with friends, working, or doing hobbies are just not as interesting or enjoyable as they once were. This includes losing interest or desire in having sex. People who are depressed may say such things as, "I just don't care anymore," or "nothings matters anymore." Friends and family of the depressed person may notice that he/she has withdrawn from friends, or has neglected or quit doing activities that were once a source of enjoyment.

This loss of interest or pleasure in activities includes a loss of interest in sex. Some people who have had more than one bout with depression may recognize their diminished interest in sex as an early warning sign of the return of their illness. For a person who is depressed, sex may seem like too much trouble. It may even be hard to remember why sex was ever enjoyable at all. Attempts to have sex may only result in problems with achieving an erection or orgasm. Negative thoughts about oneself can also feed into a lack of interest in sex. Depressed people tend to have problems with self-esteem and may believe that no one, not even a spouse or partner, find them attractive.

For the symptom to meet the criteria towards a diagnosis of major depression, a person must have had a significant reduction in level of interest of pleasure in most activities, nearly every day for a two-week period of time.



<Appetite and Weight Changes

People who develop clinical depression often have changes in their appetite. On the one hand, some people never feel very hungry. They can go long periods of time without wanting to eat anything. They may forget to eat, or if they do eat just a few bites may fill them up. They may even feel that they have to force themselves to eat. For some people, the thought of eating is unpleasant, and having to prepare a meal seems to require too much energy. In such cases, a depressed person may lose a significant amount of weight. Depressed children may not meet weight gains that are expected for their age. A reduction in weight is often associated with a melancholic type of depression.

On the other hand, some people who become depressed tend to have an increase in their appetite and may gain significant amounts of weight. They may even find that they crave certain types of food such as sweets or carbohydrates. People with seasonal affective disorder (SAD) often crave foods that are high in carbohydrates such as pasta, bread, and potatoes. Weight gain is often associated with an atypical type of depression.

In terms of a diagnostic evaluation of this symptom, a mental health professional will consider either of two things. One is whether a person has had a change of more than 5% in weight within a month. The other is whether there has been a decrease or increase from usual appetite patterns nearly every day within a two-week period of time.



<Sleeping Problems

Not being able to get enough sleep at night is the most common type of sleep disturbance for people who are clinically depressed. Sometimes people will wake up during the middle of the night and then find it difficulty to fall asleep (called "middle insomnia"). Others might wake up too early in the morning and cannot fall back asleep (known as "terminal insomnia"). And still others might have general difficulty falling asleep at night (insomnia). These types of sleeping problems are often associated with a melancholic type of depression.

Alternatively, a less common sleeping problem is when a person tends to oversleep (called "hypersomnia"). This may be in the form of sleeping for prolonged periods of time at night or increased sleeping during the daytime. Even with excess sleep, a person may still feel tired and sluggish during the day. People with seasonal affective disorder (SAD) may sleep longer during the winter months. Hypersomnia is often associated with an atypical type of depression.

For diagnostic purposes, a mental health professional will evaluate whether such problems with sleep have occurred nearly every day within a two-week period of time.



<Feeling Agitated or Slowed Down

People who are depressed may appear to be either quite agitated, or alternatively, very slowed down in their mannerisms and behavior. If a person is agitated (also known as psychomotor agitation), he or she may find it difficult to sit still. An agitated person may pace the room, wring his/her hands, or fidget with clothes or objects. Older people with depression are more likely to appear restless and agitated than those who are younger.

On the other hand, someone who is slowed down in his or her behavior (also known as psychomotor retardation) will tend to have movements that are very sluggish. A person may move across a room very slowly, avert his/her eyes, and sit slumped in a chair. When speaking, he or she will do so slowly, say few words, and may pause before responding to questions. There may also be a reduction in volume in tone of speech, inflection, and content of what is said. It is also not uncommon for a person's ability to think to be slower than usual.

In terms of diagnosis, the agitation or slowing down of one's demeanor must be to the degree that it can be observed by others. It should be more than just experiences or feelings that a person reports to have.



<Decreased Energy

Decreased energy and feeling tired and fatigued are very common symptoms for those who are clinically depressed. A person may feel quite tired even without having engaged in any physical activity. Simple day-to-day tasks are no longer simple. Even such things as getting washed and dressed in the morning can seem overwhelming and may even take twice as long to accomplish than usual. When a person is able to do things around the house or at work, he or she may become very exhausted or tire quickly. As a result of feeling fatigued, people often find that their work at home, school, or job suffers.

Towards making a diagnosis, this is not a symptom that is necessarily observable by others. Instead the person reports that he or she is experiencing a loss of energy or feeling more fatigued than usual.



<Feeling Worthless or Guilty

People who are depressed may tend to think of themselves in very negative unrealistic ways. They may become preoccupied with past "failures," personalize trivial events, or believe that minor mistakes are proof of their inadequacy. They also may have an unrealistic sense of personal responsibility and see many things as being their own fault. For example, a car salesperson may spend a great deal of time blaming himself/herself for not meeting certain sales quotas even when the overall sales of cars in the area is down and other salespeople are having similar difficulty. Sometimes this belief of personal responsibility can become delusional. For instance, a person may begin to believe that he or she is to blame for civil unrest in other parts of the world.

Self-loathing is common in clinical depression. This can be a downward spiral when combined with other symptoms such as lack of energy and difficulty with concentration. For instance, if a person has been unable to keep the house clean or finish assignments at work, he or she may look to that as proof that he or she is a bad person. The more things do not get done at home or work, the worse a person feels about him or herself. In reality, the person has problems at home and work because of the effects of a depressive illness, not because he or she is a "bad person."

Diagnostically, a person would experience feelings of worthlessness or excessive guilt almost every day for a period of two weeks in order to meet criteria for major depression. However, beliefs or thoughts that do not meet the criteria for major depression include feeling blame for being ill and not meeting personal responsibilities as a result of clinical depression.



<Thinking Problems

Thoughts and emotions are powerfully affected by clinical depression. A person's thoughts are frequently very negative and pessimistic. It becomes difficult for a person to believe that he or she can be helped or ever feel well again.

Those who are clinically depressed often find that they their ability to think, concentrate, or make decisions becomes impaired. A person may report having problems with his or her memory, or that he or she is easily distracted. This problem can be especially pronounced and cause great difficulty in functioning for those who are involved in intellectually demanding activities such as professors, computer programmers, and doctors.

For children and teenagers, an unusual drop in school grades can indicate a problem with thinking and concentration. For those who are elderly, the initial complaint may be with problems in memory and can be misdiagnosed as being some early signs of dementia. For some elderly individuals, after the clinical depression is treated their problems with memory often disappear. For others, major depression may be a precursor to inevitable dementia.

For diagnostic purposes, a person may experience difficulty in thinking, concentration, or decision making almost every day for a period of two weeks or more. This can be through subjective report of the person or by observations of others.



<Suicidal Thoughts, Plans, or Attempts

Thoughts of death, suicide, or even suicide attempts can be common for those who are clinically depressed. The frequency and intensity of thoughts about suicide can wide-ranging from believing that friends and family would be better off if he or she were dead, to frequent thoughts about committing suicide, to detailed plans about how he or she would actually carry out the act of suicide. People who are less severely suicidal may have short, but regular (a few times a week) thoughts of suicide. A person who is more severely suicidal may have made specific plans, collected materials (i.e., pills, gun, rope), and decided upon a day and location for the suicide attempt.

The motivation for a person to want to kill him- or herself may not be for the desire to actually die. It may be due to the wish to give up in the face of what seems for the person to be overwhelming obstacles, or the desire to end the emotional pain that seems to have no end.

Those who are severely depressed are at a lower risk for suicide since they lack the energy or motivation to carry it out. However, the risk can increase when a depression begins to lift and their energy begins to return. Those who "have a reason to live" such as the need to raise children may be at a lower risk for attempting suicide. At high risk are those individuals who have made plans to kill themselves and who seem to have a brighter mood after deciding to do so. People who think and behave this way must often be hospitalized to keep them from harming themselves. If you have been thinking about suicide, you should seek appropriate help for yourself by speaking with your doctor, clergy, or a mental health professional. Please do not keep these thoughts to yourself, but speak to others who can aid you in getting the help that you need.

Towards a diagnosis of major depression, a mental health professional will evaluate whether a person has repeated thoughts of death, suicidal thoughts with or without a specific plan, or previous suicide attempt.



<Delusions and/or Hallucinations

Psychotic features that may accompany depressive, manic, or mixed episodes include the presence of delusions and/or hallucinations. Delusions are firmly held beliefs that persist despite strong evidence to the contrary. Hallucinations are sensory experiences that appear real to the person experiencing them, but there is no actual physical stimulus for the perception. Most commonly hallucinations include a person hearing voices or seeing things that are not there.

Psychoses may develop in about 15% of those with major depressive disorder. The presence of delusions and hallucinations often interfere with a person's ability to make sound judgments about consequences of their actions and this may put them at risk for harming themselves. Psychotic symptoms are serious and a person in this condition needs immediate medical attention and possibly hospitalization.



<Physical Aches and Pains

It often happens that people who are depressed first seek help from their family doctors with complaints of physical symptoms rather than depressed mood. Many people do not even report to their doctors that they feel depressed or that they have been experiencing other problems related to their despondent mood. The physical symptoms people feel are real, but they are caused by the illness of clinical depression rather than by another physical illness.

Frequently, those who are depressed have chronic aches and pains. Headaches, stomachaches, and back and joint pain are common physical complaints. Others may have gastrointestinal problems such as indigestion, constipation and irritable bowel syndrome. Some women contend with painful or irregular menstrual periods.







<Causes of Depression

Unfortunately, it is not fully known what exactly causes clinical depression. There are numerous theories about causes such as biological and genetic factors, environmental influences, and childhood or developmental events. However, it is

generally believed that clinical depression is most often caused by the influence of more than just one or two factors. For instance, a person whose mother had recurrent major depression may have inherited a vulnerability to developing clinical depression (genetic influence). This combined with how the person thinks about him- or herself (psychological influence) in response to the stress of going through a divorce (environmental influence), may put him or her at a greater risk for developing depression than someone else who does not have such influences.

The causes of clinical depression are likely to be different for different people. Sometimes a depressive episode can appear to come out of nowhere at a time when everything seems to be going fine. Other times, depression may be directly related to a significant event in our lives such as losing a loved one, experiencing trauma, or battling a chronic illness.

The "Causes" section of this site describes what is known or theorized about the causes of clinical depression. Information is grouped within categories: Biological Causes, Genetic Causes, Environmental Causes, Psychological Causes, Medical Illness, and Other Causes.

<Risk Factors for Depression

Related to the discussion of the causes of clinical depression is something called, "risk factors." Essentially, we are all at risk for developing a depressive illness. People of all ages, races, and social class can become clinically depressed. No one is completely immune to this condition. However, it is important to know that the more common illnesses of major depression and bipolar disorder do tend to affect some groups of individuals more so than others. Some features of these groups, when associated with the development of a depressive illness, are known as "risk factors."

Please remember that no one is predestined to develop clinical depression. However, it can be very important to be aware of risk factors so that those of us who may be vulnerable can educate ourselves, be attentive to warning signs, and take steps towards recognizing and preventing this illness.

<Risk Factors For Major Depression-

<Gender: In the United States, women are about as twice as likely as men to be diagnosed and treated for major depression. Approximately 20-25% of women and 12% of men will experience a serious depression at least once in their lifetimes. Among children, depression appears to occur in equal numbers of girls and boys. However, as girls reach adolescence, they tend to become more depressed than boys do. This gender difference continues into older age.

There are several theories as to why more women than men are diagnosed and treated for depression:

<Women may be more likely than men to seek treatment. They may be more willing to accept that they have emotional symptoms of depressed mood and feelings of worthlessness or hopelessness.
<Men may be less willing to acknowledge their emotional symptoms and more apt to suppress their depression through the use of alcohol or other substances. In such cases depression can be "masked," or viewed only as alcohol or drug dependency/abuse rather than as clinical depression.
<Women may tend to be under more stress than men. In today's American society women often have to manage a variety of conflicting roles. They have many responsibilities and full schedules at home and work.
<Women may be more prone to depression because of the possible effects of hormones. Women have frequent changes in their hormone levels, from their monthly menstrual cycles, to the time during and after pregnancy, to menopause. Some women develop a depressive illness around these events.


<Marital factors: Women who are unhappily married, divorced, or separated, have high rates of major depression. The rates are lower for those who are happily married.

<Age: While clinical depression usually occurs for the first time when a person is between the ages of 20 and 50, people over the age of 65may be especially vulnerable.

<Previous episode: If you have had major depression once before, your chances of developing it again increase. According to some estimates, approximately one-half of those who have developed depression will experience it again.

<Heredity: People who have relatives who have had clinical depression have a greater chance of developing it themselves. Also, having a close relative with bipolar disorder may increase a person's chances of developing major depression.



<Risk Factors For Bipolar Disorder-

Bipolar disorder is diagnosed in equal numbers of men and women. It is not known for sure why major depression seems to affect more women than men while mania affects both equally. One reason may be that mania, with its very conspicuous symptoms, is much more easily recognized than depression. Depression may also go unrecognized in men.

<Previous episode: If you have had major mania once before, your chances increase of developing it again. Most of those who have had an episode of mania once will have a second.

<Heredity: People who have relatives who have had bipolar disorder have a greater chance of developing it themselves. Immediate relatives (parents, siblings, children)of those with bipolar disorder are 8 to 18 times more likely to develop the condition than those not related to people with bipolar disorder. Having a close relative with bipolar disorder may also increase a person's chances of developing major depression.



<Diagnosis of Clinical Depression

Mental health professionals and physicians are careful and deliberate when evaluating their clients for clinical depression. It takes more than just tearfulness or a feeling of sadness on the part of the client to indicate the presence of depression. A professional should take the time to gather a good deal of information about a person before determining that he or she is clinically depressed. In addition to a medical evaluation, a clinical interview, and possibly additional assessments, a professional will evaluate whether a person has specific symptoms of a mood disorder such as major depression, dysthymia or bipolar disorder. Each mood disorder is characterized by a unique set of symptoms, or diagnostic criteria, which are listed in a publication called the Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition.

<Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition

The Diagnostic and Statistical Manual of Mental Disorders- Fourth Edition (American Psychiatric Association, 1994) is the current reference used by mental health professionals and physicians to diagnose mental disorders. This publication is often referred to as the DSM or DSM-IV, and we use such abbreviations here for convenience. The American Psychiatric Association began publishing the DSM in 1952, and it has since gone through several revisions before the most recent version, the fourth edition, was published in 1994. The current DSM-IV lists over 200 mental health conditions and the criteria required for each one in making an appropriate diagnosis.

Diagnostic criteria for mental disorders are essentially descriptions of symptoms that fall into one of four categories. In major depressive disorder for example, affective or mood symptoms include depressed mood and feelings of worthlessness or guilt. Behavioral symptoms include social withdrawal and agitation. Cognitive symptoms, or problems in thinking include difficulty with concentration or making decisions. Finally, somatic or physical symptoms include insomnia or hypersomnia (sleeping too much).

The clinical usefulness of the DSM-IV is much more than a tool for making diagnoses. It is used by mental health professionals and physicians as a guide for communicating about mental health conditions. When two clinicians discuss a diagnosis such as "major depressive disorder, single episode, severe with psychotic features," they both have the same conceptualization of various aspects of the illness. Without the DSM-IV, the two clinicians might have very different perceptions of the condition. The DSM-IV also allows mental health professionals to reach consensus on which symptoms or groups of symptoms should define which disorders. Such decisions are based on empirical evidence (research results), usually by a multidisciplinary staff of professionals. Further, the DSM-IV is used as an educational tool and a reference for conducting all types of research (e.g., clinical trials, prevalence studies, outcome research).

The DSM-IV is not used to categorize people, but to categorize conditions or disorders that people have. This may be a subtle distinction, but it is a very important one. We do not say that a person is cancer, or is heart disease, or is an illness. A person has an illness. Likewise, we should not say that a person is a depressive, but that a person has clinical depression. Along the same lines, the value of diagnostic labels is often debated among mental health professionals and the general public. On the negative side, some people believe that making a diagnosis is simply the act of labeling a person. Once a person is labeled he or she may have difficulty overcoming the label, may lose hope of recovery, or may come to believe that he or she is the label. On the positive side, some people are relieved when they finally learn that the symptoms they are experiencing have a name. This often offers a sense of hope and personal control over the illness as more can be learned about its treatment, causes, and outcome.



<Mood Disorders

The depressive disorders that are described on this web site are grouped under a category in the DSM-IV called Mood Disorders. Included in this category are major depressive disorder, dysthymic disorder, bipolar disorder, cyclothymic disorder, mood disorder due to a general medical condition, and substance-induced mood disorder. Two subtypes of mood disorders include seasonal affective disorder and postpartum depression, while premenstrual dysphoric disorder has been proposed as a diagnosis for further study. For each of these mood disorders there are specific criteria that a person's symptoms must meet in order to receive a diagnosis.




<Specifiers

Once a diagnosis of a particular mood disorder is made, more detailed information about the diagnosis can be provided in the form of "specifiers." The use of specifiers gives mental health professionals and physicians more information about a person's condition, helps with choosing which treatment may be most effective, and aids the prediction of the course and prognosis of the illness. You might think of specifiers as being sub-categories of the larger categories of major depressive disorder, bipolar disorder, and so on.

For instance, take a look at the following two diagnoses:

<Major Depressive Disorder, Single Episode, Moderate, With Atypical Features
<Major Depressive Disorder, Single Episode, Moderate, With Melancholic Features

Both diagnoses indicate the presence of the mood disorder- major depressive disorder. Specifiers that follow show the presence of a first or single episode of depression that is moderate in severity. These diagnoses look very much alike. You might think that two people, each given one of these diagnoses, may seem to be experiencing similar depressive symptoms. For the most part they may be, but ultimately there are some subtle yet very important differences. If you take a look at the specifiers that are described below, you will see that "atypical features" of depression are slightly different than "melancholic features."

Specifiers associated with the mood disorders are listed below:

<Mild: A few symptoms, if any, are present beyond what is needed to make a diagnosis, and a person can function normally although with extra effort.
<Moderate: The severity of symptoms is between mild and severe. For a manic episode, a person's activity is increased or judgment is impaired.
<Severe Without Psychotic Features: Most symptoms are present and a person clearly has little or no ability to function. For a manic or mixed episode, a person needs to be supervised to protect him/her from harm to self or others.
<Severe With Psychotic Features: A person experiences hallucinations or delusions. Psychoses may develop in about 15% of those with major depressive disorder. The presence of delusions and hallucinations often interfere with a person's ability to make sound judgments about consequences of their actions and this may put them at risk for harming themselves. Psychotic symptoms are serious and a person in this condition needs immediate medical attention and possibly hospitalization.
<Single Episode/Recurrent: A first episode is considered "single," subsequent episodes are "recurrent."
<In Partial/Full Remission: There is full remission when there is an absence of symptoms for at least two months. For partial remission, full criteria for a major depressive episode are no longer met, or there are no substantial symptoms but two months have not yet passed.
<Chronic: For at least two years a person's symptoms have met criteria for a major depressive episode.
<Catatonic Features: Unusual behaviors or movements such as immobility, excessive activity that is purposeless, rigid or peculiar posturing, mimicking others' words or behaviors.
<Melancholic Features: A loss of pleasure in most activities or an inability to feel better, even for a short time when something pleasurable happens. Also, at least three of following is present: the depressed mood is distinct (i.e., unlike feelings of bereavement), it is worse in the morning, a person wakes too early in the morning, there is distinct agitation or movements are slowed down, substantial weight loss, or extreme feelings of guilt. Melancholic features are associated with a person experiencing a specific precursor to the illness and having a better response to antidepressants. Men and women may equally have these features, although they are more common in older people. They may also be more likely to occur in more severe depressive episodes, particularly ones with psychotic features.
<Atypical Features: During the last two weeks of major depression or bipolar disorder (depressive episode) or the last two years of dysthymia, a person is able to experience brightened mood when good things happen. Also, at least two of the following must be present: substantial gain in weight or appetite, sleeping too much (at nighttime or daytime napping that is at least 10 hours total or two hours beyond normal), body feels heavy or weighted down, or persistent sensitivity to rejection by others that is related to personal or social difficulties. The sensitivity to rejection tends to be a more long-standing problem. The presence of depression may increase the sensitivity, although it is often still present when the person is not depressed. Atypical features occur two to three times more often in women. They are also associated with depression beginning at an earlier age (e.g., teens) and possibly more chronic depressive episodes. Personality and anxiety disorders may also be more common.
<Postpartum Onset: The depressive episode begins within four weeks of giving birth.
<With/Without Full Interepisode Recovery: Describes a long-term course of recurrent major depression or bipolar disorder. The specifiers indicate whether a person recovered from his/her symptoms between the two latest episodes.
<Seasonal Pattern: Describes a pattern of depressive episodes in recurrent major depression or bipolar disorder. The symptoms tend to begin (usually fall or winter) and end (usually spring) at particular times of the year.
<Rapid-Cycling: Describes a recurrent pattern of depressive and manic episodes in bipolar disorder. A person has had at least four mood episodes during the last 12 months. There is either a general absence of symptoms between episodes or a clear switch from one to its opposite, such as from depression to mania. Rapid-cycling may affect5% to 15% of those with bipolar disorder, and women account for 70%-90% of those with this pattern. Certain medical conditions may be related to rapid-cycling such as neurological problems, hypothyroidism, head injury, and mental retardation, as well as treatment with antidepressants. Those who develop a pattern of rapid-cycling may have a less favorable prognosis.


<Getting Help for Depression

It is not uncommon for people to wonder just when it is necessary to seek help for depression. Sometimes we hear people casually say, "I'm depressed," when they have had a bad day at work or a fight

with their spouse. Typically, these kinds of feelings pass or lessen within a short period of time. In cases such as these, we are not really "depressed," but we experience normal and temporary feelings of sadness, frustration, or stress. These normal feelings are different than the more extreme and pervasive feelings associated with clinical depression. However, if depressive symptoms persist for a period of two weeks or more, or they are particularly distressing, then it is probably time to consult a mental health professional or a physician.

If you have any doubts or questions about seeking help for depression, it is better to be on the safe side and go ahead and speak with a professional. Left untreated, depression can continue for weeks, months, or years. Over time it can become worse and may be more difficult to treat successfully. Untreated depression can also increase a person's risk of suicide. Up to 15% of those who are clinically depressed die by suicide.

The following individuals or organizations can often provide treatment services and/or make referrals for service:

<Family doctors and other physicians
<Mental health professionals: psychiatrists, psychologists, social workers, counselors
<Your insurance provider
<Community mental health centers
<Hospital psychiatry departments and outpatient clinics
<Hospital emergency rooms in times of crisis
<University- or medical school-affiliated programs
<State hospital outpatient clinics
<Family service/social agencies
<Private clinics and facilities
<Employee assistance programs
<Local medical and/or psychiatric societies



The Yellow Pages can provide additional phone numbers and addresses under "mental health," "health," "social services," "suicide prevention," "crisis intervention services," "hotlines," "hospitals," or "physicians." Assistance may also be provided by some of the organizations listed in the Resources section of this web site.


source: National Institute of Health Publication No. NIH-99-3561

http://www.allaboutdepression.com/gen_01.html


Medical Information
It is not the intention of Raptor-Pack to provide specific medical advice but rather to provide users with information to better understand their health and their diagnosed disorders. Specific medical advice will not be provided, and Raptor-Pack urges you to consult with a qualified physician for diagnosis and for answers to your personal questions and specific medical advice


Wave

Hug
Diane



"I'd rather regret something I did, than regret never doing it at all"
 
 Send private message 
Reply with quote Back to top
Display posts from previous:     
Jump to:  
All times are GMT + 7 Hours
Post new topic   Reply to topic
View previous topic Printable version View next topic
Powered by PNphpBB2 © 2003-2004 The PNphpBB Group
Credits
Fallen Members