Depression
Contents
Depression
• Symptoms
• Pathogenesis
Objectives
At the end of this lecture, student will be able to
• Explain the definition of depression
• Explain the etiology of depression
• Explain the pathophysiology of
depression
Depression
Depression is a state
of low mood and aversion that can affect a persons’s thoughts, behavior,
feelings, and sense of well being
Causes of Depression
• Family History
• Having a family members who have depression may
increase a person’s risk
• Imbalances of certain chemicals in the brain
may lead to depression
• Major Life Changes
• Positive or negative events can trigger
depression. Examples include the death of a loved one or a promotion
• Major Illnesses such as heart attack, stroke or
cancer may trigger depression
• Certain medications used alone or in
combination can cause side effects much like the symptoms of depression
• Use of Alcohol or other Drugs can lead to or
worsen depression
• Depression can also occur for no apparent
reason!
Types of depression
• Major depression
• Inability to enjoy life and experience pleasure
• Symptoms are constant, ranging from moderate to
severe
• Some people experience just a single depressive
episode in their lifetime, but more commonly, major depression is a recurring
disorder
• Atypical Depression
• Specific symptom pattern, including a temporary
mood lift in response to positive events
• Other symptoms include weight gain, increased
appetite, sleeping excessively, a heavy feeling in the arms and legs
• Atypical depression responds better to some
therapies and medications than others
• Bipolar disorder
People with this type of illness change back and forth between periods
of depression and periods of mania (an extreme high)
• Symptoms of mania may include:
• Less need for sleep
• Overconfidence
• Racing thoughts
• Reckless behavior
• Increased energy
• Mood changes are usually gradual, but can be
sudden
• Season affective disorder
This is a depression that results from changes in the season. Most cases
begin in the fall or winter, or when there is a decrease in sunlight
Depression Pathophysiology
• Biogenic amine hypothesis: Decreased brain
levels of the neurotransmitters norepinephrine (NE), serotonin (5-HT), and
dopamine (DA)
• Postsynaptic changes in receptor sensitivity:
Changes in sensitivity of NE or 5-HT2 receptors may relate to its
onset
• Dysregulation hypothesis: A failure of
homeostatic regulation of neurotransmitter systems, rather than absolute
increases or decreases in their activities
Symptoms of depression
• Vary from person to person
• 2 key signs - loss of interest in things you
like to do and sadness or irritability
Additional signs of depression
• Feeling empty
• Inability to enjoy anything
• Hopelessness
• Loss of sexual desire
• Loss of warm feelings for family or friends
• Feelings of self-blame or guilt
• Loss of self esteem
• Inexplicable crying spells, sadness or
irritability
•
Changes
in behavior and attitude
These may include:
•
General slowing down
•
Neglect of responsibilities and appearance
•
Poor memory
•
Inability to concentrate
•
Suicidal thoughts, feelings or behaviors
•
Difficulty making decisions
Physical complaints
• Sleep disturbances such as early morning
waking, sleeping too much or insomnia
• Lack of energy
• Loss of appetite
• Weight loss or gain
• Unexplained headaches or backaches
• Stomachaches, indigestion or changes in bowel
habits
Summary
• Depression is a state of low mood and
aversion that can affect a person's
thoughts, behavior, feelings, and sense of well being
• Etiology: family history, major life changes,
drugs, work
• Decreased brain levels of the neurotransmitters norepinephrine (NE), serotonin (5-HT), and dopamine (DA), changes in sensitivity of NE or 5-HT2 receptors - failure of homeostatic regulation of neurotransmitter systems, rather than absolute increases or decreases in their activities
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