depression

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depression

 [de-presh´un]
1. a hollow or depressed area.
2. a lowering or decrease of functional activity.
3. in psychiatry, a mental state of altered mood characterized by feelings of sadness, despair, and discouragement; distinguished from grief, which is realistic and proportionate to a personal loss. Profound depression may be an illness itself, such as major depressive disorder (see also mood disorders), or it may be symptomatic of another psychiatric disorder, such as schizophrenia. adj., adj depres´sive.

Depression is closely associated with a lack of confidence and self-esteem and with an inability to express strong feelings. Repressed anger is thought to be a powerful contributor to depression. The person feels inadequate to cope with the situations that arise in everyday life and so feels insecure.

Treatment of profound and chronic depression is often very difficult, requiring in most cases intensive psychotherapy to help the patient understand the underlying cause of the depression. antidepressant drugs such as imipramine hydrochloride (Tofranil) and amitriptyline (Elavil) are often used in the treatment of profound depression. They are not true stimulants of the central nervous system, but they do block the reuptake of neurotransmitter substances, which may potentiate the action of norepinephrine and serotonin. monoamine oxidase (MAO) inhibitors are also used. When antidepressants fail, a different technique such as electroconvulsive therapy may be used in conjunction with the psychotherapy.
Patient Care. Mild, sporadic depression is a relatively common phenomenon experienced by almost everyone at some time, but hospitalized patients are particularly susceptible to feelings of depression and a sense of loss and despair. Early signs of depression of this kind include pessimistic statements about one's illness and its prognosis, refusal to eat, diminished concern about personal appearance, and reluctance to make decisions. When depression is noted in a patient, it should be listed on the treatment plan along with suggestions for resolving it.

When patients are depressed, they are likely to isolate themselves and avoid social contact even with those who are trying to help them. Since loss of contact with others contributes to depression, members of the health care team should persist in attempts to talk with these patients, by asking them questions, and actively listening when they attempt to express their feelings. One should be especially careful to avoid being judgmental when the patient does express despair, anger, hostility, or some negative feeling. Above all, it is important not to be condescending or to respond to statements with a meaningless cliché such as “Don't worry,” or “I'm sure everything will turn out okay.” These responses convey a lack of empathy with the patient's suffering and are an unrealistic approach to a problem that is very real.

Physical contact and touching may be misunderstood by depressed patients. Sometimes, it is better just to sit with them and calmly observe them without making them feel uncomfortable. Honest dialogue and expressions of support and concern can often improve their mood and sense of self worth.

Severely depressed patients usually express three basic feelings associated with their mental state. These are a lack of desire for socializing or physical activity, feelings of worthlessness and loss of self esteem, and thoughts of self-injury or destruction. In planning the care of the depressed patient, one must always consider these feelings and strive for some understanding of the reasons for the patient's behavior. Only by gradually gaining their attention and pointing out encouraging signs of progress can they be helped in their early attempts to return to reality and socialize with others.

Physical inactivity will require attention to adequate nutrition, a normal balance of fluid intake and output, proper elimination, and good skin care. Patients will need help in maintaining good personal hygiene. Severely depressed patients may be totally out of touch with reality and completely unresponsive to anyone else's presence. In such instances the health care provider may be able to do little more than demonstrate caring and empathy by remaining with the patient.

Consistency of care is helpful to depressed patients. They know what to expect, and thus are not repeatedly disappointed when their expectations are not met. An example is consistency in scheduling and carrying out treatments and routine care at the same time each day. A supportive family and interested friends should be involved in choosing and planning activities that are helpful.

Constant vigilance must be maintained to prevent the profoundly depressed patient from injuring himself or committing suicide. Self-destructive behavior is a manifestation of the patient's feeling of worthlessness and loss of self esteem. An awareness of the potential dangers in such a situation should help the provider plan and provide a safe and congenial atmosphere, remaining alert to the early signs of a patient's intention to harm or destroy himself. In most cases suicide is most likely to occur when the patient is recovering from severe depression.
agitated depression major depressive disorder characterized by signs and symptoms of agitation, such as restlessness, racing thoughts, pacing, hand-wringing, sighing, or moaning.
congenital chondrosternal depression a congenital, deep, funnel-shaped depression in the anterior chest wall.
endogenous depression a type of depression caused by somatic or biological factors rather than environmental influences, in contrast to a reactive depression. It is often identified with a specific symptom complex—psychomotor retardation, early morning awakening, weight loss, excessive guilt, and lack of reactivity to the environment—that is roughly equivalent to the symptoms of major depressive disorder.
major depression major depressive disorder.
neurotic depression one that is not a psychotic depression. The term is now little used but has been used sometimes broadly to indicate any depression without psychotic features and sometimes more narrowly to denote only milder forms of depression (dysthymic disorder).
postpartum depression moderate to severe depression beginning slowly and sometimes undetectably during the second to third week post partum, increasing steadily for weeks to months and usually resolving spontaneously within a year. Somatic complaints such as fatigue are common. It is intermediate in severity between the mood fluctuations experienced by the majority of new mothers and frank postpartum psychosis.
psychotic depression strictly, major depressive disorder with psychotic features, such as hallucinations, delusions, mutism, or stupor. The term is often used more broadly to cover all severe depressions causing gross impairment of social or occupational functioning.
reactive depression a usually transient depression that is precipitated by a stressful life event or other environmental factor, in contrast to an endogenous depression.
retarded depression major depressive disorder characterized by signs and symptoms of psychomotor retardation, such as burdened movements and slowed, toneless speech.
situational depression reactive depression.
unipolar depression a type that is not accompanied by episodes of mania or hypomania, such as major depressive disorder or dysthymic disorder. The term is sometimes used more specifically as a synonym of major depressive disorder.

de·pres·sion

(dĕ-presh'ŭn), [TA]
1. Reduction of the level of functioning.
2. Synonym(s): excavation (1)
3. Displacement of a part downward or inward.
4. A mental state or chronic mental disorder characterized by feelings of sadness, loneliness, despair, low self-esteem, and self-reproach; accompanying signs include psychomotor retardation (or less frequently agitation), withdrawal from social contact, and vegetative states such as loss of appetite and insomnia. Synonym(s): dejection (1) , depressive reaction, depressive syndrome
[L. depressio, fr. deprimo, to press down]

depression

(dĭ-prĕsh′ən)
n.
1.
a. The act of depressing.
b. The condition of being depressed.
2. An area that is sunk below its surroundings; a hollow.
3. The condition of feeling sad or despondent.
4. A mood disorder characterized by persistent sadness or inability to experience pleasure combined with other symptoms including poor concentration, indecisiveness, sleep problems, changes in appetite, and feelings of guilt, helplessness, and hopelessness. Also called clinical depression, major depressive disorder.
5. A lowering or reduction, as:
a. A reduction in physiological vigor or activity: a depression in respiration.
b. A lowering in amount, degree, or position: depression of stock prices.
6.
a. A period of drastic economic decline, characterized by decreasing aggregate output, falling prices, and rising unemployment.
b. A period of widespread poverty and high unemployment.
c. Depression See Great Depression.
7. Meteorology A region of low barometric pressure.
8. The angular distance below the horizontal plane through the point of observation.
9. Astronomy The angular distance of a celestial body below the horizon.

depression

Dejection, low spirits Psychiatry A spectrum of affective disorders characterized by attenuation of mood, accompanied by psychogenic pain, diminution of self-esteem, retardation of thought processes, psychomotor sluggishness, disturbances of sleep and appetite, and not uncommonly, suicidal ideation; depression can be triggered by stressful life events, associated with medical or mental disorders, or may be idiopathic Clinical Apathy, anorexia, lack of emotion–flat affect, social withdrawal, fatigue Types Major depression, dysthymia, bipolar disorder; depression may run in families. See Anaclitic depression, Bipolar disorder, Clinical depression, DART, Depressive disorders, Double depression, Endogenous depression, Inbreeding depression, Major depression, Masked depression, Postoperative depression, Postpartum depression, Reactive depression.
Depression
Atypical depression A term retired from the DSM, which some clinicians NEJM 1991; 325: 633 use to refer to combinations of mood reactivity, including anhedonia, overeating, oversleeping, chronic poor self-esteem; those with AD are thought to have a better response to MAOIs
Major depressive disorder-recurrent A condition defined as
A. 2 or more major depressive episodes–MDE, which is defined as ≥ 5 of the following present during the same 2-week period, and represent a change from previous functioning and at least one of the 5 is either
1. depressed mood or.
2. loss of interest
 1. Depressed mood most of the day, nearly every day, as indicated either subjectively–self or by observation of others–eg, tearfulness or in children irritability
 2. Marked decreased interest or pleasure in all or most activities for most of the day, nearly every day for the defining period
 .
3. Significant–≥5%, unintentional weight loss or weight gain or loss of appetite
 .
4. Insomnia or hypersomnia nearly every day
 .
5. Psychomotor agitation or retardation nearly every day
 .
6. Fatigue or loss of energy nearly every day
 .
7. Feelings of worthlessness or excessive or inappropriate guilt nearly every day
 .
8. Decreased ability to concentrate or think nearly every day
 .
9. Recurrent thoughts of death, recurrent suicidal ideation and/or suicidal plans
B. The MDE is not better explained for by schizoaffective disorder, or is not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or psychotic disorder NOS
C. There has never been a manic episode or hypomanic episode
Melancholic depression Endogenous depression Characterized by pervasive sadness, hopelessness, loss of interest in activities, and physical symptoms, eg weight loss, sleep problems; in MD, there may be an ↑ 'threshold' that requires little external input to initiate recurrence
Reactive depression–an excess response to stressful life events
.

de·pres·sion

(dĕ-presh'ŭn) [TA]
1. Reduction of the level of functioning.
2. A hollow or sunken area.
3. Displacement of a part downward or inward.
4. A temporary mental state or chronic mental disorder characterized by feelings of sadness, loneliness, despair, low self-esteem, and self-reproach; accompanying signs include psychomotor retardation or less frequently agitation, withdrawal from social contact, and vegetative states such as loss of appetite and insomnia.
Synonym(s): dejection.

depression

Sadness or unhappiness, usually persistent. This may be a normal reaction to unpleasant events or environment or may be the result of a genuine depressive illness. Pathological depression features a sense of hopelessness, dejection and fear out of all proportion to any external cause. There is persistent low mood, loss of interest or pleasure, low energy, fatigue, disturbed sleep, slowing down of body and mind, poor concentration, confusion, self-reproach, self-accusation and loss of self-esteem. Suicide is an ever-present risk. NICE guidelines for treatment recommend fluoxetine or citalopram. Exercise is valuable.

Depression

A state of being depressed marked especially by sadness, inactivity, difficulty with thinking and concentration, a significant increase or decrease in appetite and time spent sleeping, feelings of dejection and hopelessness, and sometimes suicidal thoughts or an attempt to commit suicide.

depression

Downward rotation of an eye. It is accomplished by the inferior rectus and superior oblique muscles. It can be induced by using base-up prisms. Syn. infraduction; deorsumduction.

de·pres·sion

(dĕ-presh'ŭn) [TA]
1. Opening or indentation on an oral cavity surface.
2. Reduction of the level of functioning.

Patient discussion about depression

Q. am i depressed i feel sad,lonely,streeted,worthless that nothing matter anymore..i sleep all the time,loss of intrest of everything..

A. yes,go see a dr. a.s.a.p.,i went through a bad depression mode during the divorce of my first wife,i slept for 3 days,no food,no shower,nobody to talk to,so i finlly went to the dr. he put me on prozac,and after a few days i was back to my old self again,JUST GO SEE A DR.

Q. what about depression?

A. Hey. It might be nice "for you" if you came back to this and said some more, or read some of the other questions and answers.

Q. what causes depression?

A. You need to define what you mean by depression. Clincal depression is one thing and feeling low from time to time is another. There is a lot of good information at your finger tips on the www. You may want to shy away from those websites that are paid for my the pharmacutical companies. They want to sell you their drugs. What is the cause of your depression? Are there one or two things that you can point to? If you are clinically depressed, see a dr., that is, if you can get out of bed...If you are depressed due to family, or the fools in Washington, those are things that you may work out with your minister or rabbi or a therapist. I have found a lot of good information on therapy and therapists on www.focusas.com
You may want to start there.

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