unipolar depression


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Related to unipolar depression: Unipolar disorder

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.

major depression

A mental disorder characterised by severe depression lasting essentially without remission for at least two weeks, with symptoms that interfere with the ability to work, sleep, eat and enjoy once-pleasurable activities.
 
Clinical findings
Feelings of guilt, hopelessness, all-encompassing low mood accompanied by low self-esteem, persistent thoughts of death or suicide; difficulties in concentration, memory and decision-making capacity, behaviour (changes in sleep patterns, appetite, weight), physical well-being; persistent symptoms (e.g., headaches or digestive disorders) that do not respond to treatment; disabling episodic major depression can occur several times in a lifetime.

uni·po·lar de·pres·sion

(yū'ni-pō'lăr dē-presh'ŭn)
Pervasive deadened mood that occurs without a manic phase.

Patient discussion about unipolar depression

Q. Bipolar depression And Unipolar depression Is bipolar depression different from unipolar depression?

A. Yes. These are two different disorders that are distinct in many ways: bipolar appears earlier (20's compared to middle aged), males and females are affected equally (depression is more prevalent among women), family tendency (more pronounced in bipolar) etc. The course is also different: bipolar have manic episodes, while depression includes only depressive episodes.

The treatment is also quite different (lithium and stabilizers for bipolar, SSRI for depression)

You may read more here:
www.nlm.nih.gov/medlineplus/bipolardisorder.html

More discussions about unipolar depression
References in periodicals archive ?
We believe that a history of multiple failed antidepressant trials is compelling evidence of misdiagnosis of a bipolar spectrum disorder as unipolar depression.
The sample was largely males (76.66% in bipolar depression & 80% in unipolar depression group) with a mean age of 31.9 years in bipolar depression & 36.3 in unipolar depression group.
This raises the question of whether rTMS has a similar effect on bipolar and unipolar depression. At a similar tangent, in one of the studies [28], participants with psychotic depression showed significantly less improvement with rTMS.
To accomplish this task, firstly the persons with psychiatric disorder were diagnosed for unipolar depression on the Diagnostic Statistical Manual of Mental Disorders-IV-Text Revised (DSM-IV-TR) and their level of depression was measured on the Beck's Depression Inventory (BDI).
Another study on patients with unipolar depression found a prevalence of MS to be 50 per cent and associated with female gender (22).
After spending some time surfing the Internet, I discovered that I had classic symptoms of major depression, also known as clinical depression, unipolar depression, and major depressive disorder.
In the 2000 National Depressive and Manic Depressive Association survey, the prevalence of bipolar I and II disorder in the US was estimated at 3.4%, with almost one third being incorrectly diagnosed as suffering from unipolar depression, and nearly half not having the condition recognised or diagnosed.
Despite many wonderful antidepressants available today, doctors can't treat bipolar depression as aggressively as they would the very much more common unipolar depression because there's always the risk of triggering that rebound effect.
A history of unipolar depression also predisposed women to develop depression during the peripartum and postpartum periods, although unipolar depression was not as potent a risk factor as bipolar disorder.
Dimensions of perfectionism in unipolar depression. Journal of Abnormal Psychology, 100, 98-101.