1. DEPRESSION

2. What causes depression?combination of genetic, biological, environmental,and psychological factors. 3. saya berasa amat sukar untuk bangun pagi ,saya hanya mahu berada disebalik cadar dantidak mahu bercakap dengan siapa-siapasaya kurang selera makan dan telah hilangbanyak berat badansaya selalu penat dan tidur malam tidak lena+saya sudah berkeluarga dan kerjaya tetapi sayaselalu rase tidak sempurna atau bertambah baik 4. Validated Screening InstrumentTHE PHQ-9Scores the frequency during the last 2 weeks of the 9 symptom domains that constitute theDSM criteria for MDD, using Likert scales. The domains include:Little interest or pleasure in doing things;Feeling down, depressed, or hopeless;Trouble falling or staying asleep or sleeping too much;Feeling tired and having little energy;Poor appetite or overeating;Feeling bad about yourself (eg, failure);Difficulty concentrating;Moving slowly or fidgety; andThoughts that you would be better off dead.The tenth question evaluates level of impairment related to any of the 9 symptom domainsendorsed by the patient 5. Signs and symptoms-Persistent sad, anxious, or "empty" feelings-Feelings of hopelessness or pessimism- Feelings of guilt, worthlessness, or helplessness- Irritability, restlessness-Loss of interest in activities or hobbies once pleasurable,including sex-Fatigue and decreased energy-Difficulty concentrating, remembering details, and makingdecisions- Insomnia, early-morning wakefulness, or excessive sleeping-Overeating, or appetite loss-Thoughts of suicide, suicide attempts-Aches or pains, headaches, cramps, or digestive problems thatdo not ease even with treatment. 6. Tr1)emaedticmatioensnt2) behavior therapy-------------------------------------------------------------*antidepressants : to regulate hormonal chemical dopamine , serotonin, norepinephrine1) SSRIs Fluoxetine (Prozac), sertraline (Zoloft),escitalopram (Lexapro)2) SNRIs - venlafaxine (Effexor) and duloxetine(Cymbalta)3) Dopamine receptors :bupropion (Wellbutrin) less likelyto cause sexual side effects. However, it can increase aperson's risk for ^seizures.*SE : tricyclic ^drymouth ^constipation ; headaches,nausea, jitters, or insomnia 7. Other drug groups2) tricyclic : imipramine and nortriptyline.SE : affect the heart in people with heartconditions. ^diarrhea/ ^ insomnia They sometimescause dizziness, especially in older adults. Theyalso may cause drowsiness, dry mouth, andweight gain3) Monoamine oxidase inhibitors (MAOIs) :"atypical" depression, such as when a personexperiences increased appetite and the need formore sleep rather than decreased appetite andsleep. They also may help with anxious feelings orpanic and other specific symptoms 8. HOW TO?All antidepressants must be taken for at least 4 to 6 weeks before they have afull effect. You should continue to take the medication, even if you are feelingbetter, to prevent the depression from returning.Medication should be stopped only under a doctor's supervision. Somemedications need to be gradually stopped to give the body time to adjust.Although antidepressants are not habit-forming or addictive, suddenly ending anantidepressant can cause withdrawal symptoms or lead to a relapse of thedepression. Some individuals, such as those with chronic or recurrentdepression, may need to stay on the medication indefinitely.In addition, if one medication does not work, you should consider trying another.NIMH-funded research has shown that people who did not get well after taking afirst medication increased their chances of beating the depression after theyswitched to a different medication or added another medication to their existingone. 9. Pychotherapy1)cognitive-behavioral therapy (CBT)2)interpersonal therapy (IPT)-------------------------------------------------------------------------------------------------**CBT helps people with depression restructure negative thought patterns.Doing so helps people interpret their environment and interactions with others ina positive and realistic way. It may also help you recognize things that may becontributing to the depression and help you change behaviors that may bemaking the depression worse**IPT helps people understand and work through troubled relationships that maycause their depression or make it worse. 10. How you can help-Offer emotional support, understanding, patience, andencouragement.-Talk to him or her, and listen carefully.-Never dismiss feelings, but point out realities and offerhope.-Never ignore comments about suicide, and report themto your loved one's therapist or doctor.-Invite your loved one out for walks, outings and otheractivities. Keep trying if he or she declines, but don't pushhim or her to take on too much too soon.-Provide assistance in getting to the doctor'sappointments.-Remind your loved one that with time and treatment, thedepression will lift 11. Other drug groups2) tricyclic : imipramine and nortriptyline.SE : affect the heart in people with heartconditions. They sometimes cause dizziness,especially in older adults. They also may causedrowsiness, dry mouth, and weight gain3) Monoamine oxidase inhibitors (MAOIs) :"atypical" depression, such as when a personexperiences increased appetite and the need formore sleep rather than decreased appetite andsleep. They also may help with anxious feelings orpanic and other specific symptoms