Major Depressive Disorder

Kriti Lodh

Major Depressive Disorderunipolar depressionlifetime prevalence:

◦up to 21% in women◦13% in men

typical age of onset:◦20s, but can occur at any time

Major Depressive EpisodeDSM-IV-TR criteria include

◦1 of 2 mood symptoms◦at least 5 symptoms total◦duration of at least 2 weeks

Major Depression in WomenTwice as many woman as menDuring extreme hormonal shiftsEarly puberty22% incidence in ages 20-45Perimenopausal symptomPregnancy –especially around wk 32Post partum ; 2wks- 3 months

Major Depression in MenCommonly occurs with attempts to

self-medicate with alcohol, drugs, food, gambling or sex;

Men often do not experience these behaviors as signs of depression and have more reluctance to ask for professional help.

Depression may be precipitated by loss of ability to function in an impt or especially valued area of life.

Depression & Life ChangesEven happy & eagerly anticipated

events (birth of a baby, retirement, new job, etc.) can precipitate a mild depression;

The chronicity of other stressors can have a profound impact on a at-risk individual (caring for an aging parent, aftermath of divorce, job lay-off, problematic family issues)

Mood Symptoms of Depressionpersistent sad, depressed moodloss of interest or pleasure in

previously enjoyable activitiesDSM-IV criteria specify that

person must have 1 of above plus 4 additional sx for at least 2 weeks

Physical Symptoms of DepressionSleep disturbance

◦too much or too littleloss of energy, fatigueappetite disturbance/weight

change◦loss of appetite or increase in

appetitechanges in activity level

◦psychomotor retardation or agitation

Cognitive Symptoms of Depressiondifficulty concentrating, thinking,

and making decisionsfeelings of worthlessness, guilt,

or hopelessnessrecurrent thoughts of death or

suicide

Course of Depressionif untreated, average duration of

first episode is 6-9 monthsoften recur