| Clinical depression is a state of | | | | psychosis. |
| sadness, melancholia or despair that has | | | | Depression with Catatonic Features - |
| advanced to the point of being | | | | This subtype can be applied to Major |
| disruptive to an individual's social | | | | Depressive episodes as well as to manic |
| functioning and/or activities of daily | | | | episodes, though it is rare, and rarer |
| living. | | | | in mania. Catatonia is characterized by |
| Although a low mood or state of | | | | motoric immobility evidenced by |
| dejection that does not affect | | | | catalepsy or stupor. This MDD subtype |
| functioning is often referred to as | | | | may also manifest excessive, nonprompted |
| depression, clinical depression is a | | | | motor activity (akathisia), extreme |
| medical diagnosis and is different from | | | | negativism or mutism, and peculiarities |
| the everyday meaning of "being | | | | in movement, including stereotypical |
| depressed". | | | | movements, prominent mannerisms, and |
| The Ebers papyrus (ca 1550 BC) contains | | | | prominent grimacing. There may also be |
| a short description of clinical | | | | evidence of echolalia or echopraxia. It |
| depression. Though full of incantations | | | | is very rarely encountered, and may not |
| and foul applications meant to turn away | | | | be a useful category. |
| disease-causing demons and other | | | | Depression with Melancholic Features - |
| superstition, it also evinces a long | | | | Melancholia is characterized by a loss |
| tradition of empirical practice and | | | | of pleasure (anhedonia) in most or all |
| observation. | | | | activities, a failure of reactivity to |
| The modern idea of depression appears | | | | pleasurable stimuli, a quality of |
| similar to the much older concept of | | | | depressed mood more pronounced than that |
| melancholia. The name melancholia | | | | of grief or loss, a worsening of |
| derives from 'black bile', one of the | | | | symptoms in the morning hours, early |
| 'four humours' postulated by Galen. | | | | morning waking, psychomotor retardation, |
| Clinical depression was originally | | | | anorexia (excessive weight loss, not to |
| considered to be a chemical imbalance in | | | | be confused with Anorexia Nervosa), or |
| transmitters in the brain, a theory | | | | excessive guilt. |
| based on observations made in the 1950s | | | | Depression with Atypical Features - |
| of the effects of reserpine and | | | | Atypicality is characterized by mood |
| isoniazid in altering monoamine | | | | reactivity (paradoxical anhedonia) and |
| neurotransmitter levels and affecting | | | | positivity, significant weight gain or |
| depressive symptoms. | | | | increased appetite, excessive sleep or |
| Since these suggestions, many other | | | | somnolence (hypersomnia), leaden |
| causes for clinical depression have been | | | | paralysis, or significant social |
| proposed. | | | | impairment as a consequence of |
| Prevalence Clinical depression affects | | | | hypersensitivity to perceived |
| about 16% of the population on at least | | | | interpersonal rejection. People with |
| one occasion in their lives. The mean | | | | this can react with interest or pleasure |
| age of onset, from a number of studies, | | | | to some things, unlike most depressed |
| is in the late 20s. About twice as many | | | | individuals. |
| females as males report or receive | | | | Depression with Psychotic Features - |
| treatment for clinical depression, | | | | Some people with Major Depressive or |
| though this imbalance is shrinking over | | | | Manic episode may experience psychotic |
| the course of recent history; this | | | | features. They may be presented with |
| difference seems to completely disappear | | | | hallucinations or delusions that are |
| after the age of 50 - 55, when most | | | | either mood-congruent (content |
| females have passed the end of | | | | coincident with depressive themes) or |
| menopause. Clinical depression is | | | | non-mood-congruent (content not |
| currently the leading cause of | | | | coincident with depressive themes). It |
| disability in the US as well as other | | | | is clinically more common to encounter a |
| countries, and is expected to become the | | | | delusional system as an adjunct to |
| second leading cause of disability | | | | depression than to encounter |
| worldwide (after heart disease) by the | | | | hallucinations, whether visual or |
| year 2020, according to the World Health | | | | auditory. |
| Organization Diagnosis The diagnosis may | | | | Other categories of depression Dysthymia |
| be applied when an individual meets a | | | | is a long-term, mild depression that |
| sufficient number of the symptomatic | | | | lasts for a minimum of two years. There |
| criteria for the depression spectrum as | | | | must be persistent depressed mood |
| suggested in the DSM-IV-TR or ICD-9 | | | | continuously for at least two years. By |
| ICD-10. An individual is often seen to | | | | definition the symptoms are not as |
| suffer from what is termed a "clinical | | | | severe as with Major Depression, |
| depression" without fully meeting the | | | | although those with Dysthymia are |
| various criteria advanced for a specific | | | | vulnerable to co-occurring episodes of |
| diagnosis on the depression spectrum. | | | | Major Depression. This disorder often |
| There is an ongoing debate regarding the | | | | begins in adolescence and crosses the |
| relative importance of genetic or | | | | lifespan. People who are diagnosed with |
| environmental factors, or gross brain | | | | major depressive episodes and dysthymic |
| problems versus psychosocial | | | | disorder are diagnosed with double |
| functioning. | | | | depression. Dysthimic disorder develops |
| Types of depression The diagnostic | | | | first and then one or more major |
| category major depressive disorder | | | | depressive episodes happen later. |
| appears in the Diagnostic and | | | | Bipolar I Disorder is an episodic |
| Statistical Manual of Mental Disorders | | | | illness in which moods may cycle between |
| of the American Psychiatric Association. | | | | mania and depression. In the United |
| The term is generally not used in | | | | States, Bipolar Disorder was previously |
| countries which instead use the ICD-10 | | | | called Manic Depression. This term is no |
| system, but the diagnosis of depressive | | | | longer favored by the medical community, |
| episode is very similar to an episode of | | | | however, even though depression plays a |
| major depression. Clinical depression | | | | much stronger (in terms of disability |
| also usually refers to acute or chronic | | | | and potential for suicide) role in the |
| depression severe enough to need | | | | disorder. "Manic Depression" is still |
| treatment. Minor depression is a | | | | often used in the nonmedical community. |
| less-used term for a subclinical | | | | Bipolar II Disorder is an episodic |
| depression that does not meet criteria | | | | illness that is defined primarily by |
| for major depression but where there are | | | | depression but evidences episodes of |
| at least two symptoms present for two | | | | hypomania. |
| weeks. | | | | Postpartum Depression or Post-Natal |
| Major clinical depression Major | | | | Depression is clinical depression that |
| Depression, or, more properly, Major | | | | occurs within two years of childbirth. |
| Depressive Disorder (MDD), is | | | | Due to physical, mental and emotional |
| characterized by a severely depressed | | | | exhaustion combined with |
| mood that persists for at least two | | | | sleep-deprivation; motherhood can "set |
| weeks. Major Depressive Disorder is | | | | women up" so to speak for clinical |
| specified as either "a single episode" | | | | depression. |
| or "recurrent"; periods of depression | | | | Premenstrual dysphoriais is a pattern of |
| may occur as discrete events or as | | | | recurrent depressive symptoms tied to |
| recurrent over the lifespan. Episodes of | | | | the menstrual cycle. The premenstrual |
| major or clinical depression may be | | | | decline in brain serotonin function is |
| further divided into mild, major or | | | | strongly correlated with the concomitant |
| severe. Where the patient has already | | | | worsening of self-rated cardinal mood |
| had an episode of mania or markedly | | | | symptoms. [7] Of considerable clinical |
| elevated mood, a diagnosis of bipolar | | | | importance, the recent understanding of |
| disorder (also called bipolar affective | | | | premenstrual dysphoria as depression |
| disorder) is usually made instead of | | | | points directly to effective treatment |
| MDD; depression without periods of | | | | with Selective serotonin reuptake |
| elation or mania is therefore sometimes | | | | inhibitor (SSRI) antidepressants. |
| referred to as unipolar depression | | | | Previously, disrupting ovarian cyclicity |
| because their mood remains on one pole. | | | | had been the only recognized treatment. |
| The diagnosis also usually excludes | | | | A recent review of studies of a number |
| cases where the symptoms are a normal | | | | of SSRIs has revealed that they can |
| result of bereavement. | | | | effectively ameliorate symptoms of |
| Diagnosticians recognize several | | | | premenstrual dysphoria and may actually |
| possible subtypes of Major Depressive | | | | work best when taken only during the |
| Disorder. ICD-10 does not specify a | | | | part of the menstrual cycle when |
| melancholic subtype, but does | | | | dysphoric symptoms are evident. |
| distinguish on presence or absence of | | | | |