Depression (mood)

Depression
Lithograph of a man diagnosed as suffering from melancholia with strong suicidal tendency (1892)
Specialty Psychiatry, psychology
Prevention Physical exercise[1]

Depression is a state of low mood and aversion to activity, that can affect a person's thoughts, behavior, tendencies, feelings, and sense of well-being. A depressed mood is a normal temporary reaction to life events such as loss of a loved one. It is also a symptom of some physical diseases and a side effect of some drugs and medical treatments. Depressed mood is also a symptom of some mood disorders such as major depressive disorder or dysthymia.[2]

Factors

Life events

Adversity in childhood, such as bereavement, neglect, mental abuse, physical abuse, sexual abuse, and unequal parental treatment of siblings can contribute to depression in adulthood.[3][4] Childhood physical or sexual abuse in particular significantly correlates with the likelihood of experiencing depression over the life course.[5]

Life events and changes that may precipitate depressed mood include (but are not limited to): childbirth, menopause, financial difficulties, unemployment, stress (such as from work, education, family, living conditions etc.), a medical diagnosis (cancer, HIV, etc.), bullying, loss of a loved one, natural disasters, social isolation, rape, relationship troubles, jealousy, separation, and catastrophic injury.[6][7][8] Adolescents may be especially prone to experiencing depressed mood following social rejection, peer pressure and bullying.[9]

Personality

High scores on the personality domain neuroticism make the development of depressive symptoms as well as all kinds of depression diagnoses more likely,[10] and depression is associated with low extraversion.[11] Other personality indicators could be: temporary but rapid mood changes, short term hopelessness, loss of interest in activities that used to be of a part of one's life, sleep disruption, withdrawal from previous social life, appetite changes, and difficulty concentrating.[12]

Gender identity and sexuality

Studies have shown that those who are marginalized due to either their gender identity or sexual orientation (such as those that identify as LGBT) are more prone to depression.[13]

Medical treatments

Depression may also be the result of healthcare, such as with medication induced depression. Therapies associated with depression include interferon therapy, beta-blockers, isotretinoin, contraceptives,[14] cardiac agents, anticonvulsants, antimigraine drugs, antipsychotics, and hormonal agents such as gonadotropin-releasing hormone agonist.[15]

Substance-induced

Several drugs of abuse can cause or exacerbate depression, whether in intoxication, withdrawal, and from chronic use. These include alcohol, sedatives (including prescription benzodiazepines), opioids (including prescription pain killers and illicit drugs such as heroin), stimulants (such as cocaine and amphetamines), hallucinogens, and inhalants.[16]

Non-psychiatric illnesses

Depressed mood can be the result of a number of infectious diseases, nutritional deficiencies, neurological conditions[17] and physiological problems, including hypoandrogenism (in men), Addison's disease, Cushing's syndrome, hypothyroidism, Lyme disease, multiple sclerosis, Parkinson's disease, chronic pain, stroke,[18] diabetes,[19] and cancer.[20]

Psychiatric syndromes

A number of psychiatric syndromes feature depressed mood as a main symptom. The mood disorders are a group of disorders considered to be primary disturbances of mood. These include major depressive disorder (MDD; commonly called major depression or clinical depression) where a person has at least two weeks of depressed mood or a loss of interest or pleasure in nearly all activities; and dysthymia, a state of chronic depressed mood, the symptoms of which do not meet the severity of a major depressive episode. Another mood disorder, bipolar disorder, features one or more episodes of abnormally elevated mood, cognition and energy levels, but may also involve one or more episodes of depression.[21] When the course of depressive episodes follows a seasonal pattern, the disorder (major depressive disorder, bipolar disorder, etc.) may be described as a seasonal affective disorder. Outside the mood disorders: borderline personality disorder often features an extremely intense depressive mood; adjustment disorder with depressed mood is a mood disturbance appearing as a psychological response to an identifiable event or stressor, in which the resulting emotional or behavioral symptoms are significant but do not meet the criteria for a major depressive episode;[22]:355 and posttraumatic stress disorder, a mental disorder that sometimes follows trauma, is commonly accompanied by depressed mood.[23]

Historical legacy

Researchers have begun to conceptualize ways in which the historical legacies of racism and colonialism may create depressive conditions.[24][25]

Management

Depressed mood may not require professional treatment, and may be a normal temporary reaction to life events, a symptom of some medical condition, or a side effect of some drugs or medical treatments. A prolonged depressed mood, especially in combination with other symptoms, may lead to a diagnosis of a psychiatric or medical condition which may benefit from treatment. The UK National Institute for Health and Care Excellence (NICE) 2009 guidelines indicate that antidepressants should not be routinely used for the initial treatment of mild depression, because the risk-benefit ratio is poor.[26]

See also

References

  1. ↑ Schuch, FB; Vancampfort, D; Firth, J; Rosenbaum, S; Ward, PB; Silva, ES; Hallgren, M; Ponce De Leon, A; Dunn, AL; Deslandes, AC; Fleck, MP; Carvalho, AF; Stubbs, B (1 July 2018). "Physical Activity and Incident Depression: A Meta-Analysis of Prospective Cohort Studies". The American Journal of Psychiatry. 175 (7): 631–648. doi:10.1176/appi.ajp.2018.17111194. PMID 29690792.
  2. ↑ Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). American Psychiatric Association. 2013.
  3. ↑ Christine Heim; D. Jeffrey Newport; Tanja Mletzko; Andrew H. Miller; Charles B. Nemeroff (July 2008). "The link between childhood trauma and depression: Insights from HPA axis studies in humans". Psychoneuroendocrinology. 33 (6): 693–710. doi:10.1016/j.psyneuen.2008.03.008. PMID 18602762. Retrieved 20 April 2014.
  4. ↑ Pillemer, Karl; Suitor, J. Jill; Pardo, Seth; Henderson Jr, Charles (2010). "Mothers' Differentiation and Depressive Symptoms Among Adult Children". Journal of Marriage and Family. 72 (2): 333–345. doi:10.1111/j.1741-3737.2010.00703.x. PMC 2894713. PMID 20607119.
  5. ↑ Lindert J, von Ehrenstein OS, Grashow R, Gal G, Braehler E, Weisskopf MG (April 2014). "Sexual and physical abuse in childhood is associated with depression and anxiety over the life course: systematic review and meta-analysis". Int J Public Health. 59 (2): 359–72. doi:10.1007/s00038-013-0519-5. PMID 24122075.
  6. ↑ Schmidt, Peter (2005). "Mood, Depression, and Reproductive Hormones in the Menopausal Transition". The American Journal of Medicine. 118 Suppl 12B (12): 54–8. doi:10.1016/j.amjmed.2005.09.033. PMID 16414327.
  7. ↑ Rashid, T.; Heider, I. (2008). "Life Events and Depression" (PDF). Annals of Punjab Medical College. 2 (1). Retrieved 15 October 2012.
  8. ↑ Mata, D. A.; Ramos, M. A.; Bansal, N; Khan, R; Guille, C; Di Angelantonio, E; Sen, S (2015). "Prevalence of Depression and Depressive Symptoms Among Resident Physicians: A Systematic Review and Meta-analysis". JAMA. 314 (22): 2373–2383. doi:10.1001/jama.2015.15845. PMC 4866499. PMID 26647259.
  9. ↑ Davey, C. G.; Yücel, M; Allen, N. B. (2008). "The emergence of depression in adolescence: Development of the prefrontal cortex and the representation of reward". Neuroscience & Biobehavioral Reviews. 32 (1): 1–19. doi:10.1016/j.neubiorev.2007.04.016. PMID 17570526.
  10. ↑ Jeronimus; et al. (2016). "Neuroticism's prospective association with mental disorders: A meta-analysis on 59 longitudinal/prospective studies with 443 313 participants". Psychological Medicine. 46 (14): 2883–2906. doi:10.1017/S0033291716001653. PMID 27523506.
  11. ↑ Kotov; et al. (2010). "Linking "big" personality traits to anxiety, depressive, and substance use disorders: a meta-analysis". Psychological Bulletin. 136 (5): 768–821. doi:10.1037/a0020327. PMID 20804236.
  12. ↑ "Signs and Symptoms of Mild, Moderate, and Severe Depression". 2017-03-27.
  13. ↑ Plöderl, M; Tremblay, P (2015). "Mental health of sexual minorities. A systematic review". International Review of Psychiatry (Abingdon, England). 27 (5): 367–85. doi:10.3109/09540261.2015.1083949. PMID 26552495.
  14. ↑ Rogers, Donald; Pies, Ronald (9 January 2017). "General Medical Drugs Associated with Depression". Psychiatry (Edgmont). 5 (12): 28–41. ISSN 1550-5952. PMC 2729620. PMID 19724774.
  15. ↑ Botts, S; Ryan, M. Drug-Induced Diseases Section IV: Drug-Induced Psychiatric Diseases Chapter 18: Depression. pp. 1–23.
  16. ↑ American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders, fifth edition. Arlington, VA: American Psychiatric Association.
  17. ↑ Murray ED, Buttner N, Price BH. (2012) Depression and Psychosis in Neurological Practice. In: Neurology in Clinical Practice, 6th Edition. Bradley WG, Daroff RB, Fenichel GM, Jankovic J (eds.) Butterworth Heinemann. 12 April 2012. ISBN 978-1437704341
  18. ↑ Saravane, D; Feve, B; Frances, Y; Corruble, E; Lancon, C; Chanson, P; Maison, P; Terra, JL; et al. (2009). "Drawing up guidelines for the attendance of physical health of patients with severe mental illness". L'Encéphale. 35 (4): 330–9. doi:10.1016/j.encep.2008.10.014. PMID 19748369.
  19. ↑ Rustad, JK; Musselman, DL; Nemeroff, CB (2011). "The relationship of depression and diabetes: Pathophysiological and treatment implications". Psychoneuroendocrinology. 36 (9): 1276–86. doi:10.1016/j.psyneuen.2011.03.005. PMID 21474250.
  20. ↑ Li, M; Fitzgerald, P; Rodin, G (2012). "Evidence-based treatment of depression in patients with cancer". Journal of Clinical Oncology. 30 (11): 1187–96. doi:10.1200/JCO.2011.39.7372. PMID 22412144.
  21. ↑ Gabbard, Glen O. Treatment of Psychiatric Disorders. 2 (3rd ed.). Washington, DC: American Psychiatric Publishing. p. 1296.
  22. ↑ American Psychiatric Association (2000a). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision: DSM-IV-TR. Washington, DC: American Psychiatric Publishing, Inc. ISBN 978-0-89042-025-6.
  23. ↑ Vieweg, W. V.; Fernandez, D. A.; Beatty-Brooks, M; Hettema, J. M.; Pandurangi, A. K.; Pandurangi, Anand K. (May 2006). "Posttraumatic Stress Disorder: Clinical Features, Pathophysiology, and Treatment". Am. J. Med. 119 (5): 383–90. doi:10.1016/j.amjmed.2005.09.027. PMID 16651048.
  24. ↑ Cvetkovich, Ann (2012). Depression: A Public Feeling. Durham, NC: Duke University Press Books. ISBN 978-0822352389.
  25. ↑ Cox, William T.L.; Abramson, Lyn Y.; Devine, Patricia G.; Hollon, Steven D. (2012). "Stereotypes, Prejudice, and Depression: The Integrated Perspective". Perspectives on Psychological Science. 7 (5): 427–49. doi:10.1177/1745691612455204. PMID 26168502.
  26. ↑ NICE guidelines, published October 2009. Nice.org.uk. Retrieved on 2015-11-24.
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