Depression

What is Depression?

1. Introduction

2. Epidemiology

3. Etiology

4. Different Forms of Depression

5. References

Contents

1. Introduction

While the term "depression" can be used to refer to sad mood, clinical depression is more than just feeling blue or down. Children who are clinically depressed feel down, sad, angry or hopeless all the time, for weeks on end. Accroding to the Diagnostic and Statistical Manual of Mental Disorders--Fourth Edition (DSM-IV), in order to meet criteria for Major Depressive Episode, an individual must experience five or more of the following symptoms during the same two-week period:

• Depressed or irritable mood most of the day, nearly every day
• Disinterest in things once enjoyed
• Fatigue or loss of energy
• Difficulty sleeping, or sleeping too much
• Significant weight loss or gain, change in appetite, or failure to make expected weight gains
• Difficulty thinking, including inability to concentrate while reading or even watching television
• Being observably agitated or slowed down
• Feeling worthless or overly guilty
• Talks about death or suicide1

 

2. Epidemiology

Major depression is a mood disorder that appears from childhood through the late adult years. Major depression can be a chronic disorder, with recurrences throughout the life span or can be limited to one episode. It is common in adolescence with a 2:1 prevalence, girls to boys. It is estimated that approximately 2 in 100 children have major depression.  After puberty, approximately 1 in 4 teen girls and 1 in 10 teen boys will have had a major depressive episode by the age of 18.2 The risk of depression in community samples has been estimated to be 1 in 5 (Lewinsohn et al., 1998).3  Major depression has adverse effects on psychosocial and cognitive functioning. Depressed children and teens are often socially isolated and do poorly in school. Up to 60% of depressed teens think about killing themselves and up to 30% attempt suicide.4

3. Etiology

There is no known etiology for depression. However, it is likely that depression results from genetic, biochemical, environmental, and psychological factors. Major depression in a parent increases the risk of a depression in youth as does a history of maternal suicide attempts. Depression often emerges in response to a psychosocial stressor such as sexual or physical abuse or neglect, parental divorce or death, unwanted pregnancy, difficulty with peers, undiagnosed learning disabilities or bullying in school.

Genetics
There is no known etiology for depression. However, it is likely that depression results from genetic, biochemical, environmental, and psychological factors. Major depression in a parent increases the risk of a depression in youth as does a history of maternal suicide attempts. Depression often emerges in response to a psychosocial stressor such as sexual or physical abuse or neglect, parental divorce or death, unwanted pregnancy, difficulty with peers, undiagnosed learning disabilities or bullying in school.

Depression can run in families but also occurs where there is no family history. Depression can be triggered by a trauma or loss and also can occur without any obvious trigger. Trauma, the loss of a loved one, a difficult relationship, unaddressed learning disabilities or any stressful situation may trigger a depressive episode. Subsequent depressive episodes may occur with or without an obvious trigger.

 

4. Different Forms of Depression:

What are the Different Forms of Depression?

Major depressive disorder, also called major depression, is characterized by a combination of symptoms that interfere with a person's ability to work, sleep, study, eat, and enjoy once–pleasurable activities. Major depression is disabling and prevents a person from functioning normally. An episode of major depression may occur only once in a person's lifetime, but more often, it recurs throughout a person's life.

Dysthymic disorder, also called dysthymia, is characterized by long–term (two years or longer) but less severe symptoms that may not disable a person but can prevent one from functioning normally or feeling well. People with dysthymia may also experience one or more episodes of major depression during their lifetimes.6

 

5. References:

1. National Institute of Mental Health, "What are Different Forms of Depression", retired from: http://www.nimh.nih.gov/health/publications/depression/what-is-a-depressive-disorder.shtml on September 24, 2008.

2. Birmaher B, Ryan ND, Williamson DE, Brent DA, Kaufman J, Dahl RE, Perel J, Nelson B. Childhood and adolescent depression: a review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 35:11: 1427-39, 1996.

3.Lewinsohn PM, Rohde P, Seeley JR. Major depressive disorder in older adolescents: prevalence, risk factors and clinical implications. Clinical Psychology Review, 18:7:765-94, 1998.

4.American Academy of Child and Adolescent Psychiatry. Practice Parameter for the Assessment and Treatment of Children and Adolescents with Suicidal Behavior. Retrieved from: http://www.aacap.org/galleries/PracticeParameters/Suicide.pdf.

5.National Institute of Mental Health. What Causes Depression. Retrieved from: http://www.nimh.nih.gov/health/publications/depression/causes-of-depression.shtml.

6. National Institutes of Mental Health.  What are the different forms of depression? Retrieved from: http://www.nimh.nih.gov/health/publications/depression/what-is-a-depressive-disorder.shtml