What Is The Course Of Depression
Depression is a recurring disorder, and about 50 percent of people who have one episode of depression have another. Studies show that the number of life stressors a person experiences influences the likelihood of recurrence. They also show that likelihood of recovery declines the longer that episodes lasta potent argument for seeking prompt treatment. There is some evidence that depression itself changes the brain, diminishing the ability to form new nerve cell connections and decreasing brain reserves, thereby curtailing the capacity for recovery.
Executive Function And Motivation
The symptoms of ADHD arise from a deficiency in certain . Executive functions are a set of that are required to successfully select and monitor behaviors that facilitate the attainment of one’s chosen goals. The executive function impairments that occur in ADHD individuals result in problems with staying organized, time keeping, excessive , maintaining concentration, paying attention, ignoring distractions, regulating emotions, and remembering details. People with ADHD appear to have unimpaired long-term memory, and deficits in long-term recall appear to be attributed to impairments in working memory. The criteria for an executive function deficit are met in 3050% of children and adolescents with ADHD. One study found that 80% of individuals with ADHD were impaired in at least one executive function task, compared to 50% for individuals without ADHD. Due to the rates of brain maturation and the increasing demands for executive control as a person gets older, ADHD impairments may not fully manifest themselves until adolescence or even early adulthood.
ADHD has also been associated with motivational deficits in children. Children with ADHD often find it difficult to focus on long-term over short-term rewards, and exhibit impulsive behavior for short-term rewards.
Diagnosing And Treating Clinical Depression
A surprising thing about depression is that sadness is only one aspect of it, and some individuals diagnosed with clinical depression dont feel sad at all. They may, for example, experience persistent fatigue and irritability or physical aches and pains without feeling sad.
Sad hurts, but it is a healthy feeling; it is a necessary thing to feel, says J.K. Rowling, author of the best-selling Harry Potter series of novels and others, who suffers from clinical depression. Depression is very different. Not everyone who is depressed experiences every symptom of the illness. Some people experience just a few symptoms, while others experience all or most of them. Further, the severity and frequency of symptoms vary among individuals.
According to the National Institute of Mental Health, gender can influence which symptoms an individual with depression experiences. For example, women typically have symptoms of sadness, worthlessness and guilt, while men typically have symptoms of insomnia and fatigue, irritability and loss of interest in activities. Symptoms can also vary depending on the stage of the illness. For a of clinical or major depression, five or more symptoms of the illness must have been present during the same two-week period and represent a change from previous functioning, with at least one of the symptoms being either depressed mood, or loss of interest or pleasure. Common signs of clinical depression include:
What Can I Do If I Have Depression
If you have symptoms of depression, see your healthcare provider. They can give you an accurate diagnosis, refer you to a specialist or suggest treatment options.
If you or someone you know is thinking of hurting themselves or taking their own life:
A note from Cleveland Clinic
Depression is a common condition that affects millions of Americans every year. Anyone can experience depression even if there doesnt seem to be a reason for it. Causes of depression include difficulties in life, brain chemistry abnormalities, some medications and physical conditions. The good news is that depression is treatable. If you have symptoms of depression, talk to your healthcare provider. The sooner you get help, the sooner you can feel better
Last reviewed by a Cleveland Clinic medical professional on 12/31/2020.
Depression In Children And Teens
It used to be believed that children couldnt be depressed, but we now know thats not true. Children, teens, and young adults can experience depression, but it may not look the same as it does in adults.
Children may not yet have the language skills and emotional awareness to express exactly what they are feeling. An adult who is depressed may feel profound , whereas a depressed child may appear angry, frustrated, and irritable.
Symptoms of depression in school-aged children and teens may interfere with school work, social activities, or friendships. For example, a child who is depressed may begin to make poor grades in school, lose interest in after school activities like sports, or no longer want to hang out with friends.
As with teens and adults, children who are experiencing depression may also have trouble sleeping, lose their appetite, or have unexplained physical symptoms such as headaches and stomachaches.
If you’re concerned that your child or teen is depressed, talk to your pediatrician. There are some medical conditions that can cause depression which will need to be ruled out. If your child is diagnosed with depression, finding the appropriate treatment is critical to their well-being.
You can help by putting together a network of mental health professionals, doctors, teams at school, as well as friends and people in the community, who can support your family as you learn about managing your childs depression.
Who Is At Risk For Depression
Depression can affect anyone, no matter their age, gender or circumstances. About 16 million Americans experience depression each year.
Women may experience depression more often than men. And your genetics or other health conditions can increase the likelihood that youll have at least one depressive episode in your lifetime.
How Does A Doctor Make A Depression Diagnosis
We’ve gotten used to doctors using special tests or other complex laboratory tests to help them make a conclusive diagnosis. But most lab tests arenât very helpful when it comes to diagnosing depression. In fact, talking with the patient may be the most important diagnostic tool the doctor has. The recommendation is that doctors routinely screen everyone for . This screening might take place during a visit for a chronic illness, at an annual wellness visit, or during a or postpartum visit.
To effectively diagnose and treat depression, the doctor must hear about specific symptoms of depression. They may use a series of standard questions to screen for depression. While a physical examination will reveal a patient’s overall state of health, by talking with a patient, a doctor can learn about other things that are relevant to making a depression diagnosis. A patient, for example, can report on such things as daily moods, behaviors, and lifestyle habits.
A depression diagnosis is often difficult to make because clinical depression can show up in so many different ways. For example, some clinically depressed people seem to withdraw into a state of apathy. Others may become irritable or even agitated. Eating and sleeping patterns can be exaggerated. Clinical depression may cause someone to or eat to excess, or almost eliminate those activities.
International Classification Of Diseases
In the tenth revision of the by the , the symptoms of hyperkinetic disorder were analogous to ADHD in the DSM-5. When a is present, the condition was referred to as hyperkinetic conduct disorder. Otherwise, the disorder was classified as disturbance of activity and attention, other hyperkinetic disorders or hyperkinetic disorders, unspecified. The latter was sometimes referred to as hyperkinetic syndrome.
In the implementation version of , the disorder is classified under 6A05 , and hyperkinetic disorder no longer exists. The defined subtypes are similar to those of the DSM-5: predominantly inattentive presentation ; predominantly hyperactive-impulsive presentation; combined presentation . However, the ICD-11 includes two residual categories for individuals who do not entirely match any of the defined subtypes: other specified presentation where the clinician includes detail on the individual’s presentation; and presentation unspecified where the clinician does not provide detail.
A proportion of adults who meet the criteria for ADHD in adulthood would not have been diagnosed with ADHD as children; for diagnosis in an adult, having symptoms since childhood is usually required. Most cases of late-onset ADHD develop the disorder between the ages of 12-16 and may therefore be considered early adult or adolescent-onset ADHD.
Common Types Of Depression
If you or a loved one are struggling with depression, contact the Substance Abuse and Mental Health Services Administration National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.
For more mental health resources, see our National Helpline Database.
When people think about depression, they often divide it into one of two thingseither clinical depression which requires treatment or regular depression that pretty much anyone can go through. As a condition, depression can be a difficult concept to grasp since we refer to it as both the symptom of a condition and a condition itself.
From a medical standpoint, depression is defined as a mood disorder that causes a persistent feeling of depressed mood or sadness and the often profound loss of interest in things that usually bring you pleasure.
Depression affects how you feel, think, and behave and can interfere with your ability to function and carry on with daily life. There are many different causes of depression, some of which we dont fully understand. Seven of the more common types of depression include the following.
What Exactly Does It Mean To Have High
When I was first diagnosed with depression, many peopleeven those who knew me well, who cared about meresponded with the opposite of what I needed to hear. This was partly because they didnt understand, but also partly because we live in a world where the prevailing view is that mental illness is a weakness and that a person with depression is someone who cant leave their house, sleeps all the time, lacks enthusiasm, and neglects personal care. Most of the time, this wasnt me at all. And even when it was, I managed to keep it hidden.
I heard a lot of Youre the last person Id imagine to be depressed! or But you have so much going for you, and How can someone like you have depression? The cumulative effect of all this unhelpful commentary was mighty. It didnt stop me from seeking treatment, but it did stop me from talking openly about my illness for over 15 years, because part of me felt that I didnt deserve help.
I was first diagnosed with depression at 19, and it was another 13 years before a professional gave me a diagnosis of major depressive disorder . Within just the last few years, the phrase high-functioning depression came on my radar. Right away, it was something I could relate to, albeit only with a very literal interpretation: I was a high-functioning person with depression.
How Is Depression Treated
Men often avoid addressing their feelings and, in many cases, friends and family members are the first to recognize that their loved one is depressed. It is important that friends and family support their loved one and encourage him to visit a doctor or mental health professional for an evaluation. A health professional can do an exam or lab tests to rule out other conditions that may have symptoms that are like those of depression. He or she also can tell if certain medications are affecting the depression.
The doctor needs to get a complete history of symptoms, such as when they started, how long they have lasted, how bad they are, whether they have occurred before, and if so, how they were treated. It is important that the man seeking help be open and honest about any efforts at self-medication with alcohol, non-prescribed drugs, gambling, or high-risk activities. A complete history should include information about a family history of depression or other mental disorders.
After a diagnosis, depression is usually treated with or, or a combination of the two.The increasingly-popular collaborative care approach combines physical and behavioral health care. Collaborative care involves a team of health care providers and managers, including a primary care doctor and specialists.
What It Feels Like To Live With High
The diagnostic criteria for PDD outline exactly what it means to struggle with high-functioning depression in clinical terms, but this is not necessarily what it feels like to go through it. It may be more useful to consider what it feels like to have this mental illness:
- You feel a little down most of the time. Other people may notice this and refer to you as gloomy, cynical, or a downer.
- Your low mood is almost always present, and it feels like you will never get relief. When you do feel happy, it doesnt last long.
- You may feel tired all the time, even if you get enough or too much sleep.
- It may seem like you are lazy, but you just cant summon the energy to do more than is necessary to function at a normal level.
- You feel bad about yourself, unworthy, and as if you dont deserve to be happy or to be liked by others.
- You do everything youre supposed to do, like go to school, or keep the house clean, but it always seems like a monumental effort.
- You gain or lose weight without meaning to, because you either have no appetite or overeat without thinking about it.
- You may feel hopeless often, or cry a lot without any real, concrete reason.
- You do well enough at work or school, but it is a challenge and focusing on tasks is difficult.
- You have to force yourself to engage in social activities, when you would rather withdraw.
- PDD may cause complications that seem unrelated, like substance abuse, chronic pain, relationship difficulties, and problems at work or school.
Common Symptoms Of Clinical Depression
There are different forms of clinical depression with different combinations of the following symptoms:
- Sleep disturbances-insomnia, oversleeping, waking much earlier than usual
- Changes in appetite or eating: much more or much less
- Decreased energy, fatigue
- Headaches, stomachaches, digestive problems or other physical symptoms that are not explained by other physical conditions or do not respond to treatment
- Loss of interest or pleasure in activities that were once enjoyed, such as going out with friends, hobbies, sports, sex, etc.
- Difficulty concentrating, remembering, or making decisions
- Neglecting responsibilities or personal appearance
- Persistent sad or “empty” mood, lasting two or more weeks
- Crying “for no reason”
- Feeling hopeless, helpless, guilty or worthless
- Feeling irritable, agitated or anxious
- Thoughts of death or suicide
New Specifiers For Depression In Dsm
The latest edition of the Diagnostic and Statistical Manual of Mental Disorders , the DSM-5, added two specifiers to further classify diagnoses:
- With Mixed Features This specifier allows for the presence of manic symptoms as part of the depression diagnosis in patients who do not meet the full criteria for a manic episode.
- With Anxious Distress The presence of anxiety in patients may affect prognosis, treatment options, and the patients response to them. Clinicians will need to assess whether or not the individual experiencing depression also presents with anxious distress.
How Is Depression Diagnosed
Many health care providers can help diagnose clinical depression: licensed mental-health therapists, family physicians, or other primary care providers, specialists whom you see for a medical condition, emergency physicians, psychiatrists, psychologists, psychiatric nurses, and social workers.
If one of these professionals suspects that you have depression, you will undergo an extensive medical interview and physical examination. As part of this examination, you may be asked a series of questions from a standardized questionnaire or self-test to help assess your risk of depression and suicide.
Depression may be associated with a number of other medical conditions or can be a side effect of various medications. For this reason, routine laboratory tests are often performed during the initial evaluation to rule out other causes of your symptoms. Occasionally, an X-ray, scan, or another imaging study may be needed.
If your symptoms indicate that you have clinical depression, your health-care provider will strongly recommend treatment. Treatment may include addressing any medical conditions that cause or worsen depression. For example, an individual who is found to have low levels of thyroid hormone might receive thyroid hormone replacement with .
Therapy frequently includes medication and supportive care such as psychotherapy. Other less widely used therapies, such as electroconvulsive therapy, are used in severe cases.
What Are Symptoms And Signs Of Depression
Clinical depression is not something you feel for a day or two before feeling better. In true depressive illnesses, the symptoms last weeks, months, or sometimes years if you don’t seek treatment. If you are depressed, you are often unable to perform daily activities. You may not care enough to get out of bed or get dressed, much less work, do errands, or socialize.
- Adults: You may be said to be suffering from a major depressive episode if you have a depressed mood for at least 2 weeks and have at least 5 of the following clinical symptoms:
- Feeling sad or blue
- Feelings of worthlessness or excessive guilt
- Thoughts of death or suicide
Men and women sometimes show depression differently. Specifically, men are more likely to experience irritability, sleep problems, , and loss of interest in activities they liked previously as a result of depression whereas women tend to have overt sadness and feelings of worthlessness and guilt when depressed. For people who tend to suffer from an increase in appetite, tiredness, and the tendency to sleep , carbohydrate craving, sometimes specifically for , may occur. That has been found to sometimes be an indication that the person tends to suffer from irritability and in addition to depression.
- Elderly: While any of the classic symptoms and signs of depression may occur in elderly men and women, other symptoms also may be noted:
- Diminished ability to think or concentrate
- Unexplained physical complaints
- Memory impairment
What Are The Different Types Of Depression
The most common types of depression are:
- Major depressiondepressive symptoms that interfere with a man’s ability to work, sleep, study, eat, and enjoy most aspects of life. An episode of major depression may occur only once in a person’s lifetime. But it is common for a person to have several episodes. Special forms of major depression include:
- Psychotic depressionsevere depression associated with delusions or hallucinations . These psychotic symptoms are depression-themed. For example, a man may believe he is sick or poor when he is not, or he may hear voices that are not real that say that he is worthless.
- Seasonal affective disordercharacterized by depression symptoms that appear every year during the winter months when there is less natural sunlight.
- Persistent depressive disorder depressive symptoms that last a long time but are less severe than those of major depression.
- Minor depressionsimilar to major depression and persistent depressive disorder, but symptoms are less severe and may not last as long.
Life Expectancy And The Risk Of Suicide
Depressed individuals have a shorter life expectancy than those without depression, in part because people who are depressed are at risk of dying of suicide. They also have a higher rate of dying from other causes, being more susceptible to medical conditions such as heart disease. Up to 60% of people who die of suicide have a mood disorder such as major depression, and the risk is especially high if a person has a marked sense of hopelessness or has both depression and borderline personality disorder. About 28% of adults with major depression die by , and about 50% of people who die by suicide had depression or another mood disorder. The lifetime risk of suicide associated with a diagnosis of major depression in the US is estimated at 3.4%, which averages two highly disparate figures of almost 7% for men and 1% for women . The estimate is substantially lower than a previously accepted figure of 15%, which had been derived from older studies of people who were hospitalized.
What Is Major Or Clinical Depression
Most people feel sad or low at some point in their lives. But clinical depression is marked by a depressed mood most of the day, sometimes particularly in the morning, and a loss of interest in normal activities and relationships — symptoms that are present every day for at least 2 weeks. In addition, according to the DSM-5 — a manual used to diagnose mental health conditions — you may have other symptoms with major depression. Those symptoms might include:
- or loss of energy almost every day
- Feelings of worthlessness or guilt almost every day
- Impaired concentration, indecisiveness
- or hypersomnia almost every day
- Markedly diminished interest or pleasure in almost all activities nearly every day
- Restlessness or feeling slowed down
- Recurring thoughts of death or suicide
- Significant weight loss or gain
Which Lab Tests Can Help Make The Depression Diagnosis
After reviewing the information from your appointment, including the signs and symptoms, patient history, family history, and physician exam, your doctor may ask for some lab tests to rule out a physical condition that may be causing your symptoms. Â Certain viruses, medicines, hormonal or vitamin deficiencies, and illnesses can cause depression-like symptoms. Â Your doctor will also want to review all youâre taking as well as the alcohol or recreational drugs you may be using.
How Is Clinical Depression Different From Normal Stress And Sadness
Feeling sad and depressed is often a normal reaction to a stressful life situation. For example, it is normal to feel down after a major disappointment, or to have trouble sleeping or eating after a difficult relationship break-up. Usually, within a few days, perhaps after talking to a friend, we start to feel like ourselves again. Clinical depression is very different. It involves a noticeable change in functioning that persists for two weeks or longer. Imagine that for the last three months you’ve slept more than 10 hours a day and still feel tired, you have stomach problems, you’re unable to cope with life, and you wonder if dying would solve all your problems. Or, imagine not being able to sleep more than four hours a night, not wanting to spend time with family or friends, and constantly feeling irritable. And when friends try to reach out to you, you get even more upset and bothered. You lose perspective, and you don’t realize that what you’re experiencing is abnormal. You want to just “wait it out,” and you don’t get help because you think it’s weak to ask for help or you don’t want to burden your friends. These are some of the experiences that people can have when they suffer from clinical depression. Unlike normal stress and sadness, the symptoms of clinical depression persist and do not go away no matter how much the individual wants.
How To Tell If You Havedepression
Depression affects people in differentways and can cause a wide varietyof symptoms.
They range from lasting feelings of unhappiness and hopelessness, to losing interest in the things you used to enjoy and feeling very tearful. Many people with depressionalso have symptoms of anxiety.
Therecan bephysical symptoms too, such asfeeling constantly tired, sleeping badly,havingnoappetiteor sex drive, and variousaches and pains.
Thesymptoms of depression range from mild to severe. At its mildest, you may simply feel persistently low in spirit, while severedepression can make you feel suicidal, that life is no longer worth living.
Most people experience feelings of stress, anxiety or low moodduring difficult times. A low moodmay improve after a short period of time, rather than being a sign of depression.