Depression (mood)

Melencolia I (ca. 1514), by Albrecht Drer

Depression is a state of low mood and aversion to activity that can affect a person's thoughts,
behavior, feelings and sense of well-being.
[1]
Depressed people can feel sad, anxious, empty,
hopeless, worried, helpless, worthless, guilty, alone, irritable, hurt, or restless. They may lose
interest in activities that were once pleasurable, experience loss of appetite or overeating, have
problems concentrating, remembering details or making decisions, and may contemplate, attempt
or commit suicide. Insomnia, excessive sleeping, fatigue, aches, pains, digestive problems or
reduced energy may also be present.
[2]

Depressed mood is not always a psychiatric disorder. It may be a normal reaction to certain life
events, a symptom of some medical conditions or a side effect of some drugs or medical
treatments. Depressed mood is also a primary or associated feature of certain psychiatric
syndromes such as clinical depression.
Contents
[hide]
1 Causes
o 1.1 Life events
o 1.2 Medical treatments
o 1.3 Non-psychiatric illnesses
o 1.4 Psychiatric syndromes
o 1.5 Drug use
2 Assessment
3 Treatment
4 See also
5 References
Causes[edit]
Life events[edit]
Adversity in childhood, such as bereavement, neglect, unequal parental treatment of siblings,
physical abuse or sexual abuse, significantly increases the likelihood of experiencing depression
over the life course.
[3][4][5]

Life events and changes that may precipitate depressed mood include childbirth, menopause,
financial difficulties, job problems, a medical diagnosis (cancer, HIV, etc.), bullying, loss of a
loved one, natural disasters, social isolation, relationship troubles, jealousy, separation, and
catastrophic injury.
[6][7]

Medical treatments[edit]
Certain medications are known to cause depressed mood in a significant number of patients.
These include interferon therapy for hepatitis C.
[8]

Non-psychiatric illnesses[edit]
Main article: Depression (differential diagnoses)
Depressed mood can be the result of a number of infectious diseases, nutritional deficiencies,
neurological conditions
[9]
and physiological problems, including hypoandrogenism (in men),
Addison's disease, Lyme disease, multiple sclerosis, chronic pain, stroke,
[10]
diabetes,
[11]
cancer,
[12]

sleep apnea, and disturbed circadian rhythm. It is often one of the early symptoms of
hypothyroidism (reduced activity of the thyroid gland).
Psychiatric syndromes[edit]
Main article: Depressive mood disorders
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 depressive episodes.
[13]
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 commonly 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;
[14]:355
and posttraumatic stress disorder, an anxiety disorder that sometimes
follows trauma, is commonly accompanied by depressed mood.
[15]

Drug use[edit]

This section requires expansion. (April 2014)
Depression is associated with abusive drug use.
[16]

Assessment[edit]
Questionnaires and checklists such as the Beck Depression Inventory or the Children's
Depression Inventory can be used to detect and assess the severity of depression.
[17]

Treatment[edit]
Main article: Management of depression
Depressed mood may not require any professional treatment, and may be a normal reaction to
certain life events, a symptom of some medical conditions, 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.
[18]
Different sub-divisions of depression have different treatment approaches.
[19]

Given an accurate diagnosis of major depressive disorder, in general the type of treatment
(psychotherapy and/or antidepressants, alternative therapies, or active intervention) is "less
important than getting depressed patients involved in an active therapeutic program."
[20]

Moderate levels of physical activity can treat depression by increasing the levels of endorphins
and the neurotransmitters serotonin, dopamine, and norepinephrine.
[21]
Exercise allows individuals
to improve their health while building new relationships with others and bolstering the sense of
community that comes with exercising as a group.
[22][23]
Group activities can lower depression by
increasing depressed individuals ability to interact with others. Exercise also increases
individuals self-confidence by promoting social skills that people with depression often lack and
interrupts the cycle of isolation from the general population that can further increase depression.
Exercise fosters non-demanding behaviors while allowing people to socialize and identify
themselves as part of the general population.
Lifestyle strategies that may improve depressed mood include wake therapy, light therapy, eating
a healthy diet, meditation, exercise, and smoking cessation.
[24][24][25][26][27][28]