mood disorder which often involves a loss of interest in life or anhedonia.

Signs and symptoms

According to the DSM-IV-TR (p. 356), the two principal or required elements

of depression include:

  1. depressed mood, or

  2. loss of interest or pleasure.

It is sufficient to have either of these symptoms in conjunction with four

of a list of other symptoms. The diagnosis does not require "loss of

interest in life, anhedonia". Likewise, "lack of energy and motivation" is

not at all a required symptom of Major Depression.

Often it is accompanied by sleep disorders such as insomnia, including early

morning awakening and by feelings of greatly lowered self-worth. Depression

is often described as being unable to feel -- even to feel many negative

emotions such as sadness. Some depressed individuals will have to sleep or

rest all day because their bodies unconsciously know it is best to lay low

away from danger during this vulnerable period.

Other symptoms accompanying depression include: changes in appetite,

feelings of guilt, failure and worthlessness, thoughts of death, fatigue,

and difficulty concentrating, withdrawal, inactivity, slow speech, walking

slow, irritability, confusion, crying easily, inability to enjoy things,

insecurity, anxiety, sore shoulders and neck, low back pain, low libido,

binge eating junk food, inability to show affection, void of emotions,

disorganized, hair becomes wiry, eczema, having trouble getting dressed or

choosing clothes, feelings of regret for past decisions, inability to

function, feeling like no one understands, boredom, fear, desire to be taken

care of, paranoia, irrational fears, easily frustrated.

Of course, each person will have some of these symptoms, but not all.

Treatment

Depressions are currently treated, with varying degrees of success, in

several ways including: psychotherapy (including cognitive therapy,

Psychoanalysis, etc.), antidepressant medication, and electroconvulsive

treatment. Some people stop their medication when they feel better, but this

is risky since each depressive episode is worse than the previous one. It is

as risky as stopping the use of a heart medication when your heart starts

feeling better.

Meditation, regular aerobic exercise (30 minutes, 5 times a week), good

nutrition, proper sleep hygiene, and avoiding alcohol, caffeine and

excessive sugar are extremely helpful in fighting depression. Exploration of

one's spirituality has also had an important impact for many people in

healing their depression. Writing (or typing) thoughts in a regular journal

helps immensely too, as well as getting outside in the sunshine and talking

to friends.

Theory and history

Note: The name "Melancholia" (derived from 'black bile', one of the imagined

'humours' of Hippocrates' four humours theory of emotion) appears to be

cognate with what is now called depression. It is also the name of an

engraving by Albrecht D?rer that allegorically depicts the symptoms of

depression.

Psychiatrists have attempted to categorize depression in many ways, one

older division was between "reactive" or "exogenous" depressions, which were

thought to be depressions caused by other medical condition or an

identifiable life trauma or loss; and "endogenous" depressions in which it

is difficult to find an external cause.

Often depression is repressed anger (in a person who has been oppressed or controlled) or repressed fear (in a

person who has been assaulted) and hence episodes of violence and/or major

anxiety can alternate with episodes of major depression. Post-traumatic

stress disorder, is a form of depression noticed in persons who have been

raped, and/or assaulted, in prostitutes, and military personnel and others

who have experienced a lot of violence.

Current psychiatric standards do not differentiate between exogenous and

endogenous depressions since research appears to show that depressions with

similar symptoms have a similar natural history and response to treatment

regardless of trigger.

Depressions can also be categorised into being just "unipolar depression" or

being a depression that is part of bipolar disorder (also known as "manic

depression"), where the patient cycles between a state of depression and a

state of mania. It appears to have well-documented physical correlates.

Though bipolar disorder often responds well to chemical treatment, it can be

harder to treat than clinical depression. This is because the medicines that

will bring the bipolar disorder patient up from the deep well of depression

can cause him to shift too far into the manic part of the bipolar spectrum

and vice versa.

It is theorized that unipolar depression and unipolar mania are the opposite

poles of a wider bipolar spectrum.

Depression can be linked to seasonal affective disorder, and a continuing

mild depression is known as dysthymia.

About 10% of women develop depression after given birth; this is known as

postpartum depression.

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