DEPRESSION DIAGNOSIS

What is depression?

Most people experience an occasional "off day" when everything seems to be going against them. The term "depression", however, is used to describe a more serious or prolonged episode of the blues, which in severe cases can interfere with an individual's social life, work and sleep patterns. Depression may develop gradually over a long period without apparent cause. Some forms of depression appear to have a repeating pattern while others are short-term and once-off episodes.

Over 300,000 Irish people suffer from depression every year. Women are affected more than men. However, statistics show that every year consistently more men than women commit suicide or attempt suicide (parasuicide), perhaps because men are more reluctant than women to seek help for depressive symptoms or talk to others about their feelings. The highest rates of depression occur in adults aged between 25 and 44 years.

What causes depression?

In many cases, an episode of depression is brought on by a combination of genetic influences and environmental triggers.

There is no doubt that depression can follow a significant "life event", especially one characterised by loss, bereavement, unemployment, or the ending of a close relationship. Financial problems, a lack of social support and drug and alcohol abuse can also trigger a depressive episode.

Some forms of depression are inherited. Research shows that individuals with a family history of depression are 2-3 times more likely to develop the illness.

Depression is also associated with some medical conditions such as:

•	Stroke.
•	Diabetes.
•	Dementia.
•	Cancer.
•	Hypothyroidism.
•	Chronic fatigue syndrome.
•	Corticosteroid use.

Recognising the symptoms

Clouded by an overwhelming sense of hopelessness and despair, an individual who is suffering from depression may feel that it is futile to reach out for help. Gentle encouragement from family and friends to seek professional help is essential.

Early recognition of the symptoms of depression is important. While symptoms will vary from person to person, they may include:

•	A depressed mood that is difficult to shake off.
•	Having no sense of enjoyment or pleasure.
•	Low self-esteem.
•	Loss of libido.
•	Feeling agitated.
•	Loss of interest in hobbies or pastimes.
•	Weight change (loss or gain).
•	Sleep disturbance (unable to get to sleep or waking early).
•	Feeling slowed down.
•	Feeling tired and lacking in energy.
•	Feeling of worthlessness or guilt.
•	Difficulty in concentrating and decision making.
•	Frequent thoughts of death or suicide.

While some people may experience many of these symptoms, others may experience only a few. Having five or more for more than two weeks suggests depression and you should make an appointment to visit your family doctor.

Seeking treatment

Effective treatment can help shorten the length of a depressive episode, reduce the severity and prevent long-term problems such as social phobias and poor self-esteem.

Most individuals suffering from depression are successfully treated by their family doctor. A smaller number attend a psychiatrist and a few people with more severe forms of depression may require treatment in hospital.

Treatment may involve psychotherapy, drug therapy or a combination of both, depending on the cause, type and severity of the illness. In certain cases electroconvulsive therapy (ECT) may be necessary.

Psychotherapy involves talking to a therapist about day-to-day relationships (interpersonal psychotherapy); how to change a negative way of thinking into positive thinking (cognitive psychotherapy) and how to change a type of behaviour (behavioural therapy). A diary may be kept to record sleep and mood patterns and to chart appetite and concentration difficulties.

During a depressive episode, it is believed that the levels of certain chemicals in the brain called neurotransmitters (noradrenaline and serotonin) are reduced. Some antidepressants used in the treatment of depression act to combat this reduction in neurotransmitters.There are three main groups of anti-dpressants: tricyclic antidepressants (TCADs); selective serotonin reuptake inhibitors (SSRIs) and monoamine oxidase inhibitors (MAOIs). Lithium, which is more commonly used for the treatment of maia may be used to treat severe and recurrent depression. It is important to note that all of these drugs have side effects, which you should discuss with your doctor.

Drug treatment can take up to three to four weeks before any effects are felt and is normally prescribed for six to nine months. However, it may be continued for a further six months after the symptoms of depression have been resolved to prevent the depression recurring. If depression does return it is important to speak to your GP as a longer duration of therapy may be considered.

ECT involves delivering an electrical impulse to the brain through electrodes, which are placed at specific points on the head. It is given under light anaesthesia. ECT is effective against severe depression and is useful in people who are unable to continue with work or social activities, people who have failed to respond to courses of antidepressants and in those who refuse fluids.

DEPRESSION RELATED ITEMS

	DEPRESSION DEFINITION
	DEPRESSION DESCRIPTION
	DEPRESSION CAUSES
	DEPRESSION SYMPTOMS
	DEPRESSION DIAGNOSIS
	DEPRESSION TREATMENTS
	DEPRESSION PROGNOSIS
	DEPRESSION INFORMATION
	DEPRESSION PREVENTION