Psychology
Clinical Depression
Clinical depression is a mental health disorder characterized by persistent feelings of sadness, hopelessness, and loss of interest in activities. It can significantly impact a person's daily functioning, relationships, and overall well-being. Symptoms may include changes in appetite, sleep disturbances, fatigue, and difficulty concentrating. Treatment often involves a combination of therapy, medication, and lifestyle changes.
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10 Key excerpts on "Clinical Depression"
eBook - ePubDepression
Current Perspectives in Research and Treatment
- Gary Christopher(Author)
- 2023(Publication Date)
- Routledge(Publisher)
Chapter 1 What is depression?DOI: 10.4324/9781315688879-1Defining depression
Even though there is a surfeit of books in the market now providing instruction on how to be happy—which is a good thing, on the whole—it is essential to know that we cannot expect to always feel positive. That is just not achievable. It is not realistic. Some days we wake ready to take on the challenge of another day; other days, we would instead prefer to stay wrapped up in our beds. This is usual. We have all experienced times in our lives when we feel down. Such feelings often accompany times of significant change. We spend most of our lives either in school or at work, and each of us knows the challenges that these bring. Even though we may feel downhearted at times, most of us are adept at bouncing back. These feelings do not last long. They may last for a few days, maybe a couple of weeks, but then we begin to feel our equilibrium restored and can cope with life as usual. In depression, this does not happen. Instead, such feelings continue for months, sometimes years, and take over a person’s life.Distinguishing between Clinical Depression and non-clinical mood states remains problematic. The most appropriate way to view depression, as it is with many mental health conditions, is to envisage a continuum of increasing severity (1 ). However, the severity of symptoms is not the only characteristic to mark out those who meet the diagnostic criteria for depression. In addition, the duration and persistence of these symptoms and the level of functional impairment the individual experiences help clinicians decide upon an accurate diagnosis.The Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5 (2
eBook - PDFAssessment and Therapy
Specialty Articles from the Encyclopedia of Mental Health
- Howard S. Friedman(Author)
- 2001(Publication Date)
- Academic Press(Publisher)
VII. CONCLUSION Depression is an experience that has been shared by most human beings at one time or another. Thus, it can be thought of as a feeling state that is within the realm of normal functioning. If the frequency, inten-sity, and duration of this feeling increase, it can be-come a pathological process. After it crosses a certain threshold, criteria for which are now well-defined, it is diagnosed as a specific mental disorder. Mental health interventions that focus on this disorder in-clude preventive, treatment, and maintenance inter-ventions, of which treatment is the most developed and the most available. The public health impact of depression is considerable. Advances in the identifica-tion and dissemination of effective mood management strategies could have a major impact in the health of our societies. BIBLIOGRAPHY Akiskal, H. S., & McKinney, W. T. J. (1973). Depressive disorders: Toward a unified hypothesis. Science, 182, 20–29. American Psychiatric Association. (1994). Diagnostic and statis-tical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association. Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press. Beckham, E. D., & Leber, W. R. (Eds.). (1995). Handbook of de-pression: Treatment, assessment, and research (2nd ed.). New York: Guilford Press. Bruce, M. L., Takeuchi, D. T., & Leaf, P. J. (1991). Poverty and psychiatric status: Longitudinal evidence from the New Haven Epidemiologic Catchment Area Study. Archives of General Psy-chiatry, 48, 470 – 474. Depression Guideline Panel. (1993). Depression in primary care: Vol. 1. Detection and diagnosis (Clinical Practice Guideline No. 5 AHCPR Publication No. 93-0550). Rockville, MD: De-partment of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research. Depression Guideline Panel. (1993). Depression in primary care: Vol.
- David Pilgrim, Anne Rogers, Bernice Pescosolido, David Pilgrim, Anne Rogers, Bernice Pescosolido(Authors)
- 2010(Publication Date)
- SAGE Publications Ltd(Publisher)
They also reveal how deeply depression is embedded in the cultural and social conditions. For this reason, it is crucial to look at depression in its cultural context and to consider its social determinants. Pilgrim and Bentall (1999) point out that using existing clinical definitions, two individuals with completely different symptoms could be diagnosed with the same condition. This is because depression and its diagnostic criteria overlap with other conditions to such an extent that it is most often impossible to distinguish in a particular case between depression, anxiety or even medical conditions, such as chronic fatigue syndrome (Pilgrim and Bentall, 1999). Some theorists thus see depression as existing on a continuum with ‘normal’ states (Schwartz, 2000). However, others see it as cat-egorically different and not related to ‘normal’ states of unhappiness or sadness. Kleinman and Good (1985) in a study of the relevance of the concept of depres-sion across culture argue that depression differs depending on who identifies and defines it. For clinicians, they comment, ‘depression is a common, often severe, sometimes mortal disease with characteristic affective (sadness, irritability, joy-lessness), cognitive (difficulty concentrating, memory disturbance) and vegetative (sleep, appetite, energy disturbances) complaints which has a typical course and predictable response rates to treatment’ (Kleinman and Good, 1985: 9). Following Foucault (1973) and Porter (2002), Bendelow (2009) argues that ‘across most of “western” society the growth of scientific medicine in general and psychiatry in particular has meant that medicalization has been the most dominant means of response [to emotional instability] since the nineteen century’ (Bendelow, 2009: 81).
eBook - PDFWhat Works for Whom?, Second Edition
A Critical Review of Psychotherapy Research
- Anthony Roth, Peter Fonagy(Authors)
- 2013(Publication Date)
- The Guilford Press(Publisher)
C H A P T E R 4 DEPRESSION DEFINITIONS DSM-IV-TR describes a number of subcategories of depression; those par- ticularly relevant to research studies are defined as follows (adapted from Wells, 1985). Major Depressive Disorder Major depressive disorder (MDD) is characterized by one or more major depressive episodes and the absence of manic episodes. A major depressive episode is defined by depressive mood or loss of interest or pleasure in almost all usual activities, accompanied by other depressive symptoms. These include disturbances in appetite, weight, and sleep; psychomotor agitation or retarda- tion; decreased energy; feelings of worthlessness or guilt; difficulty concen- trating or thinking; and thoughts of death or suicide, or suicidal attempts. DSM-IV-TR specifies that at least five of nine specific depressive symptoms must be present nearly every day for at least 2 weeks to make a diagnosis of MDD, and that the symptoms cause clinically significant distress or impair- ment in social, occupational, or other important areas of functioning. Depressive episodes are distinguished from normal bereavement reactions. Dysthymic Disorder This disorder is characterized by depressed mood or loss of interest in nearly all usual activities, though symptom severity is not sufficient to meet the cri- teria for MDD. The disorder is, by definition, chronic. Symptoms should be present for at least 2 years, and a diagnosis cannot be made if patients are 66 symptom-free for more than 2 months in any 2-year period. It is character- ized by depressed mood for most of the day, together with at least two of the following six symptoms: poor appetite, insomnia or hypersomnia, low energy, low self-esteem, poor concentration, and feelings of hopelessness. For diagnostic purposes, these symptoms should be severe enough to cause clini- cally significant distress or impairment in social, occupational, or other areas of functioning.
eBook - PDFThe Troubled Mind
A Handbook of Therapeutic Approaches to Psychological Distress
- Susy Churchill(Author)
- 2020(Publication Date)
- Red Globe Press(Publisher)
41 Chapter 3 Clients Presenting with Depression INTRODUCTION ‘Depression’ is probably the most common form of emotional distress (Gelder et al., 2005). This was not always the case, and there are claims that the drug companies ‘created’ the modern diagnosis of ‘depression’ to provide a market for their newly developed antidepressants (Healy, 2005). All practising counsellors and psychotherapists will see ‘clients with depression’: while there are certain therapeutic interventions that are normally useful, it is vital to identify the meaning to the client. Fundamentally, depression indicates a sense of loss: loss of enjoyment, of self-belief, of hope. There are physical symptoms too, and whenever you meet a client who appears depressed, it is important to check whether they have seen their doctor, as a number of physical illnesses also cause these symptoms. Depressive features are also frequent in other forms of emotional distress, such as eating disorders or obsessive-compulsive disorder. Mania is much less common, but it is important that we are aware of its symptoms. In this chapter, we’ll consider the different diag-noses listed under the heading of ‘mood disorders’, different theoretical perspectives on what causes depression, the therapeutic approaches recommended by NICE and some interventions which are helpful. The aims are to: ■ Clarify what is meant by ‘depression’. ■ Identify what help would be provided within the NHS. ■ Consider what we as counsellors/psychotherapists can offer. 42 THE TROUBLED MIND PSYCHIATRIC CLASSIFICATIONS OF MOOD DISORDERS Remember, ‘depression’ as currently classified is common – it’s likely to affect about 15% of us (NHS, 2009) – but many people won’t make it into official statistics, because they don’t go to the doctor, and they won’t Client stories George is 43, and a partner in a firm of solicitors.
No longer available |Learn more- (Author)
- 2014(Publication Date)
- Research World(Publisher)
Appetite often decreases, with resulting weight loss, although increased appetite and weight gain occasionally occur. Family and friends may notice that the person's behavior is either agitated or lethargic. The concept of depression is more controversial in regards to children, and depends on the view that is taken about when self-image develops and becomes fully established. Depressed children may often display an irritable mood rather than a depressed mood, and show varying symptoms depending on age and situation. Most lose interest in school and show a decline in academic performance. They may be described as clingy, dem-anding, dependent, or insecure. Diagnosis may be delayed or missed when symptoms are interpreted as normal moodiness. Depression may also coexist with attention-deficit hyperactivity disorder (ADHD), complicating the diagnosis and treatment of both. Older depressed people may have cognitive symptoms of recent onset, such as forget-fulness, and a more noticeable slowing of movements. Depression often coexists with physical disorders common among the elderly, such as stroke, other cardiovascular diseases, Parkinson's disease, and chronic obstructive pulmonary disease. ________________________ WORLD TECHNOLOGIES ________________________ Causes The biopsychosocial model proposes that biological, psychological, and social factors all play a role in causing depression. The diathesis–stress model specifies that depression results when a preexisting vulnerability, or diathesis, is activated by stressful life events. The preexisting vulnerability can be either genetic, implying an interaction between nature and nurture, or schematic, resulting from views of the world learned in childhood. These interactive models have gained empirical support. For example, researchers in New Zealand took a prospective approach to studying depression, by documenting over time how depression emerged among an initially normal cohort of people.
No longer available |Learn more- (Author)
- 2014(Publication Date)
- College Publishing House(Publisher)
Appetite often decreases, with resulting weight loss, although increased appetite and weight gain occasionally occur. Family and friends may notice that the person's behavior is either agitated or lethargic. The concept of depression is more controversial in regards to children, and depends on the view that is taken about when self-image develops and becomes fully established. Depressed children may often display an irritable mood rather than a depressed mood, and show varying symptoms depending on age and situation. Most lose interest in school and show a decline in academic performance. They may be described as clingy, de-manding, dependent, or insecure. Diagnosis may be delayed or missed when symptoms are interpreted as normal moodiness. Depression may also coexist with attention-deficit hyperactivity disorder (ADHD), complicating the diagnosis and treatment of both. Older depressed people may have cognitive symptoms of recent onset, such as forget-fulness, and a more noticeable slowing of movements. Depression often coexists with physical disorders common among the elderly, such as stroke, other cardiovascular dis-eases, Parkinson's disease, and chronic obstructive pulmonary disease. Causes The biopsychosocial model proposes that biological, psychological, and social factors all play a role in causing depression. The diathesis–stress model specifies that depression results when a preexisting vulnerability, or diathesis, is activated by stressful life events. The preexisting vulnerability can be either genetic, implying an interaction between nature and nurture, or schematic, resulting from views of the world learned in childhood. These interactive models have gained empirical support. For example, researchers in New Zealand took a prospective approach to studying depression, by documenting over time how depression emerged among an initially normal cohort of people. The re-
eBook - PDFDepression
A Primer for Practitioners
- Steven Richards, Michael G. Perri(Authors)
- 2002(Publication Date)
- SAGE Publications, Inc(Publisher)
Depression is more common among adult women than men. Depression often occurs with other mental disorders, includ-ing anxiety disorders, substance abuse, and eating disorders; it is also frequently associated with chronic health problems, such as cancer and heart disease. The typical episode of depression lasts from 12 to 20 weeks. Most depressed people recover within a year, but most of these people will relapse back to serious depression on several occasions during their lifetime. Thus, prevention of relapse is a major treatment challenge facing depressed patients and their therapists. Clinical guidelines for the assessment of depressed patients were presented, including recommendations to always conduct a thorough interview and to never omit an assessment of the potential for suicide. 16 DEPRESSION: SYMPTOMS AND THEORIES ABOUT THERAPIES Suggested Readings At the end of each chapter, we present a few suggested readings. This will be helpful for practitioners who wish to pursue a few of the most important and recent readings regarding the topics in that chapter. Discussions Diagnosis • DSM-IV-TR (American Psychiatric Association, 2000a) is used by most mental health professionals in the United States. The DSM-IV was initially published in 1994 (American Psychiatric Association, 1994). A newer edition with revised text—but identical diagnostic criteria—was published in 2000 (American Psychiatric Association, 2000a). Although the diagnostic criteria remain the same in the 2000 edition, its text discussions of matters such as prevalence, asso-ciated features, and course of depression have been updated. This reference is indispensable for practitioners who frequently work with depressed patients. Comorbid Conditions • Mineka et al. (1998) reviewed the association between depression and anxiety disorders. These comorbid conditions are common, and this scholarly review is interesting and helpful.
eBook - PDF- Helen Herrman, Mario Maj, Norman Sartorius(Authors)
- 2009(Publication Date)
- Wiley(Publisher)
The revival and resurgence of the term ‘melancholia’ does not help matters much; similarly the connotation of ‘bipolar’ could be misleading. Diagnosing depression as major or minor depression, masked and double depression is confusing to those who are fresh trainees into psychiatry. The implications could be misleading, as chronic minor depression may be more distressing than brief mild major depression. There are also difficulties in diagnosing the erstwhile atypical depression and neurotic depression. This assumes importance since in clinical practice one still encounters these categories. One should search for an appropriate scientific and medical term to describe depressive disorders. Currently, a web search for ‘depression’ leads to depression in the stock market, weather, earth, endocrinal functions, depressed fractures and bones, to name a few. The term ‘depression’ is too general and vague, and it is time for it to be replaced in the psychiatric nomenclature and taxonomy. Overall, there are more problems and difficulties diagnosing and classifying depressive disorders than solutions. Many attempts are being made to reduce the difficulties, but no appropriate solution seems to be emerging in the horizon. COMMENTARY 1.4 Severity and Subtypes of Depression Jules Angst Zurich University Psychiatric Hospital Research Department, Zurich, Switzerland Every creative new suggestion for defining subgroups of depression is welcome, especially a new definition of melancholia, as given by Gordon Parker, based on precise measures of psychomotor activity. The main point of the author goes further, however, as he proposes a new classification of depressive disorders. DIMENSIONAL CONCEPT OF DEPRESSION The current concept of depression is mainly categorical but also takes account of severity .
eBook - PDF- Paul C. Etter, James E. Ellison, Helen H. Kyomen, Sumer Verma, James E. Ellison, Helen H. Kyomen, Sumer Verma(Authors)
- 2008(Publication Date)
- CRC Press(Publisher)
These numbers take on alarming significance in light of the recent findings that link the presence of depression in later life with impaired functioning, diminished quality of life, excess use of nonpsychiatric med-ical services, and potentially dire health consequences including early mortality from suicide and other causes. Fortunately, the past decade has seen outstanding advances in our knowledge of depression’s characteristic clinical manifestations in older adults as well as its pathophysiology and optimal treatments. Recognition of late-life depression remains a prerequisite to treatment. Clini-cal awareness has improved in recent years, but even more aggressive case finding is needed. For a variety of reasons discussed in depth in chapter 5, treatment for late-life depression is typically first sought in the primary care setting. Many primary care clinicians consider the diagnosis and treatment of late-life depression as their responsibility, yet acknowledge their skills in this area to be inadequate (1). They discuss depression infrequently with their elderly patients (2) and may overlook its 1 2 Lawrence et al. presence in the hustle of a busy primary care practice. Mental health professionals, too, miss the presence of significant depressive symptoms in older individuals, or mistakenly attribute them to the effects of adverse life events, medical illnesses, or cognitive impairments. To aid recognition of late-life depression and suggest initial evaluative steps, this chapter will review the characteristics of late-life depression and discuss the usual process of assessment. The most commonly used diagnostic instruments, lab-oratory tests, and imaging studies will be reviewed. Many topics touched upon in this discussion are addressed in greater detail elsewhere in this book. Bipolar disor-der, in particular, is reviewed comprehensively in chapter 4, although some of the issues associated with unipolar depression also apply to bipolar depression.
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