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    (Wikipedia) - Depression (mood)   (Redirected from Unhappy) "Despair" redirects here. For other uses of despair, see Despair (disambiguation). For the mood disorder, see Major depressive disorder.Melencolia I (ca. 1514), by Albrecht Dürer

    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. Depressed people can feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable 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.

    Depression is a feature of some psychiatric syndromes such as major depressive disorder but it may also be a normal reaction to certain life events, a symptom of some bodily ailments or a side effect of some drugs and medical treatments.


    Causes Life events

    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.

    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.

    Medical treatments

    Certain medications are known to cause depressed mood in a significant number of patients. These include interferon therapy for hepatitis C.

    Non-psychiatric illnesses Main article: Depression (differential diagnoses)

    Depressed mood can be the result of a number of infectious diseases, nutritional deficiencies, neurological conditions and physiological problems, including hypoandrogenism (in men), Addison''s disease, Lyme disease, multiple sclerosis, chronic pain, stroke, diabetes, cancer, sleep apnea, and disturbed circadian rhythm. It is often one of the early symptoms of hypothyroidism (reduced activity of the thyroid gland).

    Psychiatric syndromes 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 episodes of depression. 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 often 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;:355 and posttraumatic stress disorder, an anxiety disorder that sometimes follows trauma, is commonly accompanied by depressed mood.

    Drug use
    This section requires expansion. (April 2014)

    Depression is associated with abusive drug use. Both legal and illegal drugs can be abused.


    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.

    Treatment 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. Different sub-divisions of depression have different treatment approaches.

    The UK National Institute for Health and Care Excellence (NICE) 2004 guidelines indicate that antidepressants should not be used for the initial treatment of mild depression, because the risk-benefit ratio is poor. The guidelines recommend that antidepressants treatment in combination with psychosocial interventions should be considered for:

    The guidelines further note that antidepressant treatment should be continued for at least 6 months to reduce the risk of relapse, and that SSRIs are better tolerated than tricyclic antidepressants.

    The American Psychiatric Association 2000 Practice Guideline for the Treatment of Patients with major depressive disorder indicates that, if preferred by the patient, antidepressant medications may be provided as an initial primary treatment for mild major depressive disorder; antidepressant medications should be provided for moderate to severe major depressive disorder unless electroconvulsive therapy is planned; and a combination of antipsychotic and antidepressant medications or electroconvulsive therapy should be used for psychotic depression. It states that efficacy is generally comparable between classes and within classes and that the initial selection will largely be based on the anticipated side-effects for an individual patient, patient preference, quantity and quality of clinical trial data regarding the medication, and its cost.

    Irving Kirsch has argued that 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."

    Moderate levels of physical activity can treat depression by increasing the levels of endorphins and the neurotransmitters serotonin, dopamine, and norepinephrine. 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. 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.

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