Depression

Depression is, in the normal individual, a state of despondency characterized by feelings of inadequacy, lowered activity, and pessimism about the future. In pathological cases, it is an extreme state of unresponsiveness to stimuli, together with self-depreciation, delusions of inadequacy, and hopelessness. According to Coleman, “Most of us are prone to repeated cycles in and out of this state throughout our lives. Depression is unpleasant, even noxious when, we are in it, but it usually does not last very long; sometimes, it seems almost to be self-limiting. As we come out of it, we often experience it as having been in some sense useful.”
In most instances, people suffering from normal depression will not take specialized services of a mental health professional. Normal depression may be the outcome of recent stress; adjustment disorder; grief due to the death of a loved one; loss of a favored status or position; separation or divorce; financial loss; and retirement from a valued occupation. All these reasons may have some serious effects on the mind of an individual and the very life is disrupted in some instances. The individual loses interest in nearly all external happenings and often becomes very actively involved in fantasies.Thereafter, a process of erasure occurs because of repetition of the fantasies those that were very painful initially-gradually lose their capacity to evoke pain. The capability for response to the external world is gradually regained, sadness abates, zest returns and the individual moves out again into a more productive engagement. This is the normal pattern but some people, however, become stuck in the middle of the sequence.

Other normal mood variations. Depressive feelings arise in life due to many situations other than loss too. For example, the doctoral candidates in various disciplines, including those in clinical psychology, most often undergo depressive reactions after completion of viva voce. Fifty percent of women experience an attack of “the blues” following childbirth. College students experience greater or lesser bouts of depression during study and it involved chiefly three main psychological variables: (a) dependency; (b) self-criticism; and (c) inefficacy.

Mild to moderate affective disorders. There are three principal dimensions to differentiate the affective disorders in a customary mode: (a) severity-disfunctions and degree of impairment; (b) type-depressive, manic, or mixed symptoms; (c) duration-acute, chronic, or intermittent, with periods of normal functioning. These are stated below:

Cyclothymic disorder. Cyclical mood alterations with excesses of elation (hypomania) and depression that are not disabling but real, having physical existence, occur. In depression, the person’s mood is dejected and distinct loss of interest or pleasure in usual activities and pastimes. Sleep irregularity, low energy level, and feelings of inadequacy, decreased efficiency, productivity, talkativeness, and cognitive sharpness, social withdrawal, a pessimistic and brooding attitude, and tearfulness are other problems. Hypomanic phase consists essentially of the opposite of these characteristics.

Dysthymic disorder. Symptoms are same as indicated for the depressed phase of cyclothymic disorder. The difference is that dysthymic disorder lacks hypomanic episodes.

Adjustment disorder with depressed mood. It is, behaviorally, indistinguishable from dysthymic disorder or the depressed phase of cyclothymic disorder. Instead of the latter two conditions it requires the existence of an identifiable psychosocial stressor in the person’s life within three months before the onset of depression.

Moderate to severe affective disorders. The difference between mild and severe affective disorders is of degree of abnormality. In fact, a biological defect or aberration- that renders the person liable to episodes of more or less severe affective disorder-implies. On the contrary, it is possible to have a major affective disorder with only mild current symptoms. Severe symptoms-either manic or depressed-are almost never considered, the outward manifestations of a major disorder.

Major depression. The individual has one or more major depressive episodes in the absence of any manic episode. Prominent and persistent depressed mood, accompanied by symptoms, such as, poor appetite, insomnia, psychomotor retardation, fatigue, feelings of worthlessness or guilt, inability to concentrate, and thoughts of death or suicide.

Bipolar disorder. The individual experiences a major depressive episode (as above) and has had one or more manic episodes.

Schizoaffective disorder. Unlike schizophrenia, the schizoaffective disorder tends to be very episodic, individual attacks, lucid periods between episodes, and recovery using five-year criterion-all characteristics of affective disorders.

Causes of affective disorders. Biological factors include 1.Hereditary predisposition. 2. Neurophysiological factors. 3. Biochemical factors.

Psychosocial factors include 1.Stress as a precipitating factor. 2. Predisposing personality characteristics. 3. Feelings of helplessness and loss of hope. 4. Extreme defenses against stress. 5. Interpersonal effects of affective disorders.

Sociocultural factors.Affective disorder seems to vary considerably among different societies. In addition, the different types of depressive disorder are mentioned below:

Organic affective syndrome, depressed.

Primary degenerative dementia with depression

Multi-infarct dementia with depression

Hallucinogen affective disorder, depressed.                                          *                  *                   *                *

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