History of present illness Determine history of present illness: Onset may be gradual over months or years or may be abrupt. [icsi.org]

[…] of interest) Persistent depressive disorder (dysthymia) Symptoms are present for ≥ 2 years. [amboss.com]

Symptoms, which must be present nearly every day, include: Depressed mood most of the day, nearly every day, as indicated by self-reporting or through observations made by others; in children and adolescents, this can present as irritability Markedly [baptisthealth.com]

Agitated depression (a major depressive episode with psychomotor agitation) is proposed to be a form of mixed depression as other symptoms of hypomania are often present. [psychscenehub.com]

Postpartum depression is present in new mothers experiencing hormonal fluctuations after childbirth that can be exacerbated by stressors relating to raising a child. [therecoveryvillage.com]

• Fatigue

  […] for at least 2 weeks, with at least one of the symptoms being depressed mood or anhedonia Depressed mood for most of the day, almost every day Sleep disturbance (insomnia or hypersomnia) Anhedonia Feelings of worthlessness or disproportionate guilt Fatigue [amboss.com]

  Major depressive disorder is a mood disorder characterized by a number of key features: Depressed mood Lack of interest in activities normally enjoyed Changes in weight Changes in sleep Fatigue Feelings of worthlessness and guilt Difficulty concentrating [verywellmind.com]

  More In mental disorder: Major mood disorders Symptoms of major depressive disorder include a sad or hopeless mood, pessimistic thinking, a loss of enjoyment and interest in one’s usual activities and pastimes, reduced energy and vitality, increased fatigue [britannica.com]

  […] of the time: Depressed mood Loss of interest in things you usually enjoy They must also have at least three of the following symptoms, most of the time: Appetite changes with unintentional weight loss or gain Slow thoughts and slow physical movements Fatigue [kidshelpline.com.au]

  Fatigue or loss of energy Headaches Changes in eating habits and weight fluctuations Lethargy and fatigue Depression manifests differently in children, as they may appear more irritable and agitated than sad. [therecoveryvillage.com]

• Weight Gain

  gain and requiring more sleep. [amboss.com]

  Reduced appetite and weight loss, or increased appetite and weight gain. Loss of pleasure and interest in activities once enjoyed, including sex. Restlessness, irritability. [mhawisconsin.org]

  Symptoms of Depression feeling tired or feeling as though you have no energy getting too much or too little sleep decreased appetite with weight loss or increased appetite with weight gain a slowdown of mental and physical activity difficulty thinking [study.com]

  Winter depression, typically accompanied by social withdrawal, increased sleep, and weight gain, predictably returns every year in seasonal affective disorder. [nimh.nih.gov]

  Excess weight gain or malnutrition: Overeating or undereating puts a person at risk for a variety of health conditions. Other psychological issues: These may include anxiety, panic disorders or social phobias. [baptisthealth.com]

• Weight Loss

  […] in all (or almost all) activities most of the day, nearly every day; may be subjective or observed by others Weight loss or gain Significant weight loss (without dieting) or gain (change of >5% body weight in a month), or decrease or increase in appetite [mdcalc.com]

  […] with unintentional weight loss or gain Slow thoughts and slow physical movements Fatigue/low energy Feeling worthless or guilty Recurring thoughts of death or suicide These symptoms must last for two weeks or more. [kidshelpline.com.au]

  Reduced appetite and weight loss, or increased appetite and weight gain. Loss of pleasure and interest in activities once enjoyed, including sex. Restlessness, irritability. [mhawisconsin.org]

  Symptoms of Depression feeling tired or feeling as though you have no energy getting too much or too little sleep decreased appetite with weight loss or increased appetite with weight gain a slowdown of mental and physical activity difficulty thinking [study.com]

  […] leading to weight loss or gain Recurrent suicidal ideation For differential diagnosis, physicians must investigate whether a patient has ever experienced a manic episode, which could indicate bipolar disorder; depressive symptoms could also be related [news-medical.net]

• Hypersomnia

  Depressed mood, in addition to the presence of ≥ 2 of the following symptoms: Poor appetite or overeating Insomnia or hypersomnia Low energy or fatigue Low self-esteem Poor concentration or difficulty making decisions Feelings of hopelessness Depression [amboss.com]

  […] observed by others Weight loss or gain Significant weight loss (without dieting) or gain (change of >5% body weight in a month), or decrease or increase in appetite nearly every day; in children, may be failure to gain weight as expected Insomnia or hypersomnia [mdcalc.com]

  […] presence of two (or more) of the following: Feelings of hopelessness Low self-esteem Low energy or fatigue Poor appetite or overeating Difficulty with concentration and decision-making Difficulty falling/staying asleep (insomnia) or sleeping too much (hypersomnia [my.clevelandclinic.org]

  They also have ≥ 2 of the following: overreaction to perceived criticism or rejection, feelings of leaden paralysis (a heavy or weighted-down feeling, usually in the extremities), weight gain or increased appetite, and hypersomnia. [merckmanuals.com]

• Family History of Depression

  Medications - Side effects of some medications can bring about depression. Genetic - A family history of depression increases the risk for developing the illness. [mhanational.org]

  People with a family history of depression are more likely to experience it themselves. But you can also become depressed for no obvious reason. [nhs.uk]

  […] cortisol secretion appear to be confined to subjects with a family history of depression at that age. [medicographia.com]

  These include people who have (or have a family history of) depression, bipolar illness (also called manic-depressive illness) or have a history of suicidal thoughts or actions. [fetzima.com]

  A follow-up assessment may ask about: thoughts, feelings and behavior any history of mental health problems and what treatments were helpful in the past physical health problems family history of mental health problems your day-to-day life: relationships [camh.ca]

• Overeating

  And when they ruminate on these things, when they turn them over and over in their minds, it's possible that these cognitive distortions might lead to depression. [khanacademy.org]

  A chronic episode was defined as having a current diagnosis at the follow-up assessment and consistent symptoms over 2 years. [bmcmedicine.biomedcentral.com]

  A perpetuating cause is one that worsens an individual’s current condition and can be said to push someone “over the edge” into depression. [courses.lumenlearning.com]

  Accordingly, the domain of time is central in the diagnosis of major depression, its prognosis, and its tendency to recur often over a lifetime. [medicographia.com]

  (Beck et al., 2014; Stewart, Ricci, Chee, Hahn, & Morganstein, 2003) Depression and Suicide Depression is the cause of over two-thirds of the 30,000 reported suicides in the U.S. each year. [dbsalliance.org]

• Increased Appetite

  Reduced appetite and weight loss, or increased appetite and weight gain. Loss of pleasure and interest in activities once enjoyed, including sex. Restlessness, irritability. [mhawisconsin.org]

  Symptoms of Depression feeling tired or feeling as though you have no energy getting too much or too little sleep decreased appetite with weight loss or increased appetite with weight gain a slowdown of mental and physical activity difficulty thinking [study.com]

  To remember the symptoms of dysthymia, think of “HE'S 2 SAD”: Hopelessness (insomnia or hypersomnia), Energy loss or fatigue, Self-esteem is low, 2 years minimum of depressed mood, Sleep increased or decreased, Appetite increased or decreased, Decision-making [amboss.com]

  Other symptoms of atypical depression include: Increased appetite Sleeping more than usual Feeling of heaviness in your arms and legs Oversensitive to criticism Antidepressants can help. [webmd.com]

  They also have ≥ 2 of the following: overreaction to perceived criticism or rejection, feelings of leaden paralysis (a heavy or weighted-down feeling, usually in the extremities), weight gain or increased appetite, and hypersomnia. [merckmanuals.com]

• Loss of Appetite

  Symptoms of depression may be different or less obvious in older adults, such as: Memory difficulties or personality changes Physical aches or pain Fatigue, loss of appetite, sleep problems or loss of interest in sex — not caused by a medical condition [mayoclinic.org]

  Other symptoms of MDD include sleep disturbance, loss of appetite, and thoughts of suicide. [amboss.com]

• Constipation

  The most common side effects of FETZIMA include: Nausea, vomiting, constipation, sweating, abnormal heart beat, and erectile dysfunction. Tell your healthcare provider if you have any side effect that bothers you or that does not go away. [fetzima.com]

• Bulimia Nervosa

  Examples of disorders that we evaluate in this category include anorexia nervosa, bulimia nervosa, binge-eating disorder, and avoidant/restrictive food disorder. Trauma- and stressor-related disorders (12.15). [ssa.gov]

• Low Self-Esteem

  Depressive Disorders Clinical depression is characterized by pervasive and persistent low mood that is accompanied by low self-esteem and a loss of interest. [courses.lumenlearning.com]

  Symptoms of PDD include: Low mood, hopelessness, or emptiness Low self-esteem Irritability Worry or guilt Loss of interest in things you usually enjoy Difficulties concentrating or making decisions Changes in sleep (too much sleep or not enough sleep) [heretohelp.bc.ca]

  Depressed mood, in addition to the presence of ≥ 2 of the following symptoms: Poor appetite or overeating Insomnia or hypersomnia Low energy or fatigue Low self-esteem Poor concentration or difficulty making decisions Feelings of hopelessness Depression [amboss.com]

  Although not as severe as those of major depression, symptoms of persistent depressive disorder also include the presence of two (or more) of the following: Feelings of hopelessness Low self-esteem Low energy or fatigue Poor appetite or overeating Difficulty [my.clevelandclinic.org]

  Cognitive - People with negative thinking patterns and low self-esteem are more likely to develop clinical depression. Gender - More women experience depression than men. [mhanational.org]

• Feeling of Worthlessness

  […] or concentrating feelings of worthlessness or guilt thoughts of death or suicide When someone has major depressive disorder, they experience at least five of the above symptoms as well as feelings of sadness or loss of interest in activities for most [study.com]

  This avoids adding to the already present feelings of worthlessness or guilt and also addresses the physical fatigue or loss of energy and disturbed sleep (sleeping too much or difficulty sleeping) they are likely experiencing. [psychepllc.com]

  Major depressive disorder (MDD), or ‘clinical depression’, is described as feelings of persistent sadness, worthlessness and hopelessness. [news-medical.net]

  […] of restlessness or being slowed down) Fatigue or loss of energy nearly every day Feelings of worthlessness or excessive or inappropriate guilt nearly every day Diminished ability to think, concentrate, or be decisive, nearly every day Recurrent thoughts [pyramidhealthcarepa.com]

• Delusion

  The characteristic features of a depressed patient are: in a mild to moderate case: a sad appearance sad feelings sad thought processes biological symptoms and sign of depression in a severe case: delusions of worthlessness, guilt, nihilism etc hallucinations [gpnotebook.com]

  Psychotic depression occurs when a person has severe depression plus some form of psychosis, such as having disturbing false fixed beliefs (delusions) or hearing or seeing upsetting things that others cannot hear or see (hallucinations). [nimh.nih.gov]

  This can involve hallucinations (seeing or hearing things that aren't there) or delusions (false beliefs that aren't shared by others), such as believing they are bad or evil, or that they're being watched or followed. [beyondblue.org.au]

  Depression with psychosis: In some cases, depression may become so severe that a person loses touch with reality and experiences hallucinations (hearing voices or seeing people or objects that are not really there) or delusions (beliefs that have no basis [camh.ca]

  Symptoms include: Loss of inhibition Depression Paranoia Hallucinations Delusions Suicidal ideation Thoughts of harming the baby Diagnosis Postpartum blues can increase the risk of major depression. [amboss.com]

• Suicidal Ideation

  ideation The diagnostic criteria for major depression, mild depression and dysthymia are available in the linked item. [gpnotebook.com]

  It has been reported that some people, especially teenagers, experience more suicidal ideation in the first few weeks of taking SSRIs; these are therefore not recommended for this age group. [news-medical.net]

  Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without specific plan, or suicide attempt, or a specific plan for suicide Additional required criteria Must have all 4, plus ≥5 depressive symptoms above Symptoms cause [mdcalc.com]

  There was a nonsignificant trend toward an increase in suicidal ideation (1.2% vs 0.8%), self-harm (3.3% vs 2.6%), and suicide attempts (1.9% vs 1.2%). [merckmanuals.com]

• Dysthymic Disorder

  Late onset dysthymic disorder and major depression differ from early onset dysthymic disorder and major depression in elderly outpatients. J Affect Disord. 2004; 78: 259-267 31. Klein DN Schatzberg AF McCullough JP et al. [thelancet.com]

  […] of two previous diagnoses: chronic major depressive episode and dysthymic disorder. [my.clevelandclinic.org]

  Also called: Clinical depression, Dysthymic disorder, Major depressive disorder, Unipolar depression Summary Depression is a serious medical illness. It's more than just a feeling of being sad or "blue" for a few days. [medlineplus.gov]

  course, risk factors, and pharmacological and psychotherapy treatments of children and adolescents with major depressive or dysthymic disorders. [adolescenthealth.org]

  This diagnosis combines the previous disorders of chronic major depressive disorder and dysthymic disorder, as there was no evidence for meaningful differences between these two conditions. [courses.lumenlearning.com]

• Sexual Dysfunction

  Treatment Pharmacotherapy Therapeutic principles First-line: SSRIs Alternative options SNRIs Atypical antidepressants Bupropion: lowers seizure threshold, results in less sexual dysfunction compared to SSRIs, and can also treat tobacco dependence Mirtazapine [amboss.com]

  Beta-blocker therapy and symptoms of depression, fatigue, and sexual dysfunction. JAMA. 2002 Jul 17. 288(3):351-7. [Medline]. [medscape.com]

• Agitation

  Agitated depression (a major depressive episode with psychomotor agitation) is proposed to be a form of mixed depression as other symptoms of hypomania are often present. [psychscenehub.com]

  Symptoms may include: changes in your mood, irritability and agitation, dizziness, electric shock sensation (paresthesia), anxiety, confusion, headache, tiredness, problems sleeping, hypomania, ringing in your ears (tinnitus) and seizures. [fetzima.com]

  Fatigue or loss of energy Headaches Changes in eating habits and weight fluctuations Lethargy and fatigue Depression manifests differently in children, as they may appear more irritable and agitated than sad. [therecoveryvillage.com]

  Significant weight loss (without dieting) or gain (change of >5% body weight in a month), or decrease or increase in appetite nearly every day; in children, may be failure to gain weight as expected Insomnia or hypersomnia Nearly every day Psychomotor agitation [mdcalc.com]

  Common symptoms include: Changes in sleep Changes in appetite Lack of concentration Loss of energy Lack of interest in activities Hopelessness or guilty thoughts Changes in movement (less activity or agitation) Physical aches and pains Suicidal thoughts [nami.org]

• Insomnia

  Depressed mood, in addition to the presence of ≥ 2 of the following symptoms: Poor appetite or overeating Insomnia or hypersomnia Low energy or fatigue Low self-esteem Poor concentration or difficulty making decisions Feelings of hopelessness Depression [amboss.com]

  Depression is diagnosed when negative feelings, lack of interest in previous activities, and physical symptoms like fatigue and insomnia persist for at least 2 weeks. [childmind.org]

  […] subjective or observed by others Weight loss or gain Significant weight loss (without dieting) or gain (change of >5% body weight in a month), or decrease or increase in appetite nearly every day; in children, may be failure to gain weight as expected Insomnia [mdcalc.com]

  […] depressive disorder also include the presence of two (or more) of the following: Feelings of hopelessness Low self-esteem Low energy or fatigue Poor appetite or overeating Difficulty with concentration and decision-making Difficulty falling/staying asleep (insomnia [my.clevelandclinic.org]

  For diagnosis of persistent depressive disorder, patients must have had a depressed mood for most of the day for more days than not for ≥ 2 years plus ≥ 2 of the following: Poor appetite or overeating Insomnia or hypersomnia Low energy or fatigue Low [merckmanuals.com]

• Headache

  Symptoms may include headache, difficulty concentrating, memory changes, confusion, weakness, and unsteadiness on your feet. [fetzima.com]

  Clinical features of headache patients with fibromyalgia comorbidity. J Headache Pain. 2011;12:629-38. [ Links ] 105. Mutschler I, Ball T, Wankerl J, Strigo IA. [scielo.org.co]

  Symptoms can include Feeling sad or "empty" Loss of interest in favorite activities Overeating, or not wanting to eat at all Not being able to sleep, or sleeping too much Feeling very tired Feeling hopeless, irritable, anxious, or guilty Aches or pains, headaches [medlineplus.gov]

  […] fixating on past failures or self-blame Trouble thinking, concentrating, making decisions and remembering things Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide Unexplained physical problems, such as back pain or headaches [mayoclinic.org]

  Fatigue or loss of energy Headaches Changes in eating habits and weight fluctuations Lethargy and fatigue Depression manifests differently in children, as they may appear more irritable and agitated than sad. [therecoveryvillage.com]

• Personality Change

  Symptoms of depression may be different or less obvious in older adults, such as: Memory difficulties or personality changes Physical aches or pain Fatigue, loss of appetite, sleep problems or loss of interest in sex — not caused by a medical condition [mayoclinic.org]

• Behavior Problem

  Catatonic depression occurs in individuals experiencing motor difficulties, such as immobilization or involuntary movements and behavioral problems Symptoms of Major Depressive Disorder Symptoms of major depressive disorder include: Low mood and anhedonia [therecoveryvillage.com]

Unfortunately, though treatment for depression is almost always successful, fewer than half of those suffering from this illness seek treatment. [mhawisconsin.org]

[…] and ineffective treatment Current treatments in MDD have issues in efficacy: Lengthy and ineffective treatments can prolong patient suffering, reduce expectations, and reinforce negative emotions such as hopelessness.LEU With MDD patients already at [janssenmedicalcloud.net]

Combination treatment, including both medications and psychotherapy, has been found to be more effective than either of these treatments alone.[8][9] Electroconvulsive therapy is found to be more efficacious than any other form of treatment for severe [statpearls.com]

Treatment and Ongoing Management American Academy of Pediatrics, 2007 These clinical practice guidelines assist primary care clinicians in the management of adolescent depression and the treatment and ongoing management of adolescent depression in the [adolescenthealth.org]

[…] the prognosis and testing interventions. [bmcmedicine.biomedcentral.com]

[…] reviewed: 01/2018 Links: classification epidemiology aetiology assessment clinical features diagnostic criteria differential diagnosis management of depression referral criteria from primary care - depression complications of depression prophylaxis prognosis [gpnotebook.com]

The prognosis is poor in the presence of a comorbid psychiatric disorder, personality disorder, multiple hospitalizations, and advanced age of onset. Complications MDD is one of the leading causes of disability worldwide. [statpearls.com]

DMX has been associated with: Family history of bipolar spectrum disorders Suicidality Antidepressant-induced mania Rapid cycling Young age of onset Long duration of illness Poor prognosis Severe depression Antidepressant resistance Females Comorbid anxiety [psychscenehub.com]

Thus, when they do occur together, the depressive symptoms and functional impairment tend to be more severe and the prognosis is worse compared with bereavement that is not accompanied by major depressive disorder. [psychcentral.com]

The etiology and treatment of persistent depressive disorders is much the same as that of MDD. [courses.lumenlearning.com]

Thyroid and growth hormonal abnormalities have also been implicated in the etiology of mood disorders. [statpearls.com]

The etiology is multifactorial, including both biological and psychological factors. Reduced levels of neurotransmitters (serotonin, noradrenaline, dopamine) are believed to be the pathophysiological basis in most cases. [amboss.com]

The etiology of depression in children and adolescents is unknown but is similar to etiology in adults; it is believed to result from interactions of genetically determined risk factors and environmental stress (particularly early life stress such as [merckmanuals.com]

Center for Epidemiological Studies Depression Scale for Children Bright Futures, 2015 The Center for Epidemiological Studies Depression Scale for Children (CES-DC) is a 20-item self-report depression inventory with possible scores ranging from 0 to 60 [adolescenthealth.org]

Epidemiology of major depressive disorder. Results from the national epidemiologic survey on alcoholism and related conditions. Arch Gen Psychiatry. 2005;62:1097-106. [ Links ] 33. [scielo.br]

Last reviewed: 01/2018 Links: classification epidemiology aetiology assessment clinical features diagnostic criteria differential diagnosis management of depression referral criteria from primary care - depression complications of depression prophylaxis [gpnotebook.com]

Epidemiology References: [2][3][4] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

Eaton WWKessler LG Epidemiologic Field Methods in Psychiatry: The NIMH Epidemiologic Catchment Area Program. Orlando, Florida Academic Press, Inc1985; 39. [jamanetwork.com]

Reduced levels of neurotransmitters (serotonin, noradrenaline, dopamine) are believed to be the pathophysiological basis in most cases. Other symptoms of MDD include sleep disturbance, loss of appetite, and thoughts of suicide. [amboss.com]

Inflammation and its discontents: the role of cytokines in the pathophysiology of major depression. Biol Psychiatry. 2009;65:732-41. [ Links ] 102. Carney RM, Freedland KE, Miller GE, Jaffe AS. [scielo.br]

Unexplained painful physical symptoms in patients with major depressive disorder: prevalence, pathophysiology and management. CNS Drugs. 2016;30:293-304. [ Links ] 4. Sherbourne CD, Asch SM, Shugarman LR, Goebel JR, Lanto AB, Rubenstein LV, et al. [scielo.org.co]

The role of dopamine in the pathophysiology of depression. Arch Gen Psychiatry. 2007 Mar. 64(3):327-37. [Medline]. Alexopoulos GS. Depression in the elderly. Lancet. 2005 Jun 4-10. 365(9475):1961-70. [Medline]. [medscape.com]

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can call 800-799-4889. [medicalnewstoday.com]

There's no sure way to prevent depression. [mayoclinic.org]

Can PDD be prevented or avoided? In general, PDD and other forms of depression are conditions that cannot be prevented. There are lifestyle changes you can make that can boost your mood and minimize symptoms, including: Get enough sleep. [familydoctor.org]

Preventing Suicide If you are thinking about suicide, please go the nearest medical emergency room, call 911, or call the National Suicide Prevention Lifeline at 1.800.SUICIDE (1.800.273.8255). [baptisthealth.com]

Prevention programmes have been shown to reduce depression. Effective community approaches to prevent depression include school-based programmes to enhance a pattern of positive thinking in children and adolescents. [who.int]