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

[…] 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]

  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]

  […] 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) Changes in eating habits (eating too much or eating too little) Fatigue [heretohelp.bc.ca]

• 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]

  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]

  Depressed mood most of the day, nearly every day Markedly diminished interest or pleasure in all, or nearly all activities most of the day, nearly every day Significant weight loss or weight gain, or changes in appetite nearly every day A slowing down [pyramidhealthcarepa.com]

• Weight Loss

  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 Nearly every day [mdcalc.com]

  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]

  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 to schizoaffective [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. [msdmanuals.com]

  These symptoms can include: A persistent depressed mood Excessive feelings of worthlessness and guilt Loss of interest in previously enjoyed activities Fatigue and lethargy Irritability Insomnia or hypersomnia Unexplained aches and pains Changes in appetite [news-medical.net]

• Family History of Depression

  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]

  Genetic - A family history of depression increases the risk for developing the illness. [mhanational.org]

  Family history: Major depressive disorder is more common in people whose blood relatives also have the condition. Research into genetic causes of depression is ongoing. [baptisthealth.com]

  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]

• 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]

  This is a significant change from the previous diagnostic criteria, which did not give the diagnosis of major depression if the person was grieving over a significant loss in their lives. [psychcentral.com]

• 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]

  weight gain and increased appetite), psychotic depression (with additional psychotic features such as hallucinations and delusions), and peripartum depression (which occurs during or shortly after pregnancy). [amboss.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. [msdmanuals.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]

• 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]

• 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]

• 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]

• 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]

• Feeling of Worthlessness

  […] 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 days during a two-week period [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]

  These symptoms can include: A persistent depressed mood Excessive feelings of worthlessness and guilt Loss of interest in previously enjoyed activities Fatigue and lethargy Irritability Insomnia or hypersomnia Unexplained aches and pains Changes in appetite [news-medical.net]

  […] of worthlessness or excessive or inappropriate guilt nearly every day Diminished ability to think, concentrate, or be decisive, nearly every day Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or [pyramidhealthcarepa.com]

  […] of worthlessness or excessive or inappropriate guilt nearly every day (e.g., ruminating over minor past failings) Diminished ability to think or concentrate, or indecisiveness, nearly every day (e.g., appears easily distracted, complains of memory difficulties [psychcentral.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]

  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]

  Psychotic: Patients have delusions and/or hallucinations. Delusions often involve having committed unpardonable sins or crimes, harboring incurable or shameful disorders, or being persecuted. [msdmanuals.com]

  a bipolar disorder) or if the depressed mood is better accounted for by schizoaffective disorder and is not superimposed on schizophrenia, a delusion or psychotic disorder. [psychcentral.com]

  It is important to note that MDD, particularly with psychotic features, such as hallucinations or delusions, can also transition into schizophrenia. More women experience MDD than men. [pbmhmr.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]

  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 clinically significant distress or impairment in social, occupational, or [mdcalc.com]

  ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide In order to be diagnosed, a person must experience at least five of the symptoms mentioned above for at least two weeks. [pyramidhealthcarepa.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]

  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]

  If your depression lasts for two years or more, you might have Persistent Depressive Disorder (previously called Dysthymic Disorder). [kidshelpline.com.au]

• 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]

  (often sleep-maintenance insomnia) or hypersomnia Psychomotor agitation or retardation observed by others (not self-reported) Fatigue or loss of energy Feelings of worthlessness or excessive or inappropriate guilt Diminished ability to think or concentrate [msdmanuals.com]

• Headache

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

  […] 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]

  Trouble with relationships Sleep problems, such as insomnia Changes in appetite or weight A drop in energy Problems focusing or making decisions Being grouchy, hostile, or aggressive Suicidal thoughts or attempts Frequent physical complaints, such as headache [stanfordchildrens.org]

  […] irritability, restlessness; loss of interest in activities or hobbies once pleasurable, including sex; fatigue; difficulty concentrating; insomnia, or excessive sleeping; overeating, or appetite loss; thoughts of suicide, suicide attempts; aches or pains, headaches [courses.lumenlearning.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]

• 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]

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

[…] significantly after each treatment failure, from 31% with a second treatment, to 14% with a third, and 13% with a fourth. [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]

Heredity accounts for about half of the etiology (less so in late-onset depression). Thus, depression is more common among 1st-degree relatives of depressed patients, and concordance between identical twins is high. [msdmanuals.com]

The high levels of co-occurrence [13, 33], overlapping etiologies [10, 12] and similar treatments that are effective for depression and anxiety further support this. [bmcmedicine.biomedcentral.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]

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]

Nearly 24% of US adults have a lifetime history of major depressive episodes, a prevalence much higher than the 14% who self-report them, researchers reported in the American Journal of Preventive Medicine. Bernhard T. [psychcongress.com]