iPsychology

Index

Criteria
Definition
Mood Disorder Flow Chart
Treatment ( Psychotherapy )
Treatment ( Pharmacotherapy )

Major Depressive Disorder is a mood disorder characterized by at least one Major Depressive Episode(s),with a clinical course.There must be no history of Manic, Mixed,or Hypomanic Episodes.

A person who suffers from a major depressive disorder (sometimes also referred to as clinical depression or major depression) must either have a depressed mood or a loss of interest or pleasure in daily activities consistently for at least a 2 week period. This mood must represent a change from the person's normal mood. Social, occupational, educational or other important functioning must also be negatively impaired by the change in mood. For instance, a person who has missed work or school because of their depression, or has stopped attending classes altogether or attending usual social engagements.

A depressed mood caused by substances (such as drugs, alcohol, medications) is not considered a major depressive disorder, nor is one which is caused by a general medical condition. Major depressive disorder generally cannot be diagnosed if a person has a history of manic, hypomanic, or mixed episodes (e.g., 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. Typically the diagnosis of major depression is also not made if the person is grieving over a significant loss in their lives (see note on bereavement below).

Clinical depression is characterized by the presence of the majority of these symptoms:

• Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feeling sad or empty) or observation made by others (e.g., appears tearful). (In children and adolescents, this may be characterized as an irritable mood.)
• Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day
• Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day.
• Insomnia or hypersomnia nearly every day
• Psychomotor agitation or retardation nearly every day
• Fatigue or loss of energy nearly every day
• Feelings of worthlessness or excessive or inappropriate guilt nearly every day
• Diminished ability to think or concentrate, or indecisiveness, nearly every day
• Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

In addition, for a diagnosis of major depression to be made, the symptoms must not be better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.

ONSET:

Any age.

COMMON: Mid-20s.

Major Depressive Disorder, Single Episode

1. At least one Major Depressive Episode.

2. No history of Manic,Mixed,or Hypomanic Episodes.

3. Symptoms not due to another disorder.

Specify using most recent episode:

Atypical Features
Catatonic Features
Chronic
Melancholic Features
Postpartum Onset
Remission - Psychotic - Severity

1. At least two Major Depressive Episode.

2. No history of Manic, Mixed, or Hypomanic Episodes.

3. Symptoms not due to another disorder.

Specify using most recent episode:

Atypical Features
Catatonic Features
Chronic
Melancholic Features
Postpartum Onset
Remission - Psychotic - Severity

Specify:

Longitudinal
Seasonal Pattern
Rapid Cycling

Adlerian Therapy
Behavior Therapy
Cognitive-behavioral Therapy
Existential Therapy
Gestalt Therapy
Person-centered Therapy
Psychoanalytic
Rational-emotive Therapy
Reality Therapy
Transactional Analysis

Selecting the Right Antidepressant
Definition AD's

Adapin
Amitril
Anafranil
Asendin
Aventil
Celexa
Cymbalta / Yentreve
Desyrel
Effexor
Elavil
Emitrip
Endep
Enovil
Etrafon
Etrafon-A
Etrafon-Forte
Dohme
Lexapro ( Lexaprotm )
Ludiomil
Luvox
Marplan
Nardil
Norpramine
Pamelor
Parnate
Paxil
Pertofrane
PMS-Levazine
Prozac
Sharpe
Sinequan
SK-Amitriptyline
Surmontil
Tofranil
Vivactil
Wellbutrin
Zoloft
Zyban