Determining Severity Of A Depressive/major Depressive Episode
Both ICD10 and DSMIV classify clinically important depressive episodes as mild, moderate and severe based on the number, type and severity of symptoms present and degree of functional impairment. shows the number of symptoms required by each diagnostic system, which are less specific than DSMIV. The prescriptive symptom counting approach of ICD10 tends to lend itself to using symptom counting alone to determine severity.
Number of symptoms required in ICD10 and DSMIV for a diagnosis of depressive episode/major depression .
As ICD10 requires only four symptoms for a diagnosis of a mild depressive episode, it can identify more people as having a depressive episode compared with a DSMIV major depressive episode. One study in primary care in Europe identified two to three times more people as depressed using ICD10 criteria compared with DSMIV . However another study in Australia found similar rates using the two criteria but slightly different populations were identified , which appears to be related to the need for only one of two core symptoms for DSMIV but two out of three for ICD10. These studies emphasise that, although similar, the two systems are not identical and that this is particularly apparent at the threshold taken to indicate clinical importance.
Risk Factors For Depression
There are several risk factors for depression that you should be aware of. There usually isnt only one cause and typically several factors come into play with depression. You should know and realize that it can impact anyone, even if someones life appears to be perfect from the outside. The four following factors come into play when speaking about depression and possibly being diagnosed with it.
Some major causes of depression:
- Environmental factors
What Are The Possible Causes Of Depression
Every person with depression is different, and everyone with depression has a unique set of circumstances. Usually, a combination of factors will contribute. While you often can’t pinpoint the cause of the depression, understanding the circumstances can sometimes help you understand how to best manage it.
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Most Common Depression Diagnosis Scales
Some of the most popular scales used to help clinicians diagnose depression include:
- Beck Depression Inventory
- Clinically Useful Depression Outcome Scale
- Geriatric Depression Scale
- Patient Health Questionnaire-9 and adolescent PHQ-9
- Plutchik-Van Praag Self-Report Depression Scale
- Quick Inventory of Depressive Symptomatology
- Rome Depression Inventory
- Zung Self-Rating Depression Scales
Some scales, such as the Beck Depression Inventory, are copyright protected and not available outside of a doctors office or mental health clinic . There are inventories, scales, and questionnaires that are in the public domain and, therefore, more accessible.
The PHQ, for example, is available for free online and in over 30 languages. It can be downloaded as a PDF or accessed as an interactive quiz on several reputable mental health websites.
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Symptoms of depression can occur along a spectrum both in duration and severity. Mild depression can occur during periods of stress but resolve with time and may not require any specific treatment. Moderate to severe depression causes chronic symptoms and usually requires at least one form of treatment, if not multiple treatments.
Generally speaking, severe depression requires some type of treatment to find some relief. Additionally, depression severity can change over time, growing increasingly worse or alternating between mild and severe during the same depressive episode.
If someone has severe depression, they may self-harm, have suicidal thoughts, or be at risk for attempting suicide. If you are severely depressed, help is available to help you manage your symptoms and ensure your safety and well-being.
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What Are The Signs And Symptoms
Major depression symptoms vary from person to person. To receive a diagnosis of major depressive disorder, some of these signs and symptoms must be present for at least two weeks. Anyone who has questions should consult their doctor.
- Continued feelings of sadness, hopelessness, pessimism, emptiness
- Fatigue, lack of energy
- Insomnia or other sleep issues such as waking up very early or sleeping too much
- Anxiety, irritability, restlessness
- Lack of interest or joy in hobbies and activities
- Changes in appetite, leading to weight loss or weight gain
- Moving, talking, or thinking more slowly
- Trouble concentrating, thinking clearly, or making decisions
- Vague aches and pains, such as headaches, joint pain, back pain, or digestive problems
- Thoughts of death or suicide, or suicide attempts
What Are The Types Of Major Depression
There are several types of depressive disorders:
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What Is The Most Serious Form Of Depression
Depression is a mood disorder that triggers a persistent feeling of sadness and loss of interest and trouble doing day-to-day activities. Depression can range from mild to very severe and comes in different forms or types. Clinical depression, also known as major depression or major depressive disorder, is the more severe and most serious form of depression.
You may be curious to learn more about depression and the most severe type if you or a loved one is currently suffering from this diagnosis or illness. Continue reading to learn more about what depression is in detail, the signs to be on the lookout for, the most common types of depression, and how to help yourself or a loved one manage it.
Beyond Treatment: Things You Can Do
Here are other tips that may help you or a loved one during treatment for depression:
- Try to be active and exercise.
- Set realistic goals for yourself.
- Try to spend time with other people and confide in a trusted friend or relative.
- Try not to isolate yourself, and let others help you.
- Expect your mood to improve gradually, not immediately.
- Postpone important decisions, such as getting married or divorced, or changing jobs until you feel better. Discuss decisions with others who know you well and have a more objective view of your situation.
- Continue to educate yourself about depression.
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Tap Into Your Spirituality
Religion can be an impactful source of support for many people dealing with depression, but there is no need to join a church, synagogue, or mosque unless you wish to. Simple daily practices such as meditation or adding to a list of things youâre grateful can help boost mood and overall well-being.
Meditation can have a range of beneficial effects such as lowering stress levels and helping people to become more aware of their thoughts and reactions.
Research indicates that an intervention called mindfulness-based cognitive therapy , which combines elements of cognitive behavioral therapy with mindfulness meditation, can be helpful in treating depression and preventing future relapses of symptoms.
Studies also suggest that different types of mindfulness meditative practices can also be effective in the treatment of depression.
There are many different types of meditation, but you can get started with a simple meditative exercise with these steps:
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Depression And Your Health
Mental anguish is hard on your health: People suffering from depression have three times the risk of experiencing a cardiac event. In fact, depression affects the entire body. It weakens the immune system, increasing susceptibility to viral infections and, over time, possibly even some kinds of cancera strong argument for early treatment. It also interferes with sleep, adding to feelings of lethargy, compounding problems of focus and concentration, and generally undermining health.
Those suffering from depression also experience higher rates of diabetes and osteoporosis. Sometimes depression manifests as a persistent low mood, a condition known as dysthymia which is usually marked by years-long periods of low energy, low self-esteem, and little ability to experience pleasure.
For more see Depression and Physical Health.
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Spend Time With Others
Although you should say no sometimes to others, you also dont want to isolate yourself. Therefore, one tip for living with this most severe type of depression is to get together with family and friends regularly, even if its by phone or video chat sometimes. Finding a group of people who you can talk to and who can relate to you may also help. Your goal is to avoid creating too much isolation or loneliness in your life.
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Depression is more than just feeling sad. Everyone feels low, upset, or unmotivated from time to time, but depression is much more than simply being down in the dumps. Depressive disorder is a mood disorder that affects how a person thinks, feels and behaves. Signs and symptoms of depression can range from hopelessness and fatigue, to a loss of interest in life, physical pain, and even suicidal thoughts. The DSM-5 definition of depression states that should a person present with these symptoms for a period of two weeks, the individual is experiencing a depressive episode.
There are many different types of depression, some of which are caused by events in your life, and others by chemical changes in the brain. Depression can be thought of as an umbrella term for a variety of disorders, some of which are caused by certain life events or situations, and others by chemical changes in the brain. Whatâs more, while some of the symptoms associated with the various depressive disorders overlap, there are also some key differences.
With the term âdepressionâ encompassing so many types of depression, if you think you might be depressed, you may be asking yourself: what kind of depression do I have?
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Testing And Diagnosis Of Major Depression
If you believe your child suffers from major depression, talk to your childs pediatrician or seek out either a therapist or psychiatrist who specializes in children and adolescents. An accurate diagnosis and early treatment are keys to success in managing major depression. Depression can also occur alongside other behavioral health disorders, such as substance abuse or anxiety disorders. With the level of complexity often involved in diagnosing and treating depression, finding a highly trained professional, such as a pediatrician, licensed clinical social worker, a child psychologist, or a child and adolescent psychiatrist, is important.At Childrens Hospital of Philadelphia, a specialist will perform a comprehensive psychiatric evaluation. The evaluation may assess:
Your child’s age, overall health, and medical history
Extent of your child’s current symptoms, behaviors, and functioning
Expectations for the course of the condition
Family dynamics and environmental stressors
Family psychiatric and medical history
Input from teachers and other care providers
What Is Severe Depression
Posted by Devid Wolley | Feb 18, 2009
There are three main categories of depression disorder. They are known as Bipolar Disorder, Chronic Depression Disorder and Major Depression Disorder. Of the three mood disorders Major Depression Disorder is the most severe. This disorder may also be called Severe Depression.
In Severe Depression the cause can be a single traumatic event in your life. It could even be the result of many personal disappointments and problems in your life. Sometimes it is possible to develop Severe Depression without any traumatic events or life problems. Still other times people who suffer from Chronic Depression can go into Severe Depression as a result of a traumatic event.
The symptoms of depression are also present in Severe Depression. They are however more intense than normal depression symptoms. For most people who suffer from Severe Depression, they can either have a recurring Severe Depression episode or their Severe Depression may occur only once in their lifetime and never reoccur again.
In general the medication that is prescribed for Severe Depression is anti-depressants. There are several types of depression medications that are used for Severe Depression. These medications include Tricyclics, Selective Serotonin Reuptake Inhibitors, Serotonin Noradrenaline Reuptake Inhibitors, Noradrenergic and Serotonergic anti-depressants, Serotonin 5-HT Receptor Antagonists, Monoamine Oxidase Inhibitors and Bupropion.
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Therapy And The Big Picture In Depression Treatment
One of the hallmarks of depression is feeling overwhelmed and having trouble focusing. Therapy helps you step back and see what might be contributing to your depression and how you can make changes. Here are some of the big picture themes that therapy can help with:
Relationships.Understanding the patterns of your relationships, building better relationships, and improving current relationships will help reduce isolation and build social support, important in preventing depression.
Setting healthy boundaries. If you are stressed and overwhelmed, and feel like you just cant say no, you are more at risk for depression. Setting healthy boundaries in relationships and at work can help relieve stress, and therapy can help you identify and validate the boundaries that are right for you.
Handling lifes problems. Talking with a trusted therapist can provide good feedback on more positive ways to handle lifes challenges and problems.
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Learn To Recognize Negative Thinking
Sometimes these thoughts can be obvious, such as times when you berate or criticize yourself. Other times, they can be more subtle. You might find yourself engaging in things like catastrophizing or all-or-nothing thinking.
Catastrophizing involves always anticipating negative outcomes. All-or-nothing thinking means that you think of things as either successes or failures with no in-between. Once you get better at recognizing these cognitive patterns, you can start working on some healthier replacements.
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When Should I See My Doctor
If you are experiencing symptoms of depression, its best to seek help early and your GP is a good place to start. There’s no need to struggle on your own. Seek help:
- if you are feeling sad, teary or overwhelmed most of the time
- if these feelings have been with you for 2 weeks or more
- if your low mood affects how you cope at home, work or school.
Your GP can suggest effective treatment options, and the sooner your symptoms are addressed, the better the outcome will likely be.
Some people with depression feel that life is too difficult, not worth living or even that they themselves are worthless. If you are experiencing suicidal thoughts, dont wait seek help now.
What Does Severe Depression Feel Like
Severe depression is classified as having the symptoms of mild to moderate depression, but the symptoms are severe and noticeable, even to your loved ones.
Episodes of major depression last an average of six months or longer. Sometimes severe depression can go away after a while, but it can also be recurrent for some people.
Diagnosis is especially crucial in severe depression, and it may even be time-sensitive.
Major forms of depression may also cause:
- suicidal thoughts or behaviors
Severe depression requires medical treatment as soon as possible. Your doctor will likely recommend an SSRI and some form of talk therapy.
If youre experiencing suicidal thoughts or behaviors, you should seek immediate medical attention. Call your local emergency services or the National Suicide Prevention Lifeline at 800-273-8255 right away.
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Lifestyle Changes To Treat Depression
Exercise.Regular exercise can be as effective at treating depression as medication. Not only does exercise boost serotonin, endorphins, and other feel-good brain chemicals, it triggers the growth of new brain cells and connections, just like antidepressants do. Best of all, you dont have to train for a marathon in order to reap the benefits. Even a half-hour daily walk can make a big difference. For maximum results, aim for 30 to 60 minutes of aerobic activity on most days.
Social support. Strong social networks reduce isolation, a key risk factor for depression. Keep in regular contact with friends and family, or consider joining a class or group. Volunteering is a wonderful way to get social support and help others while also helping yourself.
Nutrition. Eating well is important for both your physical and mental health. Eating small, well-balanced meals throughout the day will help you keep your energy up and minimize mood swings. While you may be drawn to sugary foods for the quick boost they provide, complex carbohydrates are a better choice. Theyll get you going without the all-too-soon sugar crash.
Sleep. Sleep has a strong effect on mood. When you dont get enough sleep, your depression symptoms will be worse. Sleep deprivation exacerbates irritability, moodiness, sadness, and fatigue. Make sure youre getting enough sleep each night. Very few people do well on less than seven hours a night. Aim for somewhere between seven to nine hours each night.
When Does Low Mood Become Depression
We all have times when our mood is low, and we’re feeling sad or miserable about life. Usually these feelings pass in due course.
But if the feelings are interfering with your life and don’t go away after a couple of weeks, or if they come back over and over again for a few days at a time, it could be a sign that you’re experiencing depression. See our page on the symptoms of depression for more information.
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