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Personal Experiences related to this article are indexed here. Depressive episode ICD-10 F32, F33 Recurrent depressive disorder ICD-9 296.2 Single episode, 296.3 Recurrent, 296.5 Bipolar I disorder most recent episode depressed OMIM 608516 DiseasesDB 3589 MedlinePlus 003213 eMedicine med/532 MeSH F01.145.126.350

Clinical depression is a state of sadness, melancholia, or despair that has worsened to the point of being disruptive to an individual's social functioning and/or activities of daily living. Although a low mood or state of dejection that does not affect functioning is often referred to as depression, clinical depression is indicative of a more severe condition and is different from the everyday meaning of "being depressed".

A psychological view of depression goes beyond the psychiatric diagnostic list of different types of depression and the medical model and makes a distinctive analysis.

From a learning perspective, severe depression is seen as the outcome of a series of processes affecting feelings, thoughts, and behaviour, which after cycles of negative feedback bring sufferers to the attention of professionals. Psychologists are interested in people's early experience, internal processes, current relationships, and social environment in order to develop hypotheses about these patterns of psychological response and their causal relationship to the person's difficulties.

From a cognitive perspective, the effects of depression can be delineated, and the pathways maintaining the low mood can be identified. Working with people to change their environment, their ways of relating to themselves and others, their thoughts, feelings and behaviour is then the substance of the different forms of therapy.

Where physical causes (e.g., genetic, biochemical, neurophysiological) dominate the picture, a psychological analysis contributes to helping people manage their condition as appropriately as possible.

Vincent van Gogh, who himself suffered from depression and committed suicide, painted this picture in 1890 of a man that can emblematize the desperation and hopelessness felt in depression.

[edit] History, Theory & Cause

[edit] History

Depression is the modern terminology for what in earlier times was described as Melancholia. As early as the 4th and 5th centuries BC, Melancholia was described as "aversion to food, despondency, sleeplessness, irritability, restlessness," as well as the statement that "Grief and fear, when lingering, provoke melancholia". It is now generally believed that melancholia was the same phenomenon as what is now called clinical depression.

Main article: Depression - history of the disorder

[edit] Theory & Etiology (Cause)

Theoretical approaches to depression are many and varied, ranging from biological explanations, such as Monoamine oxidase theory - chemical imbalances of monoamine neurotransmitters such as serotonin, norepinephrine and dopamine - to theories based more on human needs not being met, such as Freud's Psychoanalytic theory and the humanistic theories of Maslow and Rogers. Recently, the cognitive model of human psychology has lead to treatments based on cognitive theories such as Cognitive Behavioural Therapy being employed.

Main article: Depression - Evolutionary factors

Main article: Depression - Genetic factors

Main article: Depression - Biological factors

Main article: Depression - Theoretical approaches

Main article: Depression - Causes

[edit] Risk Factors

Certain risk factors have been identified that predispose people towards depression. Affective disorders, of which Unipolar depression is one type, have an approximate heritability of 60-70%, occuring more frequently in women. Men on the other hand tend to suffer Alcoholism more frequently, which can be indicative of underlying depression. Certain studies have suggested a genetic cause for depression, such as a faulty gene for the synthesis and/or transport of serotonin. Social approaches emphasize the role of traumatic Life Events in the depressed person's history.

Main article: Depression - Risk factors

[edit] Diagnosis, Co-morbidity, Treatment & Prognosis

[edit] Assessment

The accurate diagnosis of depression is an important issue. In the past evidence suggests the condition was often missed, particularly in the elderly and in children

Main article: Depression - Assessment.

[edit] Comorbidity

Depression is associated with other clinical problems including eg Anxiety, Alcoholism, Substance abuse, Abuse, PTSD, Stress

Main article: Depression - Comorbidity.

[edit] Epidemiology

The likelihood of suffering from depression is not the same for all of us. Epidemiologists study these different patterns of occurence.

Main article: Depression - Epidemiology.

[edit] Treatment & Prognosis

There are a number of different psychological therapies that aim to treat depression.

Main article: Psychological treatment for depression.

Main article: Depression:Prognosis.

[edit] Depression in Society

Depression occurs in different pattterns both within societies and between societies. There also cultural differences in how it is regarded and treated.

Main article: The social context of depression

[edit] Depression in women

Women are suffer from depression far more frequently than men (HOW MUCH), approximately 1 in 3??? women will suffer from Depression at some point in their lives, compared to only 1 in 10??? men. Reasons for this include such causes as postnatal depression, hormonal influences due to mood instability at different stages in the menstrual cycle, and hormonal changes after menopause. Culturally it has been suggested that women suffer depression more frequently than men because they are more repressed and have less control over their lives than men. To counter this it has been suggested that men are unable to express their feelings as freely as women and instead suffer from conditions such as Alcoholism. There is possible co-morbidity with eating disorders in women and rarely with men.

Main article: Depression in women

[edit] Depression in men

As mentioned above, men suffer more frequently from alcoholism, which may be a sign of underlying depression. There is a significantly higher risk of suicide in young men compared to women of the same age. It seems that men are more likely to be successful in suicide atttempts than women, as there are fewer depressed men in any age group than women.

Main article: Depression in men

[edit] Depression in children

Depression is often misdiagnosed in children, and there is some controversy surrounding prescription of anti depressants to children. Certain anti-depressants are no longer recommended for prescription to children in the UK because of the potential risk of the drugs interfering with the development of the brain.

Main article: Depression in children

[edit] Depression in later life

Depression strikes the elderly more frequently than it does the young. In part this is due to deterioration of the brain in elderly people, and can occur comorbidly with diseases such as alzheimers, parkinsons and following conditions such as stroke. It has also been suggested that a sedentiary lifestyle with little exercise can contribute to depression. Finally, aging people may become depressed after the death of a partner or loved one.

Main article: Depression in older adults - Parkinsons comorbidity, causes

[edit] Depression in primary care

There is an increasing emphasis on the early diagnosis of clinical depression in primary care and on the management of the condition by primary care professionals

Main article: Depression in primary care

[edit] Depression and physical illness

Clinical depression is often found to accompany physical illness.

Main article: Depression and physical illness

[edit] Suicide and depression

Main article: Suicide and depression

[edit] User Experiences

Personal Experiences related to this article are indexed here.

If you, a friend or family member have experienced depression, you can find lots of useful information at the Depression:Service user page.

For an index of general experiences; see the general list of user experiences.

For an index of Depression experiences; go to the Depression Experiences Index.

If you have an experience of Depression, please consider contributing it to the Psychology Wiki.

[edit] See also

• Atypical_depression
• Bipolar disorder
• Chemical imbalance theory
• Emotion and memory
• Hypoadrenia (also covers 'adrenal exhaustion', sometimes called 'adrenal fatigue')
• Learned helplessness
• Melancholic Depression
• Seasonal affective disorder (SAD)
• Post stroke depression
• Depressive realism
• Anaclitic depression
• Depressive position

[edit] Bibliography

[edit] Key texts - books

• Beck, A. T., (1987). Cognitive therapy of depression. New York: Guilford. ISBN 0898620007
• Blackburn I. M., et al (1995) Cognitive Therapy for Depression and Anxiety : A Practitioner's Guide.Blackwell Science. ISBN 0632039868
• O'connor R (2001) Active Treatment of Depression. W. W. Norton. ISBN 0393703223
• Rowe, Dorothy (2003). Depression: The way out of your prison. London: Brunner-Routledge.ISBN 0415144825

[edit] Other books

• Burns, David D. (2000). The Feeling Good Handbook. Penguin. ISBN 0452281326
• Klein, D. F., & Wender, P. H. (1993). Understanding depression: A complete guide to its diagnosis and treatment. New York: Oxford University Press.ISBN 0195086694
• Kramer, Peter D. (2005). Against Depression. New York: Viking Adult.ISBN 0670034053
• Leahy, R L,& Holland, S J Treatment Plans and Interventions for Depression and Anxiety Disorders (Clinician's Toolbox S.) ISBN 1572305142
• McCullough Jr., James P. (2003). Treatment for Chronic Depression: Cognitive Behavioral Analysis System of Psychotherapy (CBASP). Guilford Press, ISBN 1-57-230965-2

[edit] Key texts - papers

• Kessler, R.C. & Magee, W.J. (1993). Childhood adversities and adult depression: Basic patterns of association in a US National Survey. Psychological Medicine. 23:679-690. PMID 8234575

• Wong,ML Licinio,J (2001) -Research and treatment approaches in depression. Nature Reviews Neuroscience, - [149.142.238.229]

[edit] Other papers

• American Psychiatric Association (2000). Practice guidelines for the treatment of patients with major depressive disorder (revision). American Journal of Psychiatry, 157(4, Suppl): S1–S45.

• Aronson SC, Ayres VE (2000): Depression: A treatment algorithm for the family physician. Hospital Physician Full text

• Butler R, et al. (2005). Depressive disorders. Clinical Evidence (13): 1238–1276.

• Canadian Psychiatric Association and the CANMAT Depression Work Group (2001). Clinical practice guidelines for the treatment of depressive disorders. Canadian Journal of Psychiatry, 46(Suppl 1): S13–S89.

• Chilvers C, et al. (2001). Antidepressant drugs and generic counselling for treatment of major depression in primary care: Randomised trial with patient preference arms. BMJ, 322(7289): 772–775. Full text

• Davidson JRT, et al. (1999). The underrecognition and undertreatment of depression: What is the breadth and depth of the problem? Journal of Clinical Psychiatry, 60(Suppl 7): S4–S11. Abstract

• Elkin I, Shea MT, Watkins JT, et al (1989): National Institute of Mental Health Treatment of Depression Collaborative Research Program. General effectiveness of treatments. Arch Gen Psychiatry Nov; 46(11): 971-82.

• Katon WJ (2003). Clinical and health services relationships between major depression, depressive symptoms, and general medical illness. Biological Psychiatry, 54(3): 216–226.

• Nesse R.M. (2000). Is depression an adaptation? Archives of General Psychiatry. 57, 14-20. Full text

• Pignone, MP, et al. (2002) Screening for depression in adults: A summary of the evidence for the U.S. Preventive Services Task Force. Annals of Internal Medicine, 136(10): 765–776.

• Whooley MA, Simon GE (2000) Managing depression in medical outpatients. New England Journal of Medicine, 343(26): 1942–1950.

• Williams JW (2002) Is this patient clinically depressed? JAMA, 287(9): 1160–1170.

[edit] External links

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• Google Scholar
• NICE treatment guidelines
• National Institute of Mental Health - Depression booklet
• Depression at the Open Directory Project

This page uses content from the English-language version of Wikipedia. The original article was at Depression. The list of authors can be seen in the page history. As with Psychology Wiki, the text of Wikipedia is available under the GNU Free Documentation License.