Depressive illness
From ArticleWorld
Depressive illness or Depression is a tough emotional experience, though often described as an 'emptiness' or 'flatness' which relates to a loss rather than to a lower mood.
Depression, like anxiety, is a universal experience and we think about it as weird only if it appears without reason or if it seems like it is excessive in its strength or duration in relatively to the cause. As expected, such a common emotion might be joined with many a psychiatric syndrome; the depressive kinds are those in which the depressed effect appears as if it is the primary phenomenon or at the very least one of the more prominent of the clinical features.
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Endogenous depression and neurotic depression
There exist two depressive kinds - endogenous depression, which is an offshoot of manic-depressive illness and neurotic depression.
In reality, the distinction between these two disorders is very often tricky, but this is unsurprising when we think about that any primary psychiatric disturbance may be related to secondary or reactive features and among these, depression is one of the most common.
This relationship indicates that in any individual case, the patient is thought of as having 40% endogenous and sixty percent reactive or neurotic depression. Setting aside the figures for a moment, it's the endogenous component that is integral, for the remainder is a response to it.
Successful treatment of endogenous depression is probably to lead to complete recovery, whereas treatment directed only at the reactive element can hardly be more then partly successful.
Atypical depression
The term 'atypical depression' has been used as a title for a couple cases. It's only in the last 15 years that we've come to consider how often occurring depressive illness is.
It is considered that in general practice one could expect depression from about every 1000 patients, twelve would be recorded as new cases each year. Older figures, usually hospital derived and consequently making small allowance for milder cases, indicate that the presence of endogenous depression alone is one percent in men and two percents in females. It would be foolish to indicate that depressive illness has become more common in the last 10 years; the much greater number of cases seen means the fact that we have learned to pick out its milder forms.
Diagnostic decisions
As soon as the diagnosis of depression is decided, three related decisions must be made:
- Can the patient be treated by a general practitioner or ought the case be sent for specialist care,
- Is hospital administration necessary
- Is the patient suicidal.
Depression treatments
A great number of cases can be treated by a general practitioner and indeed their numbers are such that there exists no alternative. Immediate recommendation to a consultant psychiatrist or even a psychiatric hospital is usually best if the patient has strong suicidal ideas or has made a failed suicide attempt.
Severe retardation, delusional ideas of guilt, obvious retardation ideas of unworthiness or guilt and dangerous loss of weight are other indications.
Failure to respond to appropriate doses of 1 of the antidepressant medication over a period of say three weeks also makes referral a good idea.