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24.07.2014

What are the signs and symptoms of major depressive disorder, epstein barr virus chronic fatigue syndrome contagious - Within Minutes

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Had at least 2 weeks of a major depressive episode which caused significant distress or disability.
Major Depressive Disorder is a condition characterized by one or more Major Depressive Episodes without a history of Manic, Mixed, or Hypomanic Episodes.
Completed suicide occurs in up to 15% of individuals with severe Major Depressive Disorder. Alcoholism and illicit drug abuse dramatically worsen the course of this illness, and are frequently associated with it. Disorder, Obsessive-Compulsive Disorder, Anorexia Nervosa, Bulimia Nervosa, and Borderline (Emotionally Unstable) Personality Disorder. The first episode may occur at any age from childhood to old age, the onset may be either acute or insidious, and the duration varies from a few weeks to many months. There is a greater likelihood of developing additional episodes of this disorder if: (1) there was pre-existing Persistent Depressive Disorder, (2) the individual has made only a partial recovery, (3) the individual has a chronic general medical condition. Manic Episode never disappears completely, however many Major Depressive Episodes have been experienced.
Stressors may play a more significant role in the precipitation of the first or second episode of this disorder and play less of a role in the onset of subsequent episodes. First-degree biological relatives of individuals with this disorder are 2-4 times more likely to develop Major Depressive Disorder. Treatment refractory depressions may respond to a combination of an antidepressant plus lithium or electroconvulsive therapy (ECT). Although almost two-thirds of individuals with major depressive disorder respond to current therapies; at least one-third of those entering remission relapse back into depression 18 months posttreatment. In typical mild, moderate, or severe depressive episodes, the patient suffers from lowering of mood, reduction of energy, and decrease in activity. Four or more of the above symptoms are usually present and the patient is likely to have great difficulty in continuing with ordinary activities. An episode of depression in which several of the above symptoms are marked and distressing, typically loss of self-esteem and ideas of worthlessness or guilt.
A disorder characterized by repeated episodes of depression as described for depressive episode (F32.-), without any history of independent episodes of mood elevation and increased energy (mania). A disorder characterized by repeated episodes of depression, the current episode being mild, as in F32.0, and without any history of mania. A disorder characterized by repeated episodes of depression, the current episode being of moderate severity, as in F32.1, and without any history of mania. A disorder characterized by repeated episodes of depression, the current episode being severe without psychotic symptoms, as in F32.2, and without any history of mania.
A disorder characterized by repeated episodes of depression, the current episode being severe with psychotic symptoms, as in F32.3, and with no previous episodes of mania.
Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).
The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The episode is not attributable to the physiological effects of a substance or to another medical condition. The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders. Note: This exclusion does not apply if all of the manic-like or hypomanic-like episodes are substance-induced or are attributable to the physiological effects of another medical condition.
There are 4 main problems that interfere with wisdom: irrationality, forgetfulness, distractibility and lack of interest (apathy). Most behaviors have an optimal level, and too much or too little of the behavior is maladaptive. Over 5 years (2005-2011) I studied my outpatient psychiatric patients that had a DSM-IV diagnosis of Major Depressive Disorder.
Fatigue, sleep disturbance, appetite disturbance, occupational impairment and social impairment are all part of the diagnostic criteria for major depressive disorder. Depressed mood, guilt, self-harm, agitation, distractibility, apathy, and impaired executive functioning are all part of the diagnostic criteria for major depressive disorder. It's important to note that, except for 2 patients that committed suicide, none of the other depressed patients remained suicidal. The most striking finding was the extent to which depression had impaired my patients' social functioning. On the sixth day of starvation, a male member of the group just gave up, and said that they had no chance of getting any more food. Fortunately, on the seventh day of starvation, the four group members that still had the energy and optimism to hunt, actually killed an elk using their caveman spears. When you watch the video of this caveman experiment, you can see practically all of the symptoms of major depressive disorder appear.
This disorder can be triggered by exposure to any major physical, psychological, or social adversity. In terms of survival, hibernation or "shutting down" makes sense if there is nothing more you can do in the face of adversity. The factors associated with good mental health are listed on our "Mental Health Rating Scale".
When depressed, people experience significant weight loss (when not dieting) or weight gain, insomnia or hypersomnia, and marked tiredness after even minimum effort.
When severely depressed, people often become socially withdrawn, and stop their usual social activities.
When depressed, people often are disabled and unable to function at school, work, housekeeping or parenting.
The average major depressive episode lasts less than one year, but up to 15% of severely depressed individuals commit suicide because they prematurely give up any hope of recovery. When depressed, concentration is reduced, learning is impaired, and judgment is disorted by pessimism and hopelessness.
During a depression, self-esteem and self-confidence are almost always reduced and, even in the mild form, some ideas of guilt or worthlessness are often present. Summary Of Practice Guideline For The Treatment Of Patients With Major Depressive Disorder. Each recommendation is identified as falling into one of three categories of endorsement, indicated by a bracketed Roman numeral following the statement. With the patient's permission, family members and others involved in the patient's day-to-day life may also benefit from education about the illness, its effects on functioning (including family and other interpersonal relationships), and its treatment [I]. Patients should also be told about the need to taper antidepressants, rather than discontinuing them precipitously, to minimize the risk of withdrawal symptoms or symptom recurrence [I]. Patient education also includes general promotion of healthy behaviors such as exercise, good sleep hygiene, good nutrition, and decreased use of tobacco, alcohol, and other potentially deleterious substances [I]. Educational tools such as books, pamphlets, and trusted web sites can augment the face-to-face education provided by the clinician [I].
An antidepressant medication is recommended as an initial treatment choice for patients with mild to moderate major depressive disorder [I] and definitely should be provided for those with severe major depressive disorder unless ECT is planned [I].
In patients who prefer complementary and alternative therapies, S-adenosyl methionine (SAMe) [III] or St.
Patients receiving pharmacotherapy should be systematically monitored on a regular basis to assess their response to treatment and assess patient safety [I].
If antidepressant side effects do occur, an initial strategy is to lower the dose of the antidepressant or to change to an antidepressant that is not associated with that side effect [I]. Bright light therapy might be used to treat seasonal affective disorder as well as nonseasonal depression [III].
In women who are pregnant, wish to become pregnant, or are breastfeeding, a depression-focused psychotherapy alone is recommended [II] and depending on the severity of symptoms, should be considered as an initial option [I].
As with patients who are receiving pharmacotherapy, patients receiving psychotherapy should be carefully and systematically monitored on a regular basis to assess their response to treatment and assess patient safety [I].


Marital and family problems are common in the course of major depressive disorder, and such problems should be identified and addressed, using marital or family therapy when indicated [II].
The combination of psychotherapy and antidepressant medication may be used as an initial treatment for patients with moderate to severe major depressive disorder [I]. Combining psychotherapy and medication may be a useful initial treatment even in milder cases for patients with psychosocial or interpersonal problems, intrapsychic conflict, or co-occurring personality disorder [II]. Onset of benefit from psychotherapy tends to be a bit more gradual than that from medication, but no treatment should continue unmodified if there has been no symptomatic improvement after 1 month [I].
Generally, 4-8 weeks of treatment are needed before concluding that a patient is partially responsive or unresponsive to a specific intervention [II].
For individuals who have not responded fully to treatment, the acute phase of treatment should not be concluded prematurely [I], as an incomplete response to treatment is often associated with poor functional outcomes.
For patients in psychotherapy, additional factors to be assessed include the frequency of sessions and whether the specific approach to psychotherapy is adequately addressing the patient's needs [I]. With some TCAs, a drug blood level can help determine if additional dose adjustments are required [I]. For patients treated with an antidepressant, optimizing the medication dose is a reasonable first step if the side effect burden is tolerable and the upper limit of a medication dose has not been reached [II].
For patients whose symptoms have not responded adequately to medication, ECT remains the most effective form of therapy and should be considered [I]. In patients capable of adhering to dietary and medication restrictions, an additional option is changing to a nonselective MAOI [II] after allowing sufficient time between medications to avoid deleterious interactions [I]. Transdermal selegiline, a relatively selective MAO B inhibitor with fewer dietary and medication restrictions, or transcranial magnetic stimulation could also be considered [II].
The most prominent symptom of major depression is a severe and persistent low mood, profound sadness, or a sense of despair. A variety of symptoms usually accompany the mood change, and the symptoms can vary significantly among different people. Some people who have episodes of major depression also have episodes of relatively high energy or irritability. If a woman has a major depressive episode within the first two to three months after giving birth to a baby, it is called postpartum depression. A depressed person may gain or lose weight, eat more or less than usual, have difficulty concentrating, and have trouble sleeping or sleep more than usual.
A particularly painful symptom of this illness is an unshakable feeling of worthlessness and guilt. If pain and self-criticism become great enough, they can lead to feelings of hopelessness, self-destructive behavior, or thoughts of death and suicide. A primary care physician or a mental health professional usually can diagnose depression by asking questions about medical history and symptoms. Many people with depression do not seek evaluation or treatment because of society's attitudes about depression. There is no way to prevent major depression, but detecting it early can diminish symptoms and help to prevent the illness from returning. Regarding side effects, SSRIs are known to cause problems with sexual functioning, some nausea, and an increase in anxiety in the early stages of treatment. Other effective antidepressants are bupropion (Wellbutrin), venlafaxine (Effexor), mirtazapine (Remeron) and duloxetine (Cymbalta). In the past several years, investigators have raised concerns about an increased risk of suicide in people taking antidepressants. Although experts continue to debate the research, clinicians agree that it is important to have your treatment monitored closely and for you to report any troubling symptoms or worsening mood to your doctor immediately. A number of psychotherapy techniques have been demonstrated to be helpful, depending on the causes of the depression, the availability of family and other social support, and personal style and preference. In some situations, a treatment called electroconvulsive therapy (ECT) can be a life-saving option. Depression is a painful and potentially dangerous illness, so you should contact a health care professional if you have any suspicion that you or a loved one is depressed. When treatment is successful, it is important to stay in close touch with your doctor or therapist, because maintenance treatment is often required to prevent depression from returning.
Disclaimer: This content should not be considered complete and should not be used in place of a call or visit to a health professional. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. A leading expert in anxiety and depression Julie helps women overcome anxiety and depression so they can be themselves again: whole and complete. These Major Depressive Episodes are not due to a medical condition, medication, abused substance, or Psychosis. Accurate diagnosis of this disorder requires assessment by a qualified practitioner trained in psychiatric diagnosis and evidence-based treatment. Computerized diagnosis is less accurate when done by patients (because they often lack insight). There is a fourfold increase in deaths in individuals with this disorder who are over age 55.
Persistent Depressive Disorder often precedes the onset of this disorder for 10%-25% of individuals. The prevalence in 18- to 29-year-old individuals is threefold higher than the prevalence in those aged 60 or older. These vascular depressions are associated with greater neuropsychological impairments and poorer responses to standard therapies. About 5%-10% of individuals with Major Depressive Disorder eventually convert into Bipolar Disorder. Major Depressive Disorder, particularly with psychotic features, may also convert into Schizophrenia, a change that is much more frequent than the reverse. The presence or absence of stressful life events does not appear to provide a useful guide to prognosis or treatment selection. Heritability is approximately 40%, and the personality trait neuroticism accounts for a substantial portion of this genetic liability. Thus ECT is effective during the acute treatment phase in hospital, but steadily loses its benefit after hospital discharge.
St John's wort and regular exercise appear mildly effective in the treatment of depression (but their effect size is small).
Capacity for enjoyment, interest, and concentration is reduced, and marked tiredness after even minimum effort is common.
Depending upon the number and severity of the symptoms, a depressive episode may be specified as mild, moderate or severe. The patient is usually distressed by these but will probably be able to continue with most activities. Suicidal thoughts and acts are common and a number of "somatic" symptoms are usually present. If such an episode does occur, the diagnosis should be changed to bipolar affective disorder (F31.-). This decision inevitably requires the exercise of clinical judgment based on the individual's history and the cultural norms for the expression of distress in the context of loss. During major depressive disorder, individuals lack the essential social skills of self-confidence, optimism, belonging, and sociability.
Both cooperation and learning are made possible by the brain's emotional reward and punishment function. This instinctual response is built into the brains of all higher primates, as is the emotion of guilt. Unlike emotions, these 4 problems are not adaptive, but are symptoms of brain malfunctioning. For example, there is an optimal level of eating: too much or too little is life-threatening. I recorded their progress on every office visit using my Internet Mental Health Quality of Life Scale.


In this way, I could statistically determine which symptoms were elevated in major depressive disorder. As expected, these classical symptoms of major depression decreased as my patients recovered. Thus suicide is a tragic waste of life; especially when major depressive disorder is so time-limited. By the fourth day of starvation, the entire group suffered from severe fatigue, insomnia and apathy.
So depression can be triggered by a physical illness or stress, an addiction to alcohol or drugs, or a significant psychological or social stress. The following shows which items on this scale would be rated as abnormal for Major Depressive Disorder. They have depressed or apathetic mood, loss of self-esteem, and ideas of worthlessness or guilt.
John's wort [III] might be considered, although evidence for their efficacy is modest at best. It is also important to assess the quality of the therapeutic alliance and treatment adherence [I]. The mood changes that occur in major depression are defined as lasting at least two weeks but usually they go on much longer — months or even years. Some people who have many episodes of major depression also have a background pattern of a milder depressed mood called dysthymia.
They may sleep far less than normal, and may dream up grand plans that could never be carried out. Depression that occurs mainly during the winter months is called seasonal affective disorder, or SAD. The person may feel guilty about a specific life experience or may feel general guilt not related to anything in particular.
The vast majority of people who suffer severe depression do not attempt or commit suicide, but they are more likely to do so than people who are not depressed.
By definition, major depression is diagnosed when a person has many of the symptoms listed above for at least two weeks.
The person may feel the depression is his or her fault or may worry about what others will think. However, it is important to be evaluated by a primary care physician to make sure the problems are not being caused by a medical condition or medication. The most commonly prescribed antidepressants are known as selective serotonin reuptake inhibitors (SSRIs). The older classes of antidepressants, tricyclic antidepressants and monoamine oxidase inhibitors, are still in use. Once the right medication is found, it may take up to a few months to find a proper dose and for the full positive effect to be seen.
A technique called cognitive behavioral therapy is designed to help a depressed person recognize negative thinking and teaches techniques for controlling symptoms. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.
If your score indicates you may be suffering from Major Depression, talk to your doctor immediately and contact me for an appointment. Dalton, is a member of OACCPP  and affiliated with Psychology Today, Ontario Society of Adlerian Psychology and Theravive. The effectiveness of ECT vs sham ECT at one or more months posttreatment is still controversial. Each of these 5 basic dimensions of human behavior functions with a separate set of emotions. When you are successful at cooperating or problem-solving; you feel joy - an emotional reward. Thus evolution has hard-wired humans to feel anger when others harm them, and to feel guilt when they harm others. The brain maintains self-control over many behaviors by using its "craving-disgust" emotional function. Three members of the group became dysfunctional and just spent the day lying down or sitting. Or the person suffering major depression may not be able to take pleasure in activities that usually are enjoyable. The person may develop thinking that is out of step with reality — psychotic symptoms — such as false beliefs (delusions) or false perceptions (hallucinations).
People who have a family member with major depression are more likely to develop depression or drinking problems.
Sometimes, the depressed thinking is distorted enough to be called "psychotic;" that is, the person has great difficulty recognizing reality. They include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil) and citalopram (Celexa). They are as effective as the newer ones and can be very useful when someone has not responded well to other treatments. Psychodynamic, insight-oriented or interpersonal psychotherapy can help depressed people to sort out conflicts in important relationships or explore the history behind symptoms. In ECT, an electrical impulse is applied to the person's scalp and passes to the brain, causing a seizure.
Even if you do not have a Major Depression or experiencing some of the signs above, you do not have to live with these symptoms. Thus human survival requires an optimal level of both fear and courage; too much or too little doesn't work. Therefore family members or friends may need to encourage the depression suffer to seek help. They are not without problems, but they are fairly easy to take and relatively safe compared with previous generations of antidepressants. But a very small number of people taking these medications probably do have an unusual reaction and end up feeling much worse rather than better.
These include haloperidol (Haldol), risperidone (Risperdal), ziprasidone (Geodon), aripiprazole (Abilify) and olanzapine (Zyprexa, Zydis).
If the brain decides that a cooperative or problem-solving effort should cease; you feel emotional detachment and stop caring. Self-control can break down and cause impulsivity when the brain's normal inhibitions fail.
If a person has milder symptoms of mania and does not lose touch with reality, it is called "hypomania" or a hypomanic episode. Medication is given before the procedure to prevent any outward signs of convulsions, which helps to prevent injury. Malfunctioning of this self-control function is seen in Eating Disorders and Substance Use Disorders. And genetic makeup influences how vulnerable any of us is to breakdowns in these functions. In Schizophrenia and related disorders, there is malfunctioning of the brain's "detachment" function. ECT is the quickest and most effective treatment for the most severe forms of depression, and in most people, it is not more risky than other antidepressant treatments. This causes social withdrawal, intimacy avoidance, inability to feel pleasure, and restricted emotional expression.



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