Mental Disorders


'Depression is the most unpleasant thing I have ever experienced.. it is that absence of being able to envisage that you will ever be cheerful again. The absence of hope. That very deadened, which is so very different from feeling sad. Sad hurts but it's a healthy feeling. It is a necessary thing to feel. Depression is very different.'
-J.K Rowling, author of the Harry Potter Series

Introduction

Sadness is an emotion all beings have experienced in one way or the other, which may occur, usually, as reaction to a difficult time period in life. However, the feeling of sadness tends to pass with time. On the other hand, if a person gets trapped in the dark clouds, thinks life is meaningless and, losses their self-worth; it impairs and paralyses the mind and body – turning into what we call “Depression”. Depression is more than simply feeling unhappy or fed up for a few days, when someone is depressed they persistently feel sad for weeks or months or even years, rather than just a few days.

In today’s world, people still believe depression is insignificant and not a genuine illness. They're obviously wrong – it is an actual illness with real symptoms; it is far from a “sign of weakness” or something one can just "snap out of" by doing something fun. [1]

Signs and Symptoms

All depressive disorders share some similar signs and symptoms, however, the different sub-types include disorder specific signs and symptoms. According to ICD and DSM-V, symptoms of depression can be categorized on three different levels and include:

1. Psychological:

  • Continuous low mood or sadness
  • Feeling hopeless and helpless
  • Having low self-esteem
  • Feeling tearful
  • Feeling guilt-ridden
  • Feeling irritable and intolerant of others
  • Having no motivation or interest in things
  • Finding it difficult to make decisions
  • Not getting any enjoyment out of life
  • Feeling anxious or worried
  • Having suicidal thoughts or thoughts of self-harm

2. Physical/Biological:

  • Moving or speaking more slowly than usual
  • Changes in appetite or weight (usually decreased, but sometimes increased)
  • Constipation
  • Unexplained aches and pains
  • Lack of energy
  • Low sex drive (loss of libido)
  • Changes in menstrual cycle
  • Disturbed sleep – for example, finding it difficult to fall asleep at night or waking up very early in the morning

3. Social/ occupational:

  • Not doing well at work
  • Avoiding contact with friends and taking part in fewer social activities
  • Neglecting hobbies and interests
  • Having difficulties in family life [2]

Severity of Depression

Depression is usually described by the level of impact it has on ones life, namely is it is:

  • Mild - symptoms are noticeable and impact daily activities. The sufferer will show a decrease in interest of activities previously enjoyable.
  • Moderate - has a significant impact on daily activities and, has more symptoms
  • Severe – it becomes impossible to get through daily life; some individuals may show psychotic symptoms

Types of Depressive Disorders

Although the sub-types of depressive disorder share similar characteristics, certain differentiating factors can help make the diagnosis efficient. Listed are the different types of depressive disorders followed by brief explanations:

1) Disruptive Mood Dysregulation Disorder

The disorder is applicable from age 6 onwards to 17. It includes severe tantrums such as screaming or physical attacks following little or no provocation. The tantrums are thrown across different settings such as school, home, etc. The diagnosis is made if the tantrums continue for about a year with multiple outbursts during each week.

2) Major Depressive Disorder

Depression is comprised of a Major Depressive Episode which continues for a period of 2 consecutive weeks. The symptoms are severe enough to interfere in a persons daily life and, may either have single or multiple episodes.

3) Persistent Depressive Disorder (Dysthymia)

Also known as a low grade depression, it comprises of low mood and two other symptoms from a Major Depressive Episode for a period of 2 years (with an exception of 1 year for children).

4) Premenstrual Dysphoric Disorder (PMDD)

Women begin the onset of depressive symptoms at the start of the menstrual cycle.

Depression is not only excruciating for the person who is experiencing it, but is also painful for those who care about the individual. Due to various reasons such as, societal stigma, lack of awareness, accessibility and support, people tend to ignore and underestimate the negative impact of undiagnosed and untreated depression. [3]


References:

[1] Morrison, J. (2014).  DSM-5 made easy: The Clinician’s guide to Diagnosis. New York: Guilford Press.   

[2] Anxiety. (n.d.). Retrieved from http://www.apa.org/topics/anxiety/   

[3]American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, D.C: American Psychiatric Association.




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