抑郁症英文介绍

Depression-■■-The Mental Illness what is depression

Depressi on is a men tai health disorder , a psychiatric con diti on , characterized by sad ness ,loss of in terest or pleasure, feeli ngs of guilt or low self-worth ‘disturbed sleep or appetite ,feeli ngs of tired ness , and poor concen trati on.

Specifically,it is a mood disorder characterized by persiste ntly low mood in which there is a feeli ng of sad ness and lost of in terest.

Depressi on is differe nt from the fluctuati ons in mood that we all experie nee as a part of a no rmal and healthy life. Temporary emoti onal resp on ses to the challe nges of everyday life do not con stitute depressi on.

According to the US Centers for Disease Prevention and Control (CDC),8% of people over the age of 12 years has depressi on in any two-week period.

The World Health Orga ni zati on (WTO)puts depressi on at the top of the list -it is the most com mon ill ness worldwide and the lead ing cease of disability.The orga ni zati on estimates that 350 millio n people around the world are affected by depressi on. Major Depressive disorder

Major depressive disorder (MDD ), also known simply as depression, is a mental disorder characterized by at least two weeks of low mood that is prese nt across most situations. It is often accompanied by low self-esteem, loss of interest in normally enjoyable activities, low energy, and pain without a clear cause.People may also occasi on ally have false beliefs or see or hear things that others canno t.Some people have periods of depressi on separated by years in which they are no rmal while others nearly always have symptoms present. Major depressive disorder can negatively affects a person's family, work or school life, sleeping or eating habits, and general health. Betwee n 2-7% of adults with major depressi on die by suicide, and up to 60% of people who die by suicide had depressi on or ano ther mood disorder.

The cause is believed to be a comb in ati on of gen etic, en vir onmen tal, and psychological factors. Risk factors in clude a family history of the con diti on, major life cha nges, certa in medicati ons, chronic health problems, and substa nee abuse.About

40% of the risk appears to be related to gen etics .The diag no sis of major depressive disorder is based on the pers on's reported experie nces and a men tal status exam in ati on. There is no laboratory test for major depressi on. Testi ng, however, may be done to rule out physical con diti ons that can cause similar symptoms.Major depressi on should be differentiated from sadnesswhich is a normal part of life and is less severe.The Un ited States Preve ntive Services Task Force (USPSTF) recomme nds scree ning for depression among those over the age 12, while a prior Cochrane review found in sufficie nt evide nee for scree ning.

Typically, people are treated with coun sell ing and an tidepressa nt medicati on. Medicatio n appears to be effective, but the effect may only be sig nifica nt in the most severely depressed」t is un clear whether medicati ons affect the risk of suicide. Types of counselling used include cognitive behavioral therapy (CBT) and interpersonal therapy. If other measuresare not effective electroconvulsive therapy (ECT) may be tried. Hospitalizati on may be n ecessary in cases with a risk of harm to self and may occasi on ally occur aga inst a pers on's wishes.

Major depressive disorder affected approximately 253million (3.6%) of people in 2013. The perce ntage of people who are affected at one point in their life varies from 7% in Japa n to 21% in Fran ce. Lifetime rates are higher in the developed world (15%) compared to the develop ing world (11%).It causes the sec ond most years lived with disability after low back pai n. The most com mon time of on set is in a pers on in their

20s and 30s. Females are affected about twice as ofte n as males. The America n Psychiatric Association added "major depressive disorder" to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980. It was a split of the previous depressive neurosisin the DSM-II which also encompassed the conditions now known as dysthymia and adjustment disorder with depressedmood. Those curre ntly or previously affected may be stigmatized.

What are the signs and symptoms of depression? depressi on may be triggered by stressful life eve nts, other ill nesses, certa in drugs or medications, or inherited traits. although causes of depression are not entirely understood, we know it is linked to an imbalanee in brain chemistry. once the imbala nee

is corrected, symptoms of depressi on gen erally improve

People with depressive illnesses do not all experienee the same symptoms. The severity, freque ncy and duratio n of symptoms will vary depe nding on the in dividual and his or her particular ill ness.

Symptoms in clude:

Persiste nt sad, an xious or "empty" feeli ngs

Feeli ngs of hopeless ness an d/or pessimism

Feeli ngs of guilt, worthless ness an d/or helpless ness

Irritability, restless ness

Loss of in terest in activities or hobbies once pleasurable, in cludi ng sex

Fatigue and decreased en ergy

Difficulty concen trat in g, rememberi ng details and mak ing decisi ons

Insomnia, early- morning wakefulness, or excessive sleeping

Overeati ng, or appetite loss

Thoughts of suicide, suicide attempts

Persistent aches or pains, headaches, crampsor digestive problems that do not ease eve n with treatme nt

All of these symptoms can interfere with your quality of life. Even if you don ' have major depressi on , if you have experie nee a few of these symptoms for at least two weeks you may have less severe form of depressi on that still requires treatme nt.

the symptoms of slight and major depressi on

Depressi on is a medical con diti on in which a pers on feels very sad and an xious and often has physical symptoms.Slight depression could be a portion of major depressi on, so the criteria for this disease are importa nt to con sider and exam ine for people with the problem. If the depressi on is only min or, it will not have all of the comp onents of major depressi on and therefore would be treated differe ntly from the more serious versi on of the disease.The most com mon diag no stic criteria are en capsulated in the mnemon ic device SIGECAPS. They are in the order of the letters, Sleep problems, lack

of Interest, Guilty feelings, lack of Energy, problems with Concentration, Appetite and weight disturbances, Psychomotor retardation, and Suicidal thoughts or acti on s. If a pers on has five or six items in this criteria it is very likely that they have major depressi on and they should be treated for it. If they only have one or two of them they might have a less serious versi on of the disease, but it still may require treatment. The only differenee is that it could be more minor. By ask ing about these differe nt symptoms, people perform a basic diag no sis test to evaluate themselves or their patie nts.

The symptoms of serious to slight depressi on may be very debilitati ng to a patie nt and identification of the problem is the first step to a full recovery. The condition of depressive disorders is prevale nt through all walks of life and it is expected that the majority of persons will experienee symptoms of depression at least once in the course of their life. However, since most people experie nee these symptoms at some point, extended research has been done to determine the best way to treat these specific con diti ons and many soluti ons are available to sufferers.

To the tissues, which raises the carb on dioxide level, caus ing gen eral Depressi on. Associated conditions

Major depressi on freque ntly co-occurs with other psychiatric problems. The 1990—2 National Comorbidity Survey (US) reports that half of those with major depression also have lifetime anxiety and its associateddisorders such as generalized anxiety disorder. An xiety symptoms can have a major impact on the course of a depressive ill ness, with delayed recovery, in creased risk of relapse, greater disability and in creased suicide attempts.America n n euroe ndocri no logist Robert Sapolsky similarly argues that the relatio nship betwee n stress, an xiety, and depressi on could be measured and dem on strated biologically.There are in creased rates of alcohol and drug abuse and particularly dependence,and around a third of individuals diagnosed with ADHD develop comorbid depressi on. Post-traumatic stress disorder and depressi on ofte n co-occur.Depression may also coexist with attention deficit hyperactivity disorder

(ADHD), complicat ing the diag no sis and treatme nt of both.

Depressi on and pain ofte n co-occur. One or more pain symptoms are prese nt in 65% of depressedpatie nts, and any where from 5 to 85% of patie nts with pain will be sufferi

ng from depressi on, depe nding on the sett ing; there is a lower prevale nee in gen eral practice, and higher in specialty cli ni cs. The diag no sis of depressi on is ofte n delayed or missed, and the outcome worse ns. The outcome can also worse n if the depressi on is no ticed but completely misun derstood.

Depressi on is also associatedwith a 1.5- to 2-fold in creased risk of cardiovascular disease, independent of other known risk factors, and is itself linked directly or in directly to risk factors such as smok ing and obesity. People with major depressi on are less likely to follow medical recommendations for treating and preventing cardiovascular disorders, which further in creases their risk of medical complicati ons. In additi on, cardiologists may not recog nize un derly ing depressi on that complicates a cardiovascular problem un der their care.

Management

The three most com mon treatme nts for depressi on are psychotherapy, medicatio n, and electroc onv ulsive therapy. Psychotherapy is the treatme nt of choice (over medicati on) for people under 18. The UK Natio nal In stitute for Health and Care Excelle nee (NICE) 2004 guidelines indicate that antidepressants should not be used for the initial treatme nt of mild depressi on, becausethe risk-be nefit ratio is poor. The guideli nes recomme nd that an tidepressa nts treatme nt in comb in atio n with psychosocial in terve nti ons should be con sidered for:

People with a history of moderate or severe depressi on

Those with mild depressi on that has bee n prese nt for a long period

As a sec ond line treatme nt for mild depressi on that persists after other in terve nti ons As a first line treatme nt for moderate or severe depressi on

Lifestyle

Physical exercise is recommended for management of mild depression, and has a moderate effect on symptoms. Exercise has also been found to be effective for (un ipolar) major depressi on. It is equivale nt to the use of medicatio ns or psychological therapies in most people. In the older people it does appear to decrease depressio

n.Exercise may be recomme nded to people who are willi ng, motivated, and physically healthy eno ugh to participate in an exercise program as treatme nt.

There is a small amount of evidenee that skipping a night's sleep may improve

depressive symptoms, with the effects usually show ing up within a day. This effect is usually temporary. Besides sleep in ess, this method can cause a side effect of man ia or hypoma nia.

In observatio nal studies smok ing cessati on has ben efits in depressi on aslarge as or larger tha n those of medicati ons

Range

Major depressive disorder affects approximately 253 milli on people in 2013 (3.6% of the global populatio n).The perce ntage of people who are affected at one point in their life varies from 7% in Japa n to 21% in France.ln most coun tries the nu mber of people who have depression during their lives falls within an 8 —18% range. In North America, the probability of having a major depressive episode within a year-long period is 3 - 5% for males and 8 - 10% for females.Major depression to be about twice as com mon in wome n as in men, although it is un clear why this is so, and whether factors un acco un ted for are con tribut ing to this. The relative in crease in occurre nee is related to pubertal developme nt rather tha n chrono logical age, reaches adult ratios betwee n the ages of 15 and 18, and appears associated with psychosocial more tha n horm onal factors. Depressi on is a major cause of disability worldwide.

People are most likely to develop their first depressive episode betwee n the ages of 30 and 40, and there is a sec ond, smaller peak of in cide nee betwee n ages 50 and 60.The risk of major depressi on is in creased with n eurological con diti ons such as stroke, Park inson's disease, or multiple sclerosis, and duri ng the first year after childbirth .It is also more com mon after cardiovascular ill nesses, and is related more to a poor outcome tha n to a better on e.Studies con flict on the prevale nee of depressi on in the elderly, but most data suggest there is a reducti on in this age group. Depressive disorders are more com mon to observe in urba n tha n in rural populati on and the prevale nee is in groups with stro nger socioec ono mic factors i.e. homeless ness.