1. Depression Forms of Depression

3. Depression is hard to diagnose: Depressive disorder (major depressive episode) – Exogenous – Endogenous Bi polar disorder, depressive phase – Cyclothymic disorder Dysthemic disorder

4. Some one experiencing a major depressive episode may exhibit psychomotor retardation (low energy level, slowed speech and body movements) OR psychomotor agitation ( inability to sit still and become easily agitated). They can be misdiagnosed as bipolar

5. But, the person with depression and psychomotor agitation, still displays a sad mood, while the person in the manic phase of bipolar disorder appears to be happy.

6. Normal depression also poses a problem… the major difference between it and major depressive episode is the duration…some experiencing major depressive episode also display suicidal thoughts, and occasionally psychotic symptoms such as delusions or, more rarely, hallucinations.

7. The difference between exogenous and endogenous depression is only important in distinguishing treatments… – Exogenous depression or reactive depression is more likely to respond to psychotherapy. – Endogenous depression is more likely to respond to drug therapy.

8. Dysthymic disorder (chronic depression that is not severe enough to qualify for a diagnosis of major depressive episode). Cyclothemic disorder ( relatively mild symptoms of bipolar).

9. Since people seek help only when they are disturbed, people who are experiencing symptoms (especially mild ones) of bipolar disorder generally only seek help when in the depressive phase. Misdiagnosis of major depressive episode is very common. Unfortunately, the medications given are very different.

10. Prevalence Depressive disorder is quite common – 5 – 10% of the population Bipolar disorder is much more rare – only about 1% of the population. Both can be found in all age groups, but the common onset of depression is 27 (though sinking) and of bipolar is 20.

11. Etiology Hereditary predisposition Environmental factors seem to determine whether the hereditary predisposition becomes the full fledged disorder. Research shows that hereditary predisposition is a greater factor in women than in men.

12. Neurochemistry – heredity seems to create neurotransmitter abnormalities in the brain – Norepinephrine and serotonin are the most important, though other neurotransmitters also contribute.

13. Cognitive factors – negative thinking – can contribute to depression. Depression can contribute to negative thinking…..Hence, a vicious cycle. Of course, STRESS is another contributing factor. Not everyone who is stressed becomes depressed, again the genetic predisposition seems to come into play.

14. So, depression is more complicated than most people think. Like OCD, Depression is a term the general population throws around overly-freely.