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THE MANY FORMS OF DEPRESSION BY IHOR MAGUN, M.D., F.A.C.P. Depression, a mood disorder, is a common fact of life. All of us occasionally feel :blue" and this is a normal occurrence. The problem becomes more of an issue when the frequency of these "blue" moods increases and they become extreme, causing changes in our thinking, sleeping, appetite, energy level and interpersonal relationships. Depression in women is twice as common as in men. Depression can occur at any age, but in women, the symptoms generally peak in their mid forties; in men they peak a decade later. There is no known relationship between depression and occupation, race, education or socio-economic class. Data from human genetics suggest genetic influences, but the mode of transmission has not been established. A mood disorder can occur when precipitating events, such as family or marital problems, job activities, or divorce, produce psychosocial stress. This is generally transient and usually improves with supportive psychotherapy and, occasionally, medication. Seasonal affective disorder is a form of depression that is manifested in the cold winter months. Occurring more frequently in women than in men, it is associated with weight gain, hypersomnia and lethargy. Studies have shown that the treatment for this mood disorder is phototherapy -- using specific light sources for several hours a day. A relatively mild, but chronic for of depression that has a duration of at least two years is Dysthymia. A classification developed and approved by the American Psychiatric Association and accepted as the official standard in the United States (from the Diagnostic and Statistical Manual DSM-IIIR) defines major depression as a condition that can be diagnosed when at least five of the following symptoms are present during a two week period if these symptoms do not represent normal functioning: 1. Depressed mood 2. Decreased interest in pleasure in all, or almost all, activities for most of the day. 3. Weight gain or weight loss when not dieting. 4. Daily insomnia or hypersomnia. 5. Agitation or lethargy nearly every day. 6. Fatigue or loss of energy nearly every day. 7. Feelings of worthlessness or guilt. 8. Decreased ability to think or concentrate. Indecisiveness. 9. Recurrent thoughts of suicide. Many individuals suffering from depression present their physicians with physical complaints, and for this reason, depression is frequently misdiagnosed. The diagnosis may be even more complicated because of overlapping medical problems and problems relating to aging and neurological changes. Frequently, patients appear superficially happy and deny any feelings of depression. Once depression has been diagnosed, however, there are basically four treatments that physicians employ (individually or in combination): psychotherapy, medical therapy, electroconvulsive treatment, phototherapy. The duration of treatment varies, but treatment for major depression usually lasts a minimum of six months. It is important to realize that depression is a psycho-biological disorder that can easily be triggered by stress and can sometimes be spontaneously resolved when the source of stress is eliminated. Each individual should heed the early signs and symptoms that may bring on a depressive episode. Our thoughts have a significant impact on our emotions which in turn have an impact on our behavior. We are all affected by many negative and positive factors in our lives and we should pay close attention to those aspects of our lives that affect our moods. Talking to others and getting emotional support is helpful; it is equally important to talk to a professional when we recognize that things have become more overwhelming than we can manage. Editor's note: In his next article, Dr. Magun will focus on the new medications available to combat depression - the so-called "happy pills". 16 ’’НАШЕ ЖИТТЯ”, ЛИСТОПАД 1997 Видання C оюзу Українок A мерики - перевидано в електронному форматі в 2012 році . A рхів C У A - Ню Йорк , Н . Й . C Ш A.
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