Hello, friends! Humans respond to stress, loss, and adversity in a variety of ways. Many of us has experienced low mood and spirit. when faced with difficulty or loss. We may lose our sleep, appetite, and may not feel like socializing and meeting people. This change in behavior is a normal humane reaction to a stressful situation. As such a state of transient and goes away in a couple of days. But if symptoms such as low mood, hopelessness, changes in appetite, sleep patterns, loss of interests in hobbies, anhedonia, feelings of guilt persist for more than 2 weeks, and negatively affect our social, domestic and occupational functioning, then it is no more a normal reaction, but a pathological one and may merit a concern for clinical depression. Major depression is extremely common among various societies. And despite being a treatable illness, goes largely undiagnosed due to its insidious nature and the stigma attached to its diagnosis and seeking treatment. Case for Urgency According to the International Global Burden of Disease study, Major Depressive Disorder (MDD), is the 3rd leading cause of the years lived with disability, YLDs, which can be described as years lived in less than ideal health, in Pakistan and globally. The social economic burden and the mental illness in Pakistan is tremendous. Of which MDD contribute significantly and was estimated to be approximately $4,264 million in the year 2006 according to recent estimates carried out in Pakistan. Severe form of clinical depression often translate into suicides. According to a report published in 2014, every 40 second, a person commit suicide. For every person who commit suicide, there are 20 people who attempt ending their lives. Mental illness at large and major depression is particular pose for public health challenge which cause public health policy institutes and government to take appropriate steps.
Diagnosis
Signs and Symptoms
Major Depressive Disorder is diagnosed on the basis of a set of 9 symptoms formulated in the diagnostics and statistical manual, DSM-V and their context. Five or more of the 9 symptoms
including at least 1 of depressed mood and loss of interest or pleasure, in the same 2-week period; and each of the symptoms represent a change from previous functioning.
These symptoms include
- Depressed mood (subjective or observed)
- Irritability is more common in teenagers
- Loss of interest of pleasure
- Change in weight or appetite
- Insomnia or hypersomnia
- Psychomotor agitation (observed)
- Loss of energy or fatigue
- Feelings of worthlessness or guilt
- Impaired concentration or indecisiveness
- Thoughts of death or suicidal ideation and attempt
If there is depression resulting in significant clinical impairment but not meeting the above criteria for major depression, then it is termed as Adjustment Disorder with Depressed Mood. This occurs within 3 months following a stressful life event and does not persist for 6 months after the termination of the stressor. If there are depressive symptoms occuring within 2 months of the death of a loved one, then it is considered as normal grief. If symptoms persist beyond 2 months, then a diagnosis of major depression needs to be explored. Severity Major Depression can be mild, moderate or severe. In mild depression despite the symptoms, functioning would still be preserved. In moderate depressive illness, the different facets of functioning would be markedly impaired. Whereas in severe major depression disorder, one may experience and act on suicidal thoughts. In very severe forms, one may even experience hallucinations and delusions accompanying the mood symptoms which is termed as Major Depression with Psychotic features.