Depression

Diagnostic Criteria for Major Depressive Disorder and Depressive Episodes DSM-IV Criteria for Major Depressive Disorder (MDD)

Depressed mood or a loss of interest or pleasure in daily activities for more than two weeks.

Mood represents a change from the person’s baseline.

Impaired function: social, occupational, educational.

Specific symptoms, at least 5 of these 9, present nearly every day

1. Depressed mood or irritable most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful).
2. Decreased interest or pleasure in most activities, most of each day
3. Significant weight change (5%) or change in appetite
4. Change in sleep: Insomnia or hypersomnia
5. Change in activity: Psychomotor agitation or retardation
6. Fatigue or loss of energy
7. Guilt/worthlessness: Feelings of worthlessness or excessive or inappropriate guilt
8. Concentration: diminished ability to think or concentrate, or more indecisiveness 9. Suicidality: Thoughts of death or suicide, or has a suicide plan

Management options

Referral to psychologist/ Psychiatrist

Cognitive behavior therapy

Community Mental health referral

Inpatient psychiatric referral

Involuntary admission  under the Mental health section in high-risk patients

Medication groups

• Selective serotonin reuptake inhibitors (SSRIs) …
• Serotonin-noradrenaline reuptake inhibitors (SNRIs) …
• Noradrenaline and specific serotonergic antidepressants (NASSAs) …
• Tricyclic antidepressants (TCAs) …
• Monoamine oxidase inhibitors (MAOIs)