Saturday, October 25, 2008

Feeling Blue?

Symptoms of Depressed Mood -
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

Note: Do note include symptoms that are clearly due to a general medical condition, or mood-incongruent delusions or hallucinations.

(1) depressed mood 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). Note: In children and adolescents, can be irritable mood.

(2) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others)

(3) significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.

(4) insomnia (inability to fall or stay asleep) or hypersomnia (sleeping too much) nearly every day

(5) psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)

(6) fatigue or loss of energy nearly every day

(7) feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)

(8) diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)

(9) recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

B. The symptoms do not meet criteria for a Mixed Episode.

C. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).

E. The symptoms are not better accounted for by Bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation.

There is help in the form of couneling, medication, natural supplements and changes in lifestyle and behavior. Only an MD (medical doctor such as a psychiatrist, PCP, nurse preactitioner, neurologist etc can prescribe medication (in some states a PhD or PsyD- psychologist can do so only if they have been trained and credentialed in pharmacology) There are different counseling options from one on one counseling, group therapy, family counseling etc. In severe case a hospitalization is required. A person may be hospitalized for reasons such as feeling suicidal, homicidal, being psychotic or at risk to harm others and self. If you're are just feeling blue without the intent for harm most likely you will be referred to counseling and medication may be given to you as an option.
What causes depression? It may be triggered by different reasons in different people. That is why some people respond better to the same medication than others.
For some people situational trigers can cause depression such as a divorce, loss of job, death in the family etc. Depression can be also biologically based (you may have family members with this condition) Other trigers are psychological such as a pessimistic view, type A personality driven self, etc.
Natural supplements such as lack of certain vitamins and amino acids can triger depressed mood. Some people experience SAD (seasonal affec disorder) Which is marked by milder depressed mood in the falll and winter seasons. The use of a blue spectrum light and supplementation with vitamin D can help.

Anxiety is another illness commonly found in women. There are different kinds of anxiety as there are different kinds of depression. There are also different treatment options. Here the most common anxiety disorders are listed-
GAD (Generalized Anxiety Disorder) Generalized meaning no specific triger is found as a cause.
For more than half the days in at least 6 months, the patient experiences excessive anxiety and worry about several events or activities.
The patient has trouble controlling these feelings.
Associated with this anxiety and worry, the patient has 3 or more of the following symptoms, some of which are present for over half the days in the past 6 months:*
(1) Feels restless, edgy, keyed up
(2) Tires easily
(3) Trouble concentrating
(4) Irritability
(5) Increased muscle tension
(6) Trouble sleeping (initial insomnia or restless, unrefreshing sleep)

The symptoms cause clinically important distress or impair work, social or personal functioning.
The disorder is not directly caused by a general medical condition or by substance use, including medications and drugs of abuse.
It does not occur only during a Mood Disorder, Psychotic Disorder, Posttraumatic Stress Disorder or Pervasive Developmental Disorder.

PTSD (Post Traumatic Stress Disorder)
The patient has experienced or witnessed or was confronted with an unusually traumatic event that has both of these elements:
The event involved actual or threatened death or serious physical injury to the patient or to others, and
The patient felt intense fear, horror or helplessness
The patient repeatedly relives the event in at least 1 of these ways:
(1) Intrusive, distressing recollections (thoughts, images)*
(2) Repeated, distressing dreams*
(3) Through flashbacks, hallucinations or illusions, acts or feels as if the event were recurring (includes experiences that occur when intoxicated or awakening)*
(4) Marked mental distress in reaction to internal or external cues that symbolize or resemble the event.
(5) Physiological reactivity (such as rapid heart beat, elevated blood pressure) in response to these cues
The patient repeatedly avoids the trauma-related stimuli and has numbing of general responsiveness (absent before the traumatic event) as shown by 3 or more of:
(7) Tries to avoid thoughts, feelings or conversations concerned with the event(8) Tries to avoid activities, people or places that recall the event
(9) Cannot recall an important feature of the event
(10) Marked loss of interest or participation in activities important to the patient(11) -Feels detached or isolated from other people(12) -Restriction in ability to love or feel other strong emotions
(13) Feels life will be brief or unfulfilled (lack of marriage, job, children)
At least 2 of the following symptoms of hyperarousal were not present before the traumatic event:
(1) Insomnia (initial or interval)
(2) Irritability
(3) Poor concentration
(4) Hypervigilance
(5) Increased startle response
The above symptoms have lasted longer than one month.
These symptoms cause clinically important distress or impair work, social or personal functioning.
Specify whether:

Acute - When the symptoms have lasted less than 3 months

Chronic - When the symptoms have lasted 3 months or longer

Disclaimer: ALWAYS consult your PCP or another health care professional for proper diagnosis and treatment!!!!!!!!