All That You Ever Wanted To Know About Depression

P
PSRF INDIAMental Health Services
All that  you ever  wanted to  know about  DEPRESSION DR. N. SHALINI, Psychiatrist, MIND FOCUS
What is depression? PSYCHIATRIC SERVICES AND RESEARCH FOUNDATION Depression in the Bay of Bengal,  Depression in the stock market Depression in on the surface of the moon Clinical Depression…….?
What is Clinical Depression? ,[object Object],[object Object],[object Object],[object Object],PSYCHIATRIC SERVICES AND RESEARCH FOUNDATION
Why talk about Depression? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],PSYCHIATRIC SERVICES AND RESEARCH FOUNDATION
What Causes Depression? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Biological Social Psychological
Neurotransmitters  Ideas of helplessness, worthlessness, hopelessness Suicidal ideas, death fears, worries of failure… 2 weeks, continuous, impairing   PSYCHIATRIC SERVICES AND RESEARCH FOUNDATION MAJOR DEPRESSIVE DISORDER SEROTONIN ADRENALINE DOPAMINE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Signs and Symptoms Vegetative   Sleep disturbances Appetite disturbances Decreased libido Weight changes Somatic  Aches and Pains  (KKK Syndrome)  Muscle tensions Vague uneasiness Cognitive  Poor attention Decreased frustration tolerance Impaired memory Negative thinking Behavioural  Poor motivation    Decreased pleasure     Diminished interests    Easy fatigability Impulse Control   Irritability Suicidal tendency Homicidal tendency
Depressive Spectrum Disorders ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],PSYCHIATRIC SERVICES AND RESEARCH FOUNDATION
Rule out  : Normalcy : Teenage Crisis, Bereavement . Situational : Interpersonal conflicts, narcissistic injury Endocrine : Hypothyroidism, Diabetes Mellitus Systemic : Hypertension, SLE, Anaemia, AIDS Gynaec : Post partum/ perimenopausal/ PMS Neuro: SOL, CVA- esp. Left HS, Epilepsy, PD Medication induced  : Steroids, antihypertensives, etc Carcinoma:  Pancreas,   colon, breast, etc PSYCHIATRIC SERVICES AND RESEARCH FOUNDATION
Assessment of Depression   Not Several More than Nearly at all days half the every days day Over the  last 2 weeks , how often have you been bothered by any of the following problems? (less than  half the days) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],9 symptoms (a - i)
Assessment of Depression   (contd)   g. Trouble concentrating on things, such  as reading the newspaper or watching  television h. Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual i. Thoughts that you would be better off dead, or of hurting yourself in some way Diagnosis of MDD to be made if  answers to a or b and five or more of a - i are at least “more than half the days” (count i if present at all)  Not Several More than Nearly at all days half the every days day Over the  last 2 weeks , how often have you been bothered by any of the following problems? (less than  half the days)
Treatment options PSYCHIATRIC SERVICES AND RESEARCH FOUNDATION ,[object Object],[object Object],[object Object],[object Object],[object Object]
TREATMENT OPTIONS:   A.  PSYCHOPHARMOCOLOGICAL   APPROACHES Tri Cyclic Antidepressants (TCA) (Amitriptyline, Dothepin) Selective Serotonin Reuptake Inhibitors (SSRI) (Fluoxetine, Paroxetine, Escitalopram) Norepinephrine & Dopamine Reuptake Inhibitor  (NDRI) (Bupropion) Dual Serotonin & Norepinephrine Reuptake Inhibitors (SNRI) (Venlafaxine, Duloxetine, Mirtazepine) Selective Noradrenergic Reuptake Inhibitors  (Reboxetine)
Treatment options ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],PSYCHIATRIC SERVICES AND RESEARCH FOUNDATION
Working strategy ,[object Object],[object Object],[object Object],[object Object],[object Object],PSYCHIATRIC SERVICES AND RESEARCH FOUNDATION
PSYCHIATRIC SERVICES AND RESEARCH FOUNDATION
THANK YOU! PSYCHIATRIC SERVICES AND RESEARCH FOUNDATION
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All That You Ever Wanted To Know About Depression

  • 1. All that you ever wanted to know about DEPRESSION DR. N. SHALINI, Psychiatrist, MIND FOCUS
  • 2. What is depression? PSYCHIATRIC SERVICES AND RESEARCH FOUNDATION Depression in the Bay of Bengal, Depression in the stock market Depression in on the surface of the moon Clinical Depression…….?
  • 3.
  • 4.
  • 5.
  • 6.
  • 7. Signs and Symptoms Vegetative Sleep disturbances Appetite disturbances Decreased libido Weight changes Somatic Aches and Pains (KKK Syndrome) Muscle tensions Vague uneasiness Cognitive Poor attention Decreased frustration tolerance Impaired memory Negative thinking Behavioural Poor motivation   Decreased pleasure   Diminished interests   Easy fatigability Impulse Control Irritability Suicidal tendency Homicidal tendency
  • 8.
  • 9. Rule out : Normalcy : Teenage Crisis, Bereavement . Situational : Interpersonal conflicts, narcissistic injury Endocrine : Hypothyroidism, Diabetes Mellitus Systemic : Hypertension, SLE, Anaemia, AIDS Gynaec : Post partum/ perimenopausal/ PMS Neuro: SOL, CVA- esp. Left HS, Epilepsy, PD Medication induced : Steroids, antihypertensives, etc Carcinoma: Pancreas, colon, breast, etc PSYCHIATRIC SERVICES AND RESEARCH FOUNDATION
  • 10.
  • 11. Assessment of Depression (contd) g. Trouble concentrating on things, such as reading the newspaper or watching television h. Moving or speaking so slowly that other people could have noticed. Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual i. Thoughts that you would be better off dead, or of hurting yourself in some way Diagnosis of MDD to be made if answers to a or b and five or more of a - i are at least “more than half the days” (count i if present at all) Not Several More than Nearly at all days half the every days day Over the last 2 weeks , how often have you been bothered by any of the following problems? (less than half the days)
  • 12.
  • 13. TREATMENT OPTIONS:   A. PSYCHOPHARMOCOLOGICAL APPROACHES Tri Cyclic Antidepressants (TCA) (Amitriptyline, Dothepin) Selective Serotonin Reuptake Inhibitors (SSRI) (Fluoxetine, Paroxetine, Escitalopram) Norepinephrine & Dopamine Reuptake Inhibitor (NDRI) (Bupropion) Dual Serotonin & Norepinephrine Reuptake Inhibitors (SNRI) (Venlafaxine, Duloxetine, Mirtazepine) Selective Noradrenergic Reuptake Inhibitors (Reboxetine)
  • 14.
  • 15.
  • 16. PSYCHIATRIC SERVICES AND RESEARCH FOUNDATION
  • 17. THANK YOU! PSYCHIATRIC SERVICES AND RESEARCH FOUNDATION