Download Prognosis

WHAT IS DEPRESSION?
• Depression is one of the most common mental
illnesses.
• People with depression experience feelings of
unbearable sadness, despair, and hopelessness.
• It effects all people of different ages, races, and
socioeconomic groups.
• Depression carries with it disturbances in emotional,
cognitive, behavioral, somatic, and spiritual
dimensions.
HISTORY OF DEPRESSION
• Depression was apparent back to the second
millennium B.C., Mesopotamian.
• Demonic possession
• Greek physician Hippocrates believed it was an
imbalance of humors.
• Melancholia
• During the Renaissance era in the 1600s, Robert
Burton published, “Anatomy of Melancholy”.
• In the 1600s depression was rooted from deprimere.
HISTORY OF DEPRESSION
• In the 1950s depression was divided depression into two
groups: endogenous and neurotic.
• Endogenous meaning genetic or physical
• Neurotic meaning develop from environment
• Clinical observations made in the 1960s led to
formulation of the monoamine hypothesis of depression.
• This states that depression is caused by functional insufficiency
of neurotransmitters (norepinephrine, serotonin, or both).
Today depression can be both physical and mental.
PROGNOSIS
• There are many prognostic factors that can affect
depression, in particular, Major Depression Disorder
(MDD).
 This makes a depression prognosis highly individualized.
• Prognostic factors can be demographics and may
be physical and mental health treatment.
PROGNOSIS
• In the vast majority of
cases the prognosis of
depression is good.
• This true only when
someone is in
treatment for
depression.
• Untreated depression
usually does not go
away by itself, and
often gets worse with
time.
• Clinical depression
tends to occur in
episodes, most people
who experience one
such episode will
eventually have
another one.
PROGNOSIS OF ADOLESCENCE
• A Major Depressive Disorder (MDD) episode for
clinically referred youth typically lasts for 7 to 9
months.
• Approximately 90% of major depressive episodes
remit within 1 to 2 years from onset, however 6-10%
of episodes become more persistent.
• It is important to convey the message of “It gets
better” to young people and their families with
treatment.
PROGNOSIS OF POSTPARTUM
DEPRESSION
• Most mothers with postpartum depression recover
completely if the illness is diagnosed and treated
early.
• According to the World Health Organization (WHO)
about 50% of women who recover from postpartum
depression develop the illness again after future
pregnancies.
• Medication, counseling, and support from others
usually cures even severe post partum depression
which yields a good prognosis.
PROGNOSIS OF THE ELDERLY
• The prognosis for recovery is equal in young and old
patients, although remission may take longer to
achieve in older patients.
• Most patients (54-84 %) recover.
• 12-24 % relapse and 4-28 % remain ill or disabled.
• In patients with psychotic depression, recovery rates
are reduced by one half, and relapse and disability
rates are twice those in patients with nonpsychotic
depression
SIGNS AND SYMPTOMS OF DEPRESSION
• Suffering from depression can cause feelings of sadness
or anxiety and can lasts for weeks at a time.
• Symptoms include:
• Feelings of hopelessness, guilt, and worthlessness
• Persistent pessimism
• Irritability, restlessness
• Loss of interest in activities or hobbies once pleasurable
• Fatigue and decreased energy
• Insomnia, early-morning wakefulness, or excessive
sleeping
• Overeating, or appetite loss
• Thoughts of suicide, suicide attempts
TREATMENT FOR DEPRESSION
• Numerous depression treatments are available.
Medications and psychological counseling
(psychotherapy) are very effective for most people.
• Drugs are the primary therapy for major depression.
• A number of antidepressant medications are
available to treat depression.
• There are several different types of antidepressants and are
generally categorized by how they affect the naturally
occurring chemicals in your brain to change your mood.
TREATMENT FOR DEPRESSION
Types of antidepressants include:
• Selective serotonin reuptake inhibitors (SSRIs).
• fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram
(Celexa) and escitalopram (Lexapro).
• Many doctors start depression treatment by prescribing an
SSRI because these medications are safer and generally
cause fewer bothersome side effects than do other types of
antidepressants.
• Side effects include decreased sexual desire and delayed
orgasm. Other side effects may go away as your body adjusts
to the medication. They can include digestive problems,
jitteriness, restlessness, headache and insomnia.
TREATMENT FOR DEPRESSION
• Serotonin and norepinephrine reuptake inhibitors (SNRIs):
• These medications include duloxetine (Cymbalta),
venlafaxine (Effexor XR) and desvenlafaxine (Pristiq).
Side effects:
• Similar to those caused by SSRIs.
• These medications can cause increased sweating, dry
mouth, fast heart rate and constipation.
Norepinephrine and dopamine reuptake inhibitors (NDRIs).
• In this category is Bupropion (Wellbutrin).
• It's one of the few antidepressants that doesn't cause sexual
side effects. At high doses, bupropion may increase your risk
of having seizures.
TREATMENT FOR DEPRESSION
• Atypical antidepressants.
• These medications are called atypical because
they don't quite fit into another antidepressant
category.
• They include trazodone (Oleptro) and mirtazapine
(Remeron).
• Both of these are sedating and are usually taken in
the evening.
TREATMENT FOR DEPRESSION
• Other forms of treatment include:
• Psychotherapy--Psychological counseling
• Electroconvulsive therapy (ECT):electrical currents are
passed through the brain affecting levels of
neurotransmitters in your brain.
• Mind-body techniques that may be tried to ease
depression symptoms include:
• Acupuncture
• Yoga
• Meditation
• Guided imagery
• Massage therapy
PREVALENCE
• Depression is considered to be the fourth leading cause of
disability and disease worldwide
• Depression affects up to 20% of Americans.
• Women are more likely to develop depression than men.
• 1.5 -2.5 time higher in women than in men from ages 18-64
years.
• Depression is rising with age
• 2.8% ages 18-24
• 4.6% ages 45-64
• 1.6% ages < 65
• 2.5 percent of children and up to 8.3 percent adolescent
in the U.S suffer from depression
INCIDENCE
• Panic disorder: 1.7% of US adults annually
• Obsessive-compulsive disorder: 2.3% adults annually
• Post-traumatic stress disorder: 3.6% adults annually
• Social phobia: 3.7% adults annually
• Generalized anxiety disorder: 2.8% of the adults U.S.
population
INCIDENCE
• The highest countries that experience depression is:
oFrance 21%
oThe Netherlands 17.9%
oNew Zealand 16.0%
oThe U.S. 19.2 %
DON’T WORRY BE HAPPY!
BOBBY MCFERRIN SONG
DEPRESSION