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Hala Kerbage, M.D. LebMash Kafa, January 9 What is depression? Risk factors for depression Specific issues in the female gender When to consult for help Treatment modalities in depression Major depressive episode is a clinical disorder Different from transient depressed mood At least one of the following with significant impact for at least 2 weeks, most of the day, nearly every day: Abnormal depressed mood Abnormal loss of all interest and pleasure At least 5 of the following symptoms during the 2 weeks: Appetite or weight disturbance Sleep disturbance Agitation or slowing Fatigue or loss of energy Abnormal inappropriate guilt Poor concentration Thoughts of death or suicide Symptoms not due to another psychiatric disorder (psychosis, bipolar disorder) Symptoms not due to physical illness, alcohol, medication or drugs Symptoms not due to normal bereavement Slow onset, long duration of prodrome Episodes last several months 50 % will recur or have an unremitting course Heavy burden and impact on social, familial and work Frequent disorder (6.6% in Lebanon) Twice more frequent in females Peaks at the age of 30, decreases after 40 and peaks again after 55 Two major sources for depressive disorder: ◦ Inheritance ◦ Stress and environmental factors/Loss Risk of depression in GBV Impact on maternal depression on the children Post-partum: Highly at-risk period Role of life hygiene in preventing depression Good response to medications (SSRIs) If during more than 2 weeks: ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ You You You You You You You You You feel sad all the time are losing interest in things you used to like feel “emotional numbness” have suicidal thoughts feel fatigue, loss of energy and concentration have changes in appetite and sleep pattern feel agitated or very slowed have excessive guilt or self-devaluation feel all this is impacting on your functioning Pharmacological treatment Psychotherapy Physical exercise Intensifying social support and resources