SEVERELY DEPRESSED

MAJOR DEPRESSIVE EPISODE

Topics in Mental Health

By Shlomo Y. Radcliffe

What is Major Depressive Episode?

People with Major Depressive Episode have severe depression. Symptoms that  might be apparent to others include loss of appetite, chronic fatigue, agitation and problems with sleep. The sufferer him or herself has dramatic changes in mood and energy, including any of the following: loss of pleasure, intense sadness, confusion, lack of motivation and thoughts of death. Actual suicidal thoughts are often present and therefore there is an increased risk of carrying out suicide. Parents should take note of changes in their child’s mood and behaviour and get professional advice when concerned. When a child or adolescent expresses death wishes, these should be taken seriously. Parents should respond calmly, compassionately and non-judgmentally and also arrange for medical consultation immediately.

Symptoms of Major Depressive Episode (DSM-IV Criteria)

In order to be diagnosed with Major Depressive episode a person must meet the following symptoms:

• In the same two weeks, the person has had five or more of the following symptoms, which are a change from usual functioning. Either depressed mood or decreased interest or pleasure must be present.

Nearly every day:

§         The person is in a depressed mood or appears depressed to others.

§         The person has too much or not enough sleep.

§         The person experiences tiredness or loss of energy.

§         Activity of the person is speeded up or slowed down as noted by others.

§         Interest or pleasure of the person is significantly decreased in all activities.

§         There is a significant increased or decreased appetite or weight gain or loss.

§         The person feels worthless or unreasonably guilty.

§         The person is indecisive or has trouble thinking, or concentrating.

                  And:

§         The person has had repeated thoughts about death, or about suicide, or has made a suicide attempt.

• The symptoms cause significant distress or impair work, social, or personal functioning.
• Criteria are not met for Mixed Episode.
• The disorder is not directly caused by a general medical condition or by the use of substances including prescription medication.
• The episode has not begun within two months of the loss of a family member or loved one unless the symptoms are severe.

Treatment for Major Depressive Episode

Treatment for Major Depressive Episode usually consists of both psychotherapy and medication. There are many types of therapies and many types of medications that can be explored. Since Major Depressive Episode can be not only very painful but also life threatening, it is essential to arrange for professional psychiatric assessment and treatment.