📌Free webinar on "Depressive Disorder" Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. Purpose: The purpose of this webinar is to help participants learn how to reduce depression as well as other health problems.

1. MAJOR
DEPRESSIVE
DISORDER
Dr Sheikh Muhammad Huzaifa

3. Overview
■ Majordepressivedisorder(MDD)is an
episodicmooddisorderprimarilycharacterized
by depressed moodand anhedonialasting forat
leasttwo weeks.Womenhave ahigherrisk of
developingMDD than men.Thepeak ageofonset is
thethirddecade.

7. Etiologies
■ Biological factors Monoamine hypothesis:
Most antidepressants work by inhibiting the reuptake
of monoamines (e.g.,serotonin, noradrenaline, dopamine),
indicating that a lack of monoamines plays a major role in
the pathophysiology of depression (and other mood
disorders).
■ Genetic factors
– First-degree relatives of patients with depression are at
increased risk of developing depression.
– The concordance ratein identical twins is ∼ 50%.
■ Increased production of stress hormones (e.g.,dysfunction
of the hypothalamic-pituitary-adrenal axis

9. Etiologies
■ Psychologicalfactors:traumatic and stressful
experiences, behavioral factors (e.g.,learned
helplessness)
■ Comorbidities:neurodegenerative
diseases (e.g.,Alzheimer disease), chronic inflammatory
diseases (e.g.,systemic lupus
erythematosus or inflammatory bowel disease),and
other psychiatric disorders (e.g., panic disorder)

12. Depression screening
■ Depression screening with “SIGECAPS”:Sleep
(insomnia or hypersomnia), Interest loss
(anhedonia),Guilt (low self-esteem),Energy(low
energy or fatigue), Concentration(poor concentration
or difficultymaking decisions),Appetite (decreased
appetite or overeating), Psychomotor agitation or
retardation,and Suicidality.

13. May additionally manifest with:
■ Somaticfeatures,e.g.,headaches,myalgia,
gastrointestinalproblems
■ Aggression,substance use disorder,orincreasein
risk-takingbehavior

14. seasonal affective disorder, winter
depression
■ Definition:a subtypeof major depressive
disorder characterizedby ≥ 2 depressiveepisodes
associated with a seasonal pattern (e.g.,the winter
season)over≥ 2 years

15. Major depressive disorder with atypical
features
■ Increased appetite or over-eating
■ Hypersomnia
■ Leaden paralysis (legs and arms feel heavy)
■ Interpersonal rejection sensitivity that leads to social and
occupational impairment
■ Mood reactivity:brightening of mood in response to
positive events, which is usually not the case in classical
MDD
■ Diagnosticcriteria:two or more of the clinical
features arepresent

16. Persistent depressive disorder
(dysthymia)
■ Poor appetite orovereating
■ Insomnia or hypersomnia
■ Low energy or fatigue
■ Low self-esteem
■ Poor concentration or difficulty making decisions
■ Feelings of hopelessness
■ The symptoms arepresentfor mostof the day,and
forthe majorityof days,for ≥ 2 years in adults.

20. Diagnosis
■ ľhe DSM-5 outlines the following cíiteíion to make
a diagnosis of depíession. ľ h e individual musī
be expeíiencing five oí moíe sympīoms
duíing īhe same 2-week peíiod and aī
leasī one of īhe sympīoms should be
eiīheí (1) depíessed mood oí
(2) loss of inīeíesī oí pleasuíe.