Depression and Depressive Disorders

Depression is a common disorder that involves depressed mood and/or near-complete loss of interest or pleasure in activities that were previously enjoyed;somatic (egweight changesleep disturbance) & cognitive manifestations (eg difficulty concentrating) are common.Depression may markedly impair the ability to function at work & to interact socially;risk of suicide is significant.Depressive disorders occur at any age but typically develop during the mid-teens 20s or 30s.Exact cause of depressive disorders is unknown but genetic & environmental factors contribute.Sometimes depressive symptoms are caused by physical disorders (eg thyroid or adrenal gland disorders benign or malignant brain tumors stroke AIDS Parkinson diseasemultiple sclerosis) or use of certain drugs(eg corticosteroids some beta-blockers interferon reserpine ...). Diagnosis is based on clinical criteria; physical disorders must be ruled out by clinical evaluation & selected testing (CBC; electrolyte TSH B12 & folate levels). Treatment involves psychotherapy & usually drugs; SSRIs are usually tried first & if they are ineffectiveother drugs that affect serotonin and/or norepinephrine may be tried.