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Clinical depression affects about 16% 1 of the population at one time or another in their lives. The mean age of onset from a number of studies is in the late 20s. About twice as many women as men report or receive treatment for clinical depression, though the gap is shrinking and this difference disappears after menopause.
According to the DSM-IV-TR criteria for diagnosing a major depressive disorder (see also: DSM cautionary statement) one or both of the following two required elements need to be present:
It is sufficient to have either of these symptoms in conjunction with four of a list of other symptoms, these include:
The diagnosis does not require "loss of interest in life, anhedoniaIn psychology, anhedonia is a patient's inability to experience pleasure from normally pleasurable life events such as eating, exercise, and social/sexual interactions. It is most commonly seen in the mood disorder depression, although it is also seen in". Likewise, "lack of energy and motivation" is not at all a required symptom of a major depressive episode.
Improper drugThis article is about chemical substances. For other meanings of the word "drug", see Drug (disambiguation A drug is any substance that can be used to treat an illness, relieve a symptom, or modify a chemical process or processes in the body. The word "dr or alcoholIn general usage, alcohol (from Arabic al-khwl , or al-ghawl ) refers almost always to ethanol, also known as grain alcohol and often to any beverage that contains ethanol (see alcoholic beverage . This sense underlies the term alcoholism ( addiction to a use is not a diagnostic symptom, but often accompanies and may be a causal factor in major depression.
Andrew Solomon in his book The Noonday Demon (p.20) states that the DSM IV list of symptoms is, "entirely arbitrary [and] having slight versions of all the symptoms may be less of a problem than having severe versions of two symptoms".
Depression in children is not as obvious as it is in adults; symptoms children demonstrate include:
In older children and adolescents, an additional indicator may be the use of drugs or alcohol. Moreover, depressed adolescents are at risk for further destructive behaviours, such as eating disorders and self-mutilation.
It is hard for people who have not experienced clinical depression, either personally or by regular exposure to people suffering it, to understand its emotional impact and severity, interpreting it instead as being similar to "having the blues" or "feeling down". As the list of symptoms above indicates, clinical depression is a syndrome of interlocking symptoms which goes far beyond sad or painful feelings. A variety of biological indicators, including measurement of neurotransmitter levels, have shown that there are significant changes in brain chemistry and an overall reduction in brain activity. One consequence of a lack of understanding of its nature is that depressed individuals are often criticized by themselves and others for not making an effort to help themselves. However, the very nature of depression alters the way people think and react to situations to the point where they may become so pessimistic that they can do little or nothing about their condition. Because of this profound and often overwhelmingly negative outlook, it is imperative that the depressed individual seek professional help. Untreated depression is typically characterized by progressively worsening episodes separated by plateaus of temporary stability or remission. If left untreated it will generally resolve within six months to two years although occasionally depression becomes chronic and lasts for many years or indefinitely. In many cases (but not all) treatment can shorten the period of distress to a matter of weeks. While depressed, the person may damage themselves socially (e.g. the break up of relationships), occupationally (e.g. loss of a job), financially and physically. Treatment of depression can significantly reduce the incidence of this damage, including reducing the risk of suicide which is otherwise a common and tragic outcome. For all of these reasons, treatment of clinical depression is seen by many as very useful and at times life saving.
Some people can experience anhedonia for long periods of time before they discover it is a mental illness. The inability to feel pleasure can advance negativity already present in a depressed person's mental state.
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