Depression
safety net
Characterised by persistent low mood and/of loss of pleasure in most activities and a range of associated cognitive, emotional, physical and behavioural symptoms.
Average length of depressive episode is 6-8 months
risk of recurrence is 50% after 1st episode and 70% after second and 90% after a third.
suicidal thoughts/self-harm
safeguard any vulnerable adults of children in persons care
co-morbid conditions
treatment - mild to moderate depression
individual guided self-help
CBT
lifestyle advice - exercise
treatment moderate to severe
anti-depressant (sertraline 50mg) plus CBT
Diagnosis
two core symptoms - feeling depressed, hopeless or down
loss of interest in doing things or any pleasure in doing things
duration of symptoms - most days for at least 2/52
other symptoms - fatigue, worthlessness, guilt, recurrent thoughts of death, suicidal, diminished ability to concentrate/indecisiveness, agitation, insomnia/hyperinsomnia, appetite changes, weight loss/gain
investigations not usually indicated
alcohol or substance abuse, anxiety, eating disorder, psychotic symptoms, dementia
stress
employment or financial worries
poor living conditions
relationship issues
bereavement