DEPRESI
DEFINISI
a mood disorder that causes a persistent feeling of sadness and loss of interest.
CLASSIFICATION
Disruptive mood dysregulation disorder
Major depressive disorder
Persistent depressive disorder (dysthymia)
Premenstrual dysphoric disorder
Depressive disorder due to another medical condition
PATHOPHISYOLOGY
Clinical and preclinical trials suggest a disturbance in central nervous system serotonin (5-HT) activity as an important factor. Other neurotransmitters implicated include norepinephrine (NE), dopamine (DA), glutamate, and brain-derived neurotrophic factor (BDNF).
DIAGNOSIS
These are the 9 symptoms listed in the DSM-5. Five must be present to make the diagnosis (one of the symptoms should be depressed mood or loss of interest or pleasure):
Sleep disturbance
Interest/pleasure reduction
Guilt feelings or thoughts of worthlessness
Energy changes/fatigue
Concentration/attention impairment
Appetite/weight changes
Psychomotor disturbances
Suicidal thoughts
Depressed mood
DIFERENTIAL DIAGNOSIS
Schizoaffective disorders
Schizophrenia
Somatic symptom disorders
FARMAKOTHERAPY
Selective serotonin reuptake inhibitors (SSRIs)
Serotonin/norepinephrine reuptake inhibitors (SNRIs)
Atypical antidepressants
Serotonin-Dopamine Activity Modulators (SDAMs)
Tricyclic antidepressants (TCAs)
Monoamine oxidase inhibitors (MAOIs)
Selective serotonin reuptake inhibitors (SSRIs):
PSYOTHERAPY
Cognitive-behavioral therapy (CBT)
Interpersonal Therapy (IPT)
PROGNOSIS
Major depression has very high morbidity and mortality contributing to high rates of suicide. Even though effective drug treatment is available, nearly 50% may not initially respond. Complete remission is not common but at least 40% achieve partial remission in 12 months.
EDUCATION
Avoid solitude by finding a good community.
Make life simpler by making short and long term plans.
Exercise regularly, at least 3-5 times a week with a duration of about 30 minutes.
Eat a balanced diet and a regular diet.
Make life more relaxed and avoid stress.
Avoid consumption of alcoholic beverages and illegal drugs.
KLASSIFICATION ANTI-DEPRESAN DRUG's
ANTI DEPRESAN TRISIKLIK (TCA)
PENGHAMBAT REUPTAKE SEROTONIN SELEKTIF (SSRI)
PENGHAMBAT MAO (MAO-I)
ANTIDEPRESAN ATYPICAL
KOMPLICATION
Being overweight or obese, which can lead to heart disease and diabetes.
Physical illness.
Escape in the form of alcohol or drug abuse.