Into the DSM-IV – Major Depression

As of 1996, Major Depression was diagnosed in roughly 17% of the total population, with a majority of that population being women (21%). Major Depression is the single largest disease that affects the US population in terms of economic scale.

To be diagnosed with Major Depression the symptoms must not have been the result of substance use, a general medical disorder or bereavement in the previous two months.

Furthermore, the client must have exhibited four of the following symptoms for at least two solid weeks:

1) Depressed mood for most of the day (irritability in adolescents and males)
2) Loss of interest or pleasure in all activities
3) Gains or losses in weight or increased/decreased appetite
4) An interruption in sleep patterns (sleeping more or less)
5) Fatigue
6) Others view the person as speeding up or slowing down
7) Feelings of worthlessness or inappropriate guilt
8) Inability to concentrate
9) Experiencing repeated thoughts about death

Risk factors for Depression

Gender – More females are diagnosed with depression than males
Age – Major Depression occurs in 1 in 6 adults over the age of 59
Health – Poorer general health increases risks, as well as a medical illness
Substance Abuse – increases risks (cannot be comorbid with Major Depression)
Genetics – There is some research that posits a genetic component to Major Depression
Comorbidity – Major Depression is often comorbid with anxiety, dysthymia or other disorders
History – Recurrence of depression is likely over the life-span
Abuse – Women who experience abuse are more likely to exhibit Major Depressive features
Economics – Lower socio-economic classes have higher rates of depression
Support – Isolation, divorce, widowed, separated and single individuals have greater risks
Stress – Major life events contribute to risks of major depression

Protective Factors for Depression

Social – Extended education, employment, financial stability, close relationships, marriage (for men), and adequate social support can protect against depressive symptoms
Medication – Can help resolve chemical imbalances in some individuals (must be weighed against side-effects and often work better in conjunction with psychotherapy)
Exercise – This is especially important for older adults, but has some protective factors for others as well.

Treatment Possibilities

Three forms of therapy have been researched and have proven effective for the treatment of Major Depression. Cognitive, Behavioral and Interpersonal therapeutic paradigms have provided the best outcomes for clients who suffer from Major Depression. Furthermore, a fourth paradigm that combines Cognitive and Behavioral treatments is effective. Finally, there is some research that states that therapy in conjunction with medication provides for the most effective and longest lasting results in the treatment of Major Depression.