Major Depressive Episode
The main feature of a Major Depressive Episode is a depressed mood or loss of interest or pleasure in almost everything occurring for at least 2 weeks. In children and adolescents this may be exhibited in an irritable mood. Also in children separation anxiety may occur.
A depressive episode could be diagnosed if the following symptoms are seen.
- If five or more of the following are seen in the same 2 week period. These symptoms must be different from normal behaviors and actions and at least one of the symptoms must be either a depressed mood or a loss of interest or pleasure. (Symptoms can not be justified by a medical condition or mood-incongruent delusions or hallucinations)
- An apparent depressed mood most of the day (almost everyday) that can be seen by others, or described by feelings such as say or empty. Children and adolescents might also have an irritable mood.
- Apparent or announced lack of pleasure in almost all or all activities for almost the whole day (almost everyday).
- Large amounts of weight loss or weight gain when not dieting or an increased or decreased appetite almost everyday. Children my fail to have normal weight gains.
- Trouble sleeping or too much sleeping (almost everyday).
- Noticeable slower psychomotor skills (almost everyday).
- Always tired or no energy (almost everyday).
- Feeling guilty or worthless with no reason (almost everyday).
- Lack of ability to concentrate, or unsure about things (almost everyday).
- Thoughts of suicide or death.
- Individual does not meet symptoms for a mixed episode.
- The symptoms cause obvious distress or impairment in social, occupational, or other important areas.
- The symptoms can not be explained due to direct physiological effects of a substance or medical condition.
- The symptoms are not due to bereavement, do not last longer than 2 months, and are not explained by characterized functional impairments, overly occupied with worthlessness, suicidal thoughts, psychotic symptoms, or psycho-motor retardation.
Culture differences can influence the way symptoms of depression are communicated. Latino and Mediterranean cultures tend to complain about nerves and headaches. Chinese and Asian cultures tend to complain about weakness, tiredness, or imbalance. Middle Eastern cultures tend to describe depression by complaining about problems with the heart and Hopi may express depression as a broken heart.
Depressive Episodes occurs twice as frequently in women then men.