Depression: Part 1
Shawn Hersevoort, MD, and Heidi James, MD
Primary care psychiatrist and educator Shawn Hersevoort stops by to share insights into the diagnosis and management of depression.
- Depression is common
- It affects 25% of adults in their lifetime.
- It is the number 1 cause of disability and premature death.
- It affects 30%-50% of those with chronic medical illnesses.
- Etiology
- Depression is generally, but not exclusively, felt to be multifactorial:
- Biological
- Social
- Psychological
- Adverse childhood experiences increase risk.
- Signs and symptoms
- Presentation varies
- Must have loss of pleasure and/or depressed mood
- Anxious or stimulated depression
- Most common presentation
- Includes prominent anxiety and insomnia
- Atypical or lethargic depression
- Low energy
- Hypersomnia
- Increased appetite
- Melancholic depression
- More severe form
- Loss of pleasure
- Guilt
- Anorexia
- Insomnia
- Physical symptoms can include
- Enhanced experience of pain
- Screening/diagnosis
- SIGECAPS mnemonic:
- Sleep
- Interest
- Guilt
- Energy
- Concentration
- Appetite/anorexia
- Psychomotor slower
- Suicide
- PHQ9 (Patient Health Questionnaire-9) and GAD-7 (General Anxiety Disorder-7) screening tools
PEARL: Depression is common and can severely affect function. Thankfully, there are many effective management options, including exercise, therapy, and various classes of medications.
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