Major Depression is one of the important mental problems considering its social and individual effects. It is one of the diseases that causes the most disability among mental illnesses.
Not every state of depression is defined as major depressive disorder. In order for us to call it MDD, the symptoms listed below must continue throughout the day and for at least the last fifteen days and must have changed the level of functionality. • A depressed feeling observed almost every day and for most of the day. -state of mind (feeling unhappy, tearful, sad).
• Decreased interest and pleasure in all or most activities that last almost every day (previously enjoyed jobs, hobbies and activities) disliking habits, boredom, lack of sexual reluctance).
• Weight loss or gain (increase or decrease of more than 5% of body weight in a month) or an increase or decrease in appetite almost every day.
• Insomnia or excessive sleepiness almost every day.
• Normal brain and body functionality, decrease in mobility or restlessness almost every day.
• Feelings of weakness, fatigue, not feeling as energetic as the previous days almost every day.
• Feeling worthless, despising, disliking yourself, feeling guilty or sinful almost every day.
< br /> • A decrease in the ability to think or concentrate almost every day (inability to pay attention to what is spoken, read, watched, etc.) or a state of indecision.
• Recurrent thoughts of death, suicide plans or actions.
Some patients may experience anxiety, anxiety or anger along with sadness. The severity and characteristics of depression may vary depending on the number of these symptoms, the duration of their occurrence, and the disorders they cause.
Suicidal tendencies are a condition that requires sensitivity in depression. The risk of death by suicide in depression that is not treated appropriately is around 15%.
The average duration of a depression attack is usually 6-24 months. Major depressive disorder is twice as common in women than in men. Lifetime prevalence; It is 5-12% in men and 10-25% in women. A triggering event occurs in 25% of patients. Depressive disorders are more common in single and divorced people than in married people. There is no difference between racial and religious groups.
When diagnosing depression, it should be investigated whether there are other underlying causes and possible causes should be excluded. Vitamin deficiencies, anemia, thyroid diseases, kidney diseases, infections, endocrine and inflammatory diseases, neurological diseases, substance use, etc. should be evaluated carefully.
TREATMENTI
Treatments for major depressive disorder are usually medications, psychotherapy or any other treatment. two are included. Depending on the patient's condition, treatment can be arranged by inpatient or outpatient follow-up.
Patient-physician cooperation and the patient's active participation in the treatment are very important. Providing information about the treatment process increases compliance with treatment. The positive effects of the drugs usually begin to be seen after the 2nd week. In order to decide whether the patient benefits from the treatment, this drug must be used for 6-8 weeks with appropriate dosing. After the disease symptoms subside, drug treatment should be continued for approximately 6-9 months. Afterwards, the treatment should be terminated under the supervision of a doctor and by reducing the dose. This period may be longer in cases of frequently recurring depression.
Psychotherapy can be applied alone or in combination with medication to treat depression. It has been found to be very effective in treating a wide range of patients. It is also known that psychotherapy practices reduce the frequency of recurrence of the disease.
Electroconvulsive therapy (ECT) is an effective and safe treatment method in severe MDD cases, those who do not respond to other treatments, and those experiencing psychotic symptoms.
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