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SYMPTOMS OF DEPRESSION
Anxiety:
A state in which the individual experiences feelings of uneasiness (apprehension) and activation of the autonomic nervous system in response to a vague, nonspecific threat. It is a common manifestation of depression, with up to 70% of individuals experiencing combined anxiety and depression. Anxiety symptoms can be very distressing to the individual, and may markedly affect his/her mood.
Situational Anxiety:
| Actual or perceived threats to the concept of self, such as:
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- Loss of status and prestige.
- Lack of recognition from others.
- Failure (or success).
- Loss of valued possessions.
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| Actual or perceived loss of significant others: |
Death; divorce; moving; temporary or permanent separation. |
| Actual or perceived threat to biological integrity: |
Dying; assault; invasive procedures; disease. |
| Actual or perceived change in environment: |
Hospitalization; moving; retirement. |
| Actual or perceived change in socioeconomic status: |
Unemployment; new job; promotion. |
| Transmission of another person's anxiety to the individual may also occur. |
Defining Characteristics Of Anxiety
| Physiological: |
Increased heart rate; elevated blood pressure, increased
respiratory rate; excessive sweating; dilated pupils;
voice tremors/pitch changes; tremors; palpitations;
nausea and/or vomiting; insomnia; fatigue and weakness;
flushing; dry mouth; body aches and pains; urinary frequency;
restlessness; faintness; paresthesias (eg numbness and/or tingling).
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| Emotional: |
Person states that he/she has feelings of apprehension;
helplessness; nervousness; fear.
Person exhibits irritability; angry outbursts; crying;
tendency to blame others; lack of self-confidence; loss of control;
tension or being "keyed up"; criticism of self and others;
withdrawal; lack of initiative; self-deprecation.
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| Cognitive: |
Inability to concentrate; lack of awareness of surroundings;
forgetfulness; rumination; orientation to the past rather than to the
present or future; blocking of thoughts (inability to remember).
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Anxiety differs from fear in that the anxious person cannot identify the threat. With fear, the threat can be identified. However, fear and anxiety can be present simultaneously in an individual.
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Disturbance of Sleep Pattern
The state in which the individual experiences, or is at risk of experiencing, a change in the quantity or quality of his rest pattern as related to his biologic and emotional needs. Sleep disturbances are common in depression and can be the individual's first complaint. One study estimates that as many as 80% of patients who suffer from depression experience frequent sleep disturbances. Failure to treat this condition is a major cause of noncompliance with therapy.
Situational: |
| Related to Depression: |
Lack of exercise, anxiety response. |
| Life-style Disruptions: |
Occupational; emotional; social; financial. |
| Medications: |
Tranquilizers; sedatives; hypnotics; antidepressants; monoamine oxidase inhibitors; amphetamines; barbiturates. |
Defining Characteristics:
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Difficulty falling asleep or remaining asleep; fatigue on awakening or during the day; dozing during the day; agitation; mood alterations. |
| Mood: |
A prevailing emotional tone or feeling. Individuals with
depression will often describe their mood as sad, hopeless,
"down in the dumps" or empty. Often, the presence of
depression can be deduced from a person's facial expressions
and demeanour.
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| Emotional: |
Increased irritability manifesting as persistent anger, angry
outbursts or over-reaction to minor events. Loss of interest or
pleasure in activities is almost always present to some degree.
Lack of motivation, indifference and displayal of a pessimistic
attitude are frequent. Concentration and memory problems are
common, and some patients may worry that they have
Alzheimer's disease.
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| Social Withdrawal: |
Those suffering from depression tend to avoid interactions with family and friends. |
| Sexual Dysfunction: |
The state in which an individual experiences, or is at risk of
experiencing, a change in sexual health or sexual function that
is viewed as unrewarding or inadequate.
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| Suicidal Risk: |
When the diagnosis of depression is suspected, a person's
suicide risk must be assessed. It is a sobering statistic that 10
to 15% of hospitalized depressed patients will eventually
commit suicide.
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