Depression, major

Depression, major

Also known as unipolar disorder, major depression is a syndrome of persistently sad, dysphoric mood accompanied by disturbances in sleep and appetite, lethargy, and an inability to experience pleasure (anhedonia). Major depression occurs in 3% to 5% of adults, affecting all racial, ethnic, and socioeconomic groups. It affects both sexes but is more common in women. (See Depression.)

About half of all depressed patients experience a single episode and recover completely; the rest have at least one recurrence. Major depression can profoundly alter social, family, and occupational functioning.

However, suicide is the most serious complication of major depression, resulting when the patient’s feelings of worthlessness, guilt, and hopelessness are so overwhelming that he no longer considers life worth living. Nearly twice as many women as men attempt suicide, but men are far more likely to succeed.


The multiple causes of depression aren’t completely understood. Current research suggests possible genetic, familial,
biochemical, physical, psychological, and social causes.

Psychological factors

Such causes may include feelings of helplessness and vulnerability, anger, hopelessness and pessimism, and low self-esteem; they may be related to abnormal character and behavior patterns and troubled personal relationships.

In many patients, the history identifies a specific personal loss or severe stressor that probably interacts with the person’s predisposition to provoke major depression.

Medical conditions

Depression may be secondary to a specific medical condition—for example, metabolic disturbances, such as hypoxia and hypercalcemia; endocrine disorders, such as diabetes and Cushing’s disease; neurologic diseases, such as Parkinson’s and Alzheimer’s disease; and cancer, especially of the pancreas.

Other medical conditions that may underlie depression include viral and bacterial infections, such as influenza and pneumonia; cardiovascular disorders such as heart failure; pulmonary disorders such as chronic obstructive pulmonary disease; musculoskeletal disorders such as degenerative arthritis; GI disorders such as irritable bowel syndrome; genitourinary problems such as incontinence; collagen vascular diseases such as lupus; and anemias.


Drugs prescribed for medical and psychiatric conditions as well as many commonly abused substances, can also cause depression. Examples include antihypertensives, psychotropics, narcotic and nonnarcotic analgesics, antiparkinsonian drugs, numerous cardiovascular medications, oral antidiabetics, antimicrobials, steroids, chemotherapeutic agents, cimetidine, and alcohol.

Jun 16, 2016 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Depression, major

Full access? Get Clinical Tree

Get Clinical Tree app for offline access
%d bloggers like this: