HJAR May/Jun 2020

24 MAY / JUN 2020  I  HEALTHCARE JOURNAL OF ARKANSAS DEPRESSION Let’s say you go to your doctor because you have been experiencing a low mood for weeks or months. During your appointment, you are likely to be asked a handful of ques- tions to determine if you meet the diagnostic criteria for major depressive disorder (MDD). Major depressive disorder can be diagnosed by a history of one or more major depressive episodes. A major depressive episode is when five of the following nine criteria are present nearly every day for two consecutive weeks, including at least one of the first two criteria. • Depressed mood * • Loss of interest or pleasure in most or all activities * • Sleeping too little or too much • Significant appetite changes; weight loss or weight gain percent of people experience major depres- sive disorder in their lifetimes 1 . The prevalence is increased among those with chronic medical conditions. If your doctor determines that you fit the criteria for major depressive disorder, you are very likely to be offered a prescription for an antidepressant, usually an SSRI (selective se- rotonin reuptake inhibitor). Examples of SSRIs are fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft). There are reasons why you and your doctor might decide to first try a non- SSRI antidepressant; some antidepressants can offer additional benefits for concomitant condi- tions, such as smoking addiction, chronic pain, or insomnia. You may also be prescribed an antidepressant if you seem to be experiencing an anxiety disorder, or simply have negative • Thoughts of worthlessness or increased guilt • Fatigue or low energy • Decreased concentration; decreased abil- ity to think and make decisions • Psychomotor changes (e.g., slowed speech or movements, decreased speech, inability to sit still) observed by your healthcare provider • Recurrent thoughts of death or suicide To diagnose major depressive disorder, one must rule out a history of mania or hypomania (episodes of markedly increased activity and energy, among other features). Depression is the most common cause of disability worldwide. In the United States, it is estimated that 10 percent of people suf- fer from depression in a given year; over 20 diagnostic criteria for major depressive disorder (MDD) Depressed mood Loss of interest or pleasure in most or all activities Sleeping too little or too much Significant appetite changes; weight loss or weight gain Thoughts of worthlessness or increased guilt Fatigue or low energy Decreased concentration; decreased ability to think and make decisions Psychomotor changes (e.g., slowed speech or movements, decreased speech, inability to sit still) observed by your healthcare provider Recurrent thoughts of death or suicide