Depression is a mental illness characterised by a persistent mood of low self-esteem and loss of interest or pleasure in activities that would normally be considered enjoyable. It is sometimes accompanied by an irrational tendency to self-harm, even to the point of death.
The causes are not yet clear but it is related to psychological, psychosocial, hereditary, developmental and biological factors.
It manifests itself in a very low mood, feelings of worthlessness, inappropriate guilt, regret, helplessness, hopelessness and self-contempt. In severe cases, psychosis clinical pictures may occur, with delusions and unpleasant hallucinations.
Diagnosis is made by clinical interrogation, interview with friends or relatives, and physical and mental examination.
There are three lines of treatment that can be applied separately or in combination: psychotherapy, medication and electroconvulsive therapy.
It is necessary to consult in A&E (or Psychiatry/General Medicine departments) if there are self-harming or suicidal ideas, previous episodes of self-harm, aggressiveness, psychosis with hallucinations, self-inflicted injuries and/or ingestion of toxic substances.
- John Williams, MD. Jason Nieuwsma, PhD. Screening for depression in adults. UpToDate. Jul 19, 2016.
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- Siu AL, US Preventive Services Task Force (USPSTF), Bibbins-Domingo K, et al. Screening for Depression in Adults: US Preventive Services Task Force Recommendation Statement. JAMA 2016; 315:380.
- Peter P Roy-Byrne, MD. Unipolar depression in adults: Treatment with antidepressant combinations. UpToDate. May 27, 2015.
