Assignment:
Depression - Pathophysiology and Treatment
Major depressive disorder (MDD) is a prevalent, heterogeneous illness characterized by depressed mood, anhedonia, low energy or fatigue, and altered cognitive function. Other symptoms, such as sleep and psychomotor disturbances, feelings of guilt, low self-esteem, suicidal tendencies, as well as autonomic and gastrointestinal disturbances, are also often present (Jia, & Le, 2015).
MDD involves complex signaling networks. This includes alterations of cytokines, monoaminedeficiency in the central nervous system, and dysfunction of the glutamate system. MDD can often be related to disturbed neurogenesis which is the structural and/or functional alterations of the limbic and cortical regions. It is also proposed that dysfunction of synaptic plasticity is a basis of the etiology of MDD (Jia, & Le, 2015).
The treatment for depression is typically done through psychotherapy, medication and electroconvulsive therapy (ECT). There are many different medication options for patients with depression that include:
Selective serotonin-reuptake inhibitors (SSRIs): These drugs have become the standard antidepressants. They target the brain chemical (neurotransmitter) serotonin. They can be effective and usually have moderate side effects.
Neurotransmitter inhibitors: These drugs target neurotransmitters other than or in addition to serotonin, such as norepinephrine. Many are proving to be effective in patients who do not respond to standard antidepressants or in specific patients, such as smokers who want to quit or patients with chronic pain.
Tricyclic antidepressants (TCAs): These drugs are effective but can have severe adverse effects, particularly in older people.
Monoamine oxidase inhibitors (MAOIs): MAOIs are very effective for some types of depression, but can have severe side effects and require restrictive dietary rules and care to avoid drug interactions.
(American Accreditation HealthCare Commission, 2016).
Depression and Gender
Depression has been found to be more prevalent in women than in men. In a study done in China on University students they found that 708 of the 5989 students surveyed had some level of depression. Of these 708 there were significantly more female students than male students. They also found that this female to male ration increased as the severity of the depression increased (Sun, Niu, Zhou, Tang & You, n.d).
How does UIHC educate patients?
I am currently an employee and a patient of the University of Iowa Hospital. One thing that I have found as a patient to be extremely helpful is our patient portal called MyChart. Many of our patients receive face to face education during their appointment but this can be overwhelming. Patients are able to come back to their patient portal and search for any medical diagnosis and learn more (American Accreditation HealthCare Commission, 2016).
When I looked for information regarding depression I was amazed at the amount of information provided. The site reviews what depression is and all the different diagnosis of depression. The site gives an overview of risk factors and causes, including genetic and biologic factors. It also reviews treatment options and medications. This site truly covered all the information I would be looking for as a patient wanting more information regarding depression.