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DYSTHYMIA: chronic depression
A. Depressed mood (or can be irritable in children and adolescents) for most of the day, more days than not, for at least two years (one year for children and adolescents.
B. Presence, while depressed, of at least two of the following:
1. poor appetite or overeating
2. insomnia or hypersomnia
3. low energy or fatigue
4. low self-esteem
5. poor concentration or difficulty making decisions
6. feelings of hopelessness
C. During a two-year period (one year for children and adolescents) of the disturbance, never without the symptoms in A for more than two months at a time.
D. No evidence of an unequivocal Major Depressive Episode during the first two years (one year for children and adolescents) of the disturbance.
E. Has never had a Manic episode.
F. Not superimposed on a chronic psychotic disorder.
G. It cannot be established that an organic factor initiated and maintained the disturbance, e.g. prolonged antihypertensive medication.
MAJOR DEPRESSIVE EPISODE
A. At least five of the following symptoms have been present during the same two-week period, and at least one of the symptoms is (1) depressed mood, or (2) loss of interest or pleasure.
1. depressed mood (or can be irritable mood in children and adolescents) most of the day, nearly every day.
2. markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
3. significant weight loss or weight gain when not dieting, or decrease or increase in appetite nearly every day. (In children, failure to make expected weight gain.)
4. insomnia or hypersomnia nearly every day.
5. psychomotor agitation or retardation nearly every day.
6. fatigue or loss of energy nearly every day.
7. feelings of worthlessness or excessive or inappropriate guilt nearly every day.
8. diminished ability to think or concentrate, or indecisiveness, nearly every day.
9. recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
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If you are depressed, you might be helped by a combination of counseling and antidepressant medication. There is a wide variety of antidepressant medication, having different effects and side effects.
For example, Prozac tends to also have a wakeful (stimulant) effect, while other antidepressants may have a sleepiness effect, especially when you first begin taking them. Some of the antidepressants require a couple of weeks before they begin to take effect.
One way to deal with the wake/drowsy effect is to take one type in the morning, or to take the other type at bedtime.
For some people, Prozac can also interfere with sexual function. Ask your doctor which is best for you. Keep in mind that a board-certified psychiatrist knows most about what type of medication to use.
Other treatments, such as EMDR, EFT, TFT, or TAT can also be effective on certain types of depression. (Eye Movement Desensitization and Restructuring, Emotional Freedom Technique, Thought Field Therapy, and Tapas Accupressure Technique.)