First Glance
| Fundamentals | |||
| Biological symptoms
Sleep disturbance are the commonest biological symptoms. In fact, the occurrence of sadness along with disturbed sleep might be a good indication that the sadness is morbid or pathological and thus one can differenciate it from normal sadness. The commonest sleep disturbance is reduction in total sleep time. Depressed patients have difficulty in falling asleep, have numerous interruptions while asleep and also wake up much earlier than their usual waking up time. Moreover, the depressed person might report that he does not feel fresh after waking up from sleep. In contrast, some depressed persons might have increased sleep. Appetite also, is reduced commonly in depression. The loss of appetite might also lead to loss of weight. Sometimes the patient may complain about loss of taste of food and thus explain his reduced intake of food. The loss of weight could be due to loss of interest in eating food. Like with sleep, some depressed patients could have increased appetite rather than decreased appetite. Loss of libido is also reported. The depressed person has interest in matters of sex and sexual activity. This might arise from the general loss of interest in all surroundings and the opposite sex. Sometimes there might be an increased libido but this is not very common. |
|||
|
|||
Psychotic symptoms There are certain psychotic symptoms which also might occur in psychotic depression. These are usually in the form of delusions and hallucinations. In more advanced cases, insight is lost and the idea of guilt becomes fully delusional. There may be grandiose element in these delusions, with the patient believing that some action or omission of his is responsible for great disasters in faraway places. Associated with delusional pathological guilt may be guilty ideas of reference, in which the patient feels that those around him are blaming him or even accusing him. In early stages insight may be retained, but later the patient may develop delusions of reference and delusional misinterpretations. Delusions of persecution are often an extension of this line of thought, the patient feeling that people are quite justified in acting against, him in the way be imagines. However, not all depressed patients with delusions of persecution do feel their persecutors are justified. |
|||
|
|||
Severely depressed patients may experienced auditory hallucinations. These are usually 'second person' and are always consistent with mood, being derogatory or jeering, or foretelling disaster. They are not persistent - if they are, consideration should be given to the possibility of schizophrenia. Signs of depression These may be prominent or altogether missing - they include sad faces, stooped posture, tearfulness and motor retardation or agitation. At times, depressed patients may put on a smile, the so-called 'smiling depression'. Speech may be retarded, with a delay in answering and gaps between phrases and words. The voice may die away at the end of the sentence and often has a monotonous tone. The patient may experience subjective slowing of movements, the feelings that he can only move in slow motion. Energy is reduced as is work output and efficiency. The patient may look retarded, with a slow laboured walk and a reduction of purposive and expressive movements. In extreme cases, the patient may pass into a depressive stupor in which case he may need feeding but is rarely incontinent. Some patients are visibly agitated with much purposeless activity, pacing up and down, wringing their hands and showing signs of obvious distress. No single patient is likely to manifest all the symptoms and signs of depression and virtually any symptoms of which patients commonly complain can be associated with depression. Dry mouth, constipation, difficulty in concentrating, poor memory, dryness of the skin and many other symptoms have been associated by patients with their depression. |
|||
1 2 3 4 5 6 7 8 9 10  |
