depression /dipresh″ən/ [L, deprimere, to press down] , 1. a depressed area, hollow, or fossa. 2. downward or inward displacement. 3. a decrease of vital functional activity. 4. a mood disturbance characterized by feelings of sadness, despair, and discouragement resulting from and normally proportionate to some personal loss or tragedy. 5. an abnormal emotional state characterized by exaggerated feelings of sadness, melancholy, dejection, worthlessness, emptiness, and hopelessness that are inappropriate and out of proportion to reality. Because the origin of depression can be genetic, pharmacological, endocrinal, infectious, nutritional, neoplastic, or neurological, the behavioral effects can appear as aggression or withdrawal, anorexia or overeating, anger or apathy, or any of myriad responses. Kinds include agitated depression, involutional melancholia, major depressive disorder, reactive depression, retarded depression, anaclitic depression. See also bipolar disorder. −depressive, adj. ▪ OBSERVATIONS: Depression may be expressed in a wide spectrum of affective, physiological, cognitive, and behavioral manifestations. The varied behaviors represent the complex actions, reactions, and interactions of the person with depression to stimuli that may be either internal or external. Numerous symptoms representing a change from previous function are noted. The symptoms of depression are present during the same 2-week period and at least one of the symptoms is depressed mood or loss of interest in pleasurable activities. ▪ INTERVENTIONS: Depending on the root cause of the depression, a regime of antidepressant medication will be started to co-occur with individual and/or group psychotherapy. Depending on the severity of the depression, hospitalization may be warranted. In difficult-to-treat cases, a regime of electroconvulsive therapy may be the treatment of choice, to be followed by antidepressant medications and therapy. ▪ PATIENT CARE CONSIDERATIONS: The condition is neurotic when the precipitating cause is an intrapsychic conflict or a traumatic situation or event that is identifiable, even though the person is unable to explain the overreaction to it. The condition is psychotic when there is severe physical and mental functional impairment caused by an unidentifiable intrapsychic conflict; it is often accompanied by hallucinations, delusions, and confusion concerning time, place, and identity.
