major depressive disorder

抑郁障碍 major depressive disorder
抑郁心境 Depressed mood
缺乏愉快体验 diminished interest or pleasure 
食欲改变 decrease or increase in appetite
睡眠障碍 Dyssomnia (sleeping disorder): Insomnia or hypersomnia
精力丧失、精神和躯体活动的变化 Psychomotor  retardation or agitation（激越）
；Fatigue or loss of energy 
无价值感和过度的罪恶感 Feelings of worthlessness or excessive or inappropria
te guilt 
犹豫不决或注意减退 Diminished ability to think or concentrate, or indecisive
ness
自杀观念与自杀 thoughts of death or suiside

Diagnosis of Depression
Diagnostic Criteria
A. At least one of the following three abnormal moods which significantly in
terfered with the person's life: 
1. Abnormal depressed mood most of the day, nearly every day, for at least 2
 weeks. 
2. Abnormal loss of all interest and pleasure most of the day, nearly every
day, for at least 2 weeks. 
3. If 18 or younger, abnormal irritable mood most of the day, nearly every d
ay, for at least 2 weeks. 
B. At least five of the following symptoms have been present during the same
 2 week depressed period. 
1. Abnormal depressed mood (or irritable mood if a child or adolescent) . 
2. Abnormal loss of all interest and pleasure . 
3. Appetite or weight disturbance, either: 
       (1)Abnormal weight loss (when not dieting) or decrease in appetite. 

       (2)Abnormal weight gain or increase in appetite. 
4. Sleep disturbance, either abnormal insomnia or abnormal hypersomnia. 
5. Activity disturbance, either abnormal agitation or abnormal slowing (obse
rvable by others).  医.学全.在线www.med126.net
6. Abnormal fatigue or loss of energy. 
7. Abnormal self-reproach or inappropriate guilt. 
8. Abnormal poor concentration or indecisiveness. 
9. Abnormal morbid thoughts of death (not just fear of dying) or suicide. 
C. The symptoms are not due to a mood-incongruent psychosis. 
D. There has never been a Manic Episode, a Mixed Episode, or a Hypomanic Epi
sode. 
E. The symptoms are not due to physical illness, alcohol, medication, or str
eet drugs. 
F. The symptoms are not due to normal bereavement. 

ABSTRACT
Depression is the common cold of mental disorders -- most people will be aff
ected by depression in their lives either directly or indirectly, through a
friend or family member. Confusion is commonplace about depression, for exam
ple, about what depression exactly is and what makes it different from just
feeling down. There is also confusion surrounding the many types of depressi
on (e.g., unipolar depression, biological depression, manic depression, seas
onal affective disorder, dysthymia, etc.) that people may experience. There
have been so many terms used to describe this set of feelings we've all felt
 at one time or another in our lives, to one degree or another, that it is t
ime to set the record straight. 

Depression is characterized by a number of common symptoms. These include a
persistent sad, anxious, or "empty" mood, and feelings of hopeless
ness or pessimism. A person who is depressed also often has feelings of guil
t, worthlessness, and helplessness. They no longer take interest or pleasure
 in hobbies and activities that were once enjoyed; this may include things l
ike going out with friends or even sex. Insomnia, early-morning awakening, a
nd oversleeping are all common. 

Appetite and/or weight loss or overeating and weight gain may be symptoms of
 depression in some people. Many others experience decreased energy, fatigue
, and a constant feeling of being "slowed down." Thoughts of death
 or suicide are not uncommon in those suffering from severe depression. Rest
lessness and irritability among those who have depression is common. A perso
n who is depressed also has difficulty concentrating, remembering, and troub
le making decisions. And sometimes, persistent physical symptoms that do not
 respond to traditional treatments -- such as headaches, digestive disorders
, and chronic pain -- may be signs of a depressive illness. 

Feeling down or feeling like you've got the blues is pretty common in today'
s fast-paced society. People are more stressed than ever, working longer hou
rs than ever, for less pay than ever. It is therefore natural to not feel 10
0% some days. That's completely normal. 

What differentiates occasionally feeling down for a few days from depression
 is the severity of the symptoms listed above, and how long you've had the s
ymptoms. Typically, for most depressive disorders, you need to have felt som
e of those symptoms for longer than two weeks. They also need to cause you a
 fair amount of distress in your life, and interfere with your ability to ca
rry on your normal daily routine. 

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