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Depressive Disorder NOS - Depressive Disorder NOS Symptom, Cause, Treatment
Depressive Disorder Not Otherwise Specified (NOS) is a type of Bipolar Disorder (also known as "manic-depressive illness" or "manic depression"). If a patient exhibits the depressive symptoms as the major feature of their disorder, but does not meet the criteria for any other mood disorder or any other mental disorder, then the depressive disorder, NOS is used. Depressive Disorder not Otherwise Specified ( NOS ) is a depressive disorder that fits no other category. This designation abbreviated NOS can be used when the mental disorder appears to fall within the larger category but does not meet the criteria of any specific disorder within that category.
Symptoms of Depressive Disorder NOS
Depressive Disorder Not Otherwise Specified. Major depressive episode
- At least five of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either 1) depressed mood or 2) loss of interest or pleasure (do not include symptoms that are clearly due to general medical condition or mood-incongruent delusions or hallucinations)
1. Depressed mood most of the day, nearly every day, as indicated either
by subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful)
2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated either by subjective account or observation made by others)
3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day
4. Insomnia or hypersomnia nearly every day
5. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
6. Fatigue or loss of energy nearly every day
7. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
8. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others)
9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or specific plan for committing suicide
- The symptoms do not meet criteria for a mixed episode
- The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
- The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism)
- The symptoms are not better accounted for by bereavement, i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms,or psychomotor retardation
Major depressive disorder,single episode
- Presence of a single major depressive episode
- The major depressive episode is not better accounted for by schizoaffective disorder and is not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or psychotic disorder not otherwise specified
- There has never been a manic episode, a mixed episode, or a hypomanic episode
Major depressive disorder, recurrent
- Presence of two or more major depressive episodes (each separated by at least 2 months in which criteria are not met for a major depressive episode)
- The major depressive episodes are not better accounted for by schizoaffective disorder and are not superimposed on schizophrenia, schizophreniform disorder, delusional disorder, or psychotic disorder not otherwise specified
- There has never been a manic episode, a mixed episode, or a hypomanic episode
Causes of Depressive Disorder NOS
Depression may be caused by an imbalance of naturally-occurring chemicals, serotonin and norepinephrine, in the brain and the body. In the brain, these two chemicals are thought to be associated with mood. These same chemicals are thought to be associated with regulating and reducing feelings of pain that come from the body. Depression may be secondary to a specific medical condition, for example:
- Metabolic disturbances, such as hypoxia and hypercalcemia
- Endocrine disorders, such as diabetes and Cushing's syndrome
- Neurologic diseases, such as Parkinson's disease and Alzheimer's disease
- Cancer (especially of the pancreas)
- Viral and bacterial infections, such as influenza and pneumonia
- Cardiovascular disorders such as heart failure
- Pulmonary disorders such as chronic obstructive pulmonary disease
- musculoskeletal disorders such as degenerative arthritis
- GI disorders such as irritable bowel syndrome
- Genitourinary problems such as incontinence
- Collagen vascular diseases such as lupus
- Anemia's.
Treatment of Depressive Disorder NOS
Basic types of treatment for depression Disorder NOS include antidepressant medications, psychotherapy, or electroconvulsive therapy (ECT).
- Antidepressant medications- Antidepressant medicines are almost always prescribed, effective especially when combined with psychotherapy
- Psychotherapy- most often cognitive-behavioral and/or interpersonal therapy) for the individual. Cognitive-behavioral focused on the negative thinking and behavioral patterns associated with depression, and teaches the individual to recognize and target the self-defeating behavioral patterns that contribute to their depression.
- Electroconvulsive therapy (ECT)- ECT (shock treatments) is an effective treatment for major depression when medicines have not worked, or when medicines cannot be used because of health problems.
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