Depression is second only to hypertension as the most common chronic condition encountered in general medical practice (at least one in ten outpatients has major depression). Depression should not be viewed as a mood. Sadness is a mood. Depression is a disorder in which the individual loses the emotional flexibility to respond to what is happening in their world.
Initially, it often starts with anxiousness, insomnia, and heightened irritability. This often progresses to problems with concentrating and making decisions. There often is a decline in productivity at work and tension develops with family and friends. This results finally in a state of frustration and feeling ashamed causing the person to withdraw from social activities and develop a state of hopelessness. It is important to treat aggressively in patients with other medical conditions (obesity, stroke, heart disease, seizures) because depression increases the patient’s sensitivity to somatic distress, leads to poorer self-care, and worsens the prognosis associated with these disorders.
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