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The Corporate States of America: A Map That Shows Each State's Most Famous Brand Room for argument? AdFreak is a daily blog of the best and worst of creativity in advertising, media, marketing and design. Had at least 2 weeks of a major depressive episode which caused significant distress or disability. When individuals face adversity, they often resort to our instinctual "fight, flight or fail" response.
Although "fight" (anger) may have been essential for our ancient ancestor's survival; in modern life, overuse of the anger-fight response usually makes more problems than it solves. Successful problem-solving usually involves making mistakes, and learning from these mistakes so that they are not repeated. If this problem persists: She will feel sad, hopeless, discouraged, "down in the dumps", or "blah". If this problem persists: She will feel less interested in hobbies, "not caring anymore," or not feeling any enjoyment in activities that were previously considered pleasurable.
If this problem persists: She will have unrealistic negative evaluations of her worth or guilty preoccupations or ruminations over minor failings. If this problem persists: She will have an impaired ability to think, concentrate, or make decisions. Major Depressive Disorder is a condition characterized by one or more Major Depressive Episodes without a history of Manic, Mixed, or Hypomanic Episodes. Completed suicide occurs in up to 15% of individuals with severe Major Depressive Disorder. Alcoholism and illicit drug abuse dramatically worsen the course of this illness, and are frequently associated with it. Disorder, Obsessive-Compulsive Disorder, Anorexia Nervosa, Bulimia Nervosa, and Borderline (Emotionally Unstable) Personality Disorder.
The first episode may occur at any age from childhood to old age, the onset may be either acute or insidious, and the duration varies from a few weeks to many months.
There is a greater likelihood of developing additional episodes of this disorder if: (1) there was pre-existing Persistent Depressive Disorder, (2) the individual has made only a partial recovery, (3) the individual has a chronic general medical condition.
Manic Episode never disappears completely, however many Major Depressive Episodes have been experienced. Stressors may play a more significant role in the precipitation of the first or second episode of this disorder and play less of a role in the onset of subsequent episodes. First-degree biological relatives of individuals with this disorder are 2-4 times more likely to develop Major Depressive Disorder.
The major psychological treatments for depression [cognitive behavior therapy (CBT), mindfulness-based cognitive therapy (MBCT), interpersonal therapy (IPT), short-term psychodynamic psychotherapy (STPP)] when compared to each other are equally effective.
One large NIMH study on major depressive disorder found that the remission rate (after 16 weeks of treatment, at 18-month followup) did not differ significantly among four treatments: 30% for cognitive behavior therapy, 26% for interpersonal therapy, 19% for imipramine plus clinical management, and 20% for placebo plus clinical management. The addition of psychological treatment (CBT, MBCT, IPT, STTP) to antidepressant medication results in an improvement in outcome. Recent research on antidepressant medication has made startling findings: (1) all second-generation antidepressant medications are equally effective, (2) treatment with a combination of antidepressant medications (especially TCA + SSRI) is much more effective than treatment with a single antidepressant medication, (3) only 60% of individuals with major depression respond to antidepressant medication, and (4) antidepressant medications have relatively modest effects when compared with an active placebo - such as patients seeing their GP for brief counselling. Treatment refractory depressions may respond to a combination of an antidepressant plus lithium or electroconvulsive therapy (ECT). Although almost two-thirds of individuals with major depressive disorder respond to current therapies; at least one-third of those entering remission relapse back into depression 18 months posttreatment.
In typical mild, moderate, or severe depressive episodes, the patient suffers from lowering of mood, reduction of energy, and decrease in activity. Four or more of the above symptoms are usually present and the patient is likely to have great difficulty in continuing with ordinary activities. An episode of depression in which several of the above symptoms are marked and distressing, typically loss of self-esteem and ideas of worthlessness or guilt.
A disorder characterized by repeated episodes of depression as described for depressive episode (F32.-), without any history of independent episodes of mood elevation and increased energy (mania). A disorder characterized by repeated episodes of depression, the current episode being mild, as in F32.0, and without any history of mania. A disorder characterized by repeated episodes of depression, the current episode being of moderate severity, as in F32.1, and without any history of mania.
A disorder characterized by repeated episodes of depression, the current episode being severe without psychotic symptoms, as in F32.2, and without any history of mania.
A disorder characterized by repeated episodes of depression, the current episode being severe with psychotic symptoms, as in F32.3, and with no previous episodes of mania. Five (or more) 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. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation). Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down). Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others). Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The episode is not attributable to the physiological effects of a substance or to another medical condition. The occurrence of the major depressive episode is not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified and unspecified schizophrenia spectrum and other psychotic disorders. Note: This exclusion does not apply if all of the manic-like or hypomanic-like episodes are substance-induced or are attributable to the physiological effects of another medical condition.
Which Behavioral Dimensions Are Involved?The ancient Greek civilization lasted approximately 3,000 years (16th century BC to 15th century AD). In life there is a constant struggle between good and evil; hence there is a need for justice. Individuals that are open to new experience are creative, imaginative, philosophical, intellectual, complex, and curious.


Over 5 years (2005-2011) I studied my outpatient psychiatric patients that had a DSM-IV diagnosis of Major Depressive Disorder. Fatigue, sleep disturbance, appetite disturbance, occupational impairment and social impairment are all part of the diagnostic criteria for major depressive disorder.
Depressed mood, guilt, self-harm, agitation, distractibility, apathy, and impaired executive functioning are all part of the diagnostic criteria for major depressive disorder. It's important to note that, except for 2 patients that committed suicide, none of the other depressed patients remained suicidal. The most striking finding was the extent to which depression had impaired my patients' social functioning. Studies on starvation have repeatedly shown that, after a few days of starvation, some individuals can become clinically depressed.
On the sixth day of starvation, a male member of the group just gave up, and said that they had no chance of getting any more food.
Fortunately, on the seventh day of starvation, the four group members that still had the energy and optimism to hunt, actually killed an elk using their caveman spears. When you watch the video of this caveman experiment, you can see practically all of the symptoms of major depressive disorder appear.
This disorder can be triggered by exposure to any major physical, psychological, or social adversity.
In terms of survival, hibernation or "shutting down" makes sense if there is nothing more you can do in the face of adversity.
Adverse Drug Reaction Probability Scale (Naranjo Scale) - This scale was developed to help standardize assessment of causality for all adverse drug reactions.
Summary Of Practice Guideline For The Treatment Of Patients With Major Depressive Disorder.
Each recommendation is identified as falling into one of three categories of endorsement, indicated by a bracketed Roman numeral following the statement.
With the patient's permission, family members and others involved in the patient's day-to-day life may also benefit from education about the illness, its effects on functioning (including family and other interpersonal relationships), and its treatment [I].
Patients should also be told about the need to taper antidepressants, rather than discontinuing them precipitously, to minimize the risk of withdrawal symptoms or symptom recurrence [I]. Patient education also includes general promotion of healthy behaviors such as exercise, good sleep hygiene, good nutrition, and decreased use of tobacco, alcohol, and other potentially deleterious substances [I]. Educational tools such as books, pamphlets, and trusted web sites can augment the face-to-face education provided by the clinician [I].
An antidepressant medication is recommended as an initial treatment choice for patients with mild to moderate major depressive disorder [I] and definitely should be provided for those with severe major depressive disorder unless ECT is planned [I]. For most patients, a selective serotonin reuptake inhibitor (SSRI), serotonin norepinephrine reuptake inhibitor (SNRI), mirtazapine, or bupropion is optimal [I].
In patients who prefer complementary and alternative therapies, S-adenosyl methionine (SAMe) [III] or St. Patients receiving pharmacotherapy should be systematically monitored on a regular basis to assess their response to treatment and assess patient safety [I].
If antidepressant side effects do occur, an initial strategy is to lower the dose of the antidepressant or to change to an antidepressant that is not associated with that side effect [I]. Follow us as we celebrate (and skewer) the latest, greatest, quirkiest and freakiest commercials, promos, trailers, posters, billboards, logos and package designs around. Depressed mood plays an important role in problem-solving because it signals that the individual's current attempt at problem-solving has failed, and that an alternative approach should be tried. She may often misinterpret neutral or trivial day-to-day events as evidence of her defects and have an exaggerated sense of responsibility for untoward events.
Many studies have shown that it is not possible to predict accurately whether or when a particular individual with depression will attempt suicide. These Major Depressive Episodes are not due to a medical condition, medication, abused substance, or Psychosis. Accurate diagnosis of this disorder requires assessment by a qualified practitioner trained in psychiatric diagnosis and evidence-based treatment. Computerized diagnosis is less accurate when done by patients (because they often lack insight).
There is a fourfold increase in deaths in individuals with this disorder who are over age 55.
Persistent Depressive Disorder often precedes the onset of this disorder for 10%-25% of individuals. The prevalence in 18- to 29-year-old individuals is threefold higher than the prevalence in those aged 60 or older. These vascular depressions are associated with greater neuropsychological impairments and poorer responses to standard therapies. About 5%-10% of individuals with Major Depressive Disorder eventually convert into Bipolar Disorder. Major Depressive Disorder, particularly with psychotic features, may also convert into Schizophrenia, a change that is much more frequent than the reverse. The presence or absence of stressful life events does not appear to provide a useful guide to prognosis or treatment selection.
Heritability is approximately 40%, and the personality trait neuroticism accounts for a substantial portion of this genetic liability. Among patients who had recovered, rates of relapse back into depression (at 18-month followup) were 36% for cognitive behavior therapy, 33% for interpersonal therapy, 50% for imipramine plus clinical management, and 33% for placebo plus clinical management.
St John's wort and regular exercise appear mildly effective in the treatment of depression (but their effect size is small). Capacity for enjoyment, interest, and concentration is reduced, and marked tiredness after even minimum effort is common. Depending upon the number and severity of the symptoms, a depressive episode may be specified as mild, moderate or severe. The patient is usually distressed by these but will probably be able to continue with most activities.
Suicidal thoughts and acts are common and a number of "somatic" symptoms are usually present.
If such an episode does occur, the diagnosis should be changed to bipolar affective disorder (F31.-). This decision inevitably requires the exercise of clinical judgment based on the individual's history and the cultural norms for the expression of distress in the context of loss.


During major depressive disorder, individuals lack the essential social skills of self-confidence, optimism, belonging, and sociability.
Research has shown that these 5 themes are basic dimensions of personality disorders and other mental disorders. Agreeable, cooperative individuals are sympathetic, warm, kind, altruistic, empathetic, and polite. They find it easy to think in symbols and abstractions (hence excel in mathematical, logical or geometric thinking). Extraverted, enthusiastic people are talkative, bold, energetic, emotionally positive, and sociable. Individuals with an optimal level of courage are stable and calm; they do not emotionally over-react to stress. I recorded their progress on every office visit using my Internet Mental Health Quality of Life Scale.
In this way, I could statistically determine which symptoms were elevated in major depressive disorder.
As expected, these classical symptoms of major depression decreased as my patients recovered. Thus suicide is a tragic waste of life; especially when major depressive disorder is so time-limited. By the fourth day of starvation, the entire group suffered from severe fatigue, insomnia and apathy.
So depression can be triggered by a physical illness or stress, an addiction to alcohol or drugs, or a significant psychological or social stress.
John's wort [III] might be considered, although evidence for their efficacy is modest at best. Individuals that accept responsibility for their mistakes, are more likely to learn from their mistakes. She may find that washing and dressing in the morning are exhausting and take twice as long as usual.
Motivations for suicide may include a desire to give up in the face of perceived insurmountable obstacles or an intense wish to end an excruciatingly painful emotional state that is perceived by the person to be without end.
A second study on moderate to severe major depressive disorder found (at 12-month followup) a 31% relapse rate back into depression for cognitive behavioral therapy, and a 47% relapse rate for patients who kept taking medication. When compared to the 40% remission rate on active placebo, the remission rate on antidepressant medication is 45% for mild depression, 52% for moderate depression, and 56% for severe depression. Of those going into remission with ECT, at 6 months posttreatment: (1) on placebo 84% relapse, and (2) on antidepressant medication plus lithium 39% relapse. Human behavior is governed by conscience - an inner sense of what is right or wrong - which guides conscientious behavior. They often excel in literature, music composition or performance, or in the visual or performing arts. Whereas reserved, quiet people (introverts) are aloof and lack the exuberance, energy, and activity of the talkative, assertive extraverts.
Individuals with too much courage, and not enough fear, become reckless, and this usually leads to failure.
Three members of the group became dysfunctional and just spent the day lying down or sitting. They are more likely to focus on what they can do differently to avoid repeating their mistakes.
A third study on moderate to severe major depressive disorder found that (after 16 weeks of therapy) there was a 46% remission rate for medication, and a 40% remission rate for cognitive therapy.
Since antidepressant medication is no more effective than active placebo for the treatment of mild major depressive disorder; antidepressant medication has proven benefit only in the treatment of moderate to severe major depressive disorder. Thus ECT is effective during the acute treatment phase in hospital, but steadily loses its benefit after hospital discharge.
Conscientious, careful, responsible people follow the rules, conform to norms, think before acting, and control their impulses. In contrast, individuals that don't accept responsibility for their mistakes, and blame their mistakes on external circumstances, don't learn from their mistakes and go on repeating the same mistakes. However, for those whose depression causes marked distress or disability; antidepressant medication dramatically reduces the risk of suicide, and returns the individual back to health, months sooner than would have been the case without treatment.
The effectiveness of ECT vs sham ECT at one or more months posttreatment is still controversial. They set clear goals and pursue them with determination; they are reliable and hard-working.
Individuals that are conventional and uncreative are conforming and prefer dealing with either people or things rather than ideas.
Thus they over-react emotionally to stress, and their fear or despair usually leads to failure.
Unfortunately, if individuals get stuck and can't solve their problems or walk away from them, the resulting depressed mood can be very demoralizing and can trigger a major shutdown in adaptive functioning. It should be remembered that, even without treatment, the median duration of major depressive disorder is 6 months. Unconscientious, careless, irresponsible people are disorderly, frivolous, and undependable.
They have narrow, commonplace interests, and they prefer the plain and obvious over the complex and subtle. In contrast to the chaotic, undercontrolled life of individuals with Antisocial Personality Disorder, is the highly ordered, overcontrolled life of individuals with Obsessive-Compulsive Personality Disorder.
Bean has the biggest footprint in Maine, General Electric electrifies my home state of Connecticut, and Hooters stands out in Florida. Individuals with Obsessive-Compulsive Personality Disorder are overly conscientious, perfectionistic, scrupulous and meticulous.



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