DEPRESSION...

Core symptoms...
Low mood
Anhedonia
Reduced energy

Other symptoms:
Reduced concentration
Loss of appetite with weight loss
sleep disturbance - 1. early morning wakening, 2. initial insomnia
low self esteem
worthlessness and guilt
feeling hopeless about the future
suicidal ideation


Investigating low mood
Biological
Physical examination
Bloods - to exclude physical causes of low mood
Urinary drug screen
? based on the results do further.. CXR / ECF / EEG / CT head

Psychological
Rating scale (HADS)
Psychology referral

Social
Collateral history
OT assessment
SW assessment

Management of depression
Biological
Antidepressants - SSRIs, SNRIs
Adjuncts e.g. Lithium
Other mood stabilisers - sodium valproate
ECT

Psychological
Psychology referral
CBT
Psychodynamic psychotherapy
IPT / DBT / CAT (cognitive analytical therapy)

Social
Involve the multidisciplinary team
OT assessment
Family support, involvement and psychoeducation (to avoid stigmatisation)
Support groups
Social work ( good if got children on board)