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Depression

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Understand and Prevent Depression

6. How doctors classify mental illness

ICD10 is the International Classification of Disease. It is a way of classifying mental illnesses and is internationally understood and accepted. This makes the diagnosis of mental illness as clear in Lagos as it is in London. Information and research can be applied widely if a classification system is used, and it is clear that we are discussing the same illness. The classification system aims to be practical and versatile. Each mental illness is given a code, which you may have seen used on insurance claims forms as a form of shorthand. The DSM4 is the Fourth Diagnostic and Statistical Manual for Mental Disorders, which was evolved by the Americans. It is the second important diagnostic manual that we have in use.

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7. Diagnosis of depressive illness

Depressive illness cannot be diagnosed by a blood test or a scan – there is no single test that can diagnose depression with certainty. What the doctor is looking for is evidence that a person is ill, and ill with depression – they are not able to function normally and they feel different. They feel that they have changed, and are ‘not themselves’. The doctor will ask questions about your symptoms. The person who is depressed will experience many of the changes described.

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8. Who gets depressive illness?

8.1 Depression in children

Depressive symptoms or features (as opposed to depressive illness) are common in emotionally disturbed children. Serious depressive illness in children is very uncommon and may occur in about 1 in 1000 children aged 10–11. Less severe depression occurs in about 2 children in 100. Much more commonly in children, depression is expressed as a behavioral disorder, or shows itself with bodily complaints, e.g. worry about health, abdominal pain, headache and fatigue.

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9. Other medical disorders

9.1 Seasonal affective disorder (SAD)

Someone told me about a condition called SAD. How does this affect you?

SAD stands for seasonal affective disorder – mood disorder related to the seasons of the year. Some people do describe feeling particularly low during the dark winter months. Of course, good weather cheers everybody up, and bad weather can make one gloomy, but for a few people seasonal climate changes do appear to trigger off real symptoms of depression. It seems to relate to shorter daylight hours. It seems that these people are particularly sensitive to the stimulating effects of sunlight.

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10. Causes of Depression

We do not know exactly how depressive illness is caused, but we are learning more and more about it. There are many components: genetic vulnerability, stresses, ‘life-events’ – major milestones good and bad, and some physical illnesses. Once initiated, there are biochemical, psychological and sociological mechanisms that inflame, or perpetuate, the illness.

10.1 Genetics

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