The term depression derives from the Latin verb deprimere (to press down, lower) and evokes a sense of oppression, crushing or sinking. It is now widely used in everyday language, but often incorrectly as a synonym for sadness. In medicine, by contrast, it denotes a true psychiatric disorder, often highly disabling and, in its most severe forms, potentially leading to suicide.
Depression manifests as a pathological lowering of mood that impairs the overall functioning of the personality, slowing cognitive, motivational and behavioral processes. It is a psychogenic disorder that can affect any age group and is the most common mood disorder.
In milder cases, diagnosis may be difficult because the boundary between clinical depression and a normal lowering of mood in response to adverse life events, such as bereavement, is often subtle. Diagnostic assessment is strictly within the competence of psychiatry and is based on the criteria of the DSM (Diagnostic and Statistical Manual of Mental Disorders) published by the American Psychiatric Association.
A distinguishing feature of depressive syndromes is the recurrence of depressive episodes over time, which are divided into major depressive episodes and minor depressive episodes. The former occur in major depressive disorders, dysthymic disorder and bipolar I and II disorders, although they may be absent in type II. The latter are typical of minor depressive disorders and have similar symptoms, but a lower degree of functional impairment.
Treatment is managed by specialists and is based on a combination of pharmacotherapy and psychotherapy, with structured and targeted psychological interventions. In some cases, complementary interventions such as music therapy or the Pet therapy may be added, respectively involving the therapeutic use of music and interaction with companion animals.
The electroshock (electroconvulsive therapy), once widely used, is now reserved for extremely severe cases and is performed by a limited number of specialists. Experimental approaches include new techniques such as Vagus nerve stimulation, a form of electrical stimulation of the vagus nerve using a small implanted device, similar to a pacemaker, that delivers regular impulses for antidepressant purposes.