THE DIAGNOSIS OF A DEPRESSIVE EPISODE

 1.   THE DIAGNOSIS OF A DEPRESSIVE EPISODE   including a sadness of mood, a psychomotor slowing syndrome and   instinctive   disorders   evolving   for   at   least   15   days   and   inducing   clinically   significant   distress   or   impairment in social or other important functioning.   1.1.   Depressive Syndrome   It combines a clinical triad, often with an insidious onset.   1.1.1.   Depressed mood   A sad mood   There  is  a  feeling  of  sadness,  which  can  vary  from  the  exaggeration  of  a  normal  feeling  of  sadness  to   moral   pain.   The   sadness   is   apparent,   persistent   and   sometimes   inconsolable.  It  may  be  replaced  by   dysphoria, which is a feeling of boredom associated with an irritable mood.   A loss of interest and pleasure   Sadness   can   be   replaced   by   or   coexist   with   a   general   feeling   of   weariness   and   disinterest,   often   leading  to  an  experience  of  helplessness  and  guilt.  There  is  also  an  inability  to  feel  pleasure  in  usually   pleasant   activities:   this   is   depressive   anhedonia   which   can   affect,   in   severe   forms,   affectionate   feelings: this is affective anesthesia.   A negative view of oneself, the world and the future       The vision of self   is negative : feelings of inferiority, incapacity and uselessness, sometimes with ideas   of helplessness and guilt.       The world view   and relationships with those around them are also negative.       The vision of the future   is reduced to only pessimistic potentialities.   Pessimism, anhedonia, disinterest and discouragement can lead to a disgust with life, sometimes   leading to suicidal thoughts.   1.1.2.   Psychomotor slowing   Engine slowdown   He experiences bradykinesia which results in hypomimia and a reduction in gestural punctuation of   speech. Everything in the subject's attitude seems slow: slow walking. 

 1.1.3.   Instinctual disorders   Sleeping troubles       Insomnia   late  nightis  the  most  evocative  (early  awakening).  It  can  also  be  insomnia  falling  asleep,  in   the middle of the night, or mixed.       Hypersomnia   is possible,but more rare Appetite disorders       Anorexia   , more frequent, may be accompanied by weight loss.       The increase   appetiteis rarer. Sexual disorders      Sexual disinterest with reduced desire in both sexes.      Erectile dysfunction in men and orgasm problems in women.   1.1.4.   Associated symptoms   Anxiety   Anxiety is often present in depression and leaves a specific mark on it:   dysphoric mood, motor instability, insomnia when  falling asleep. Somatic   symptoms   In addition to asthenia, various pains, including headaches, may be reported, as well as digestive and   genitourinary symptoms.   Character disorders   Sometimes, the depressive picture combines either regression and passivity or hostility and intolerance to   those around them (noise, requests, etc.).