(1) Exogenous depression. A typical symptom cluster for exogenous
(a) Precipitating event.
(b) Trouble getting to sleep at night.
Feeling fine in the morning and getting worse as the day goes on.
(d) Weight loss of less than 10 pounds.
(e) Reaction to the environment--if the person is with an "up" crowd, he
will seem to come out of his depression for a while.
(2) Endogenous depression. A typical symptom cluster for endogenous
Retardation of thought and motion (thinks in "slow motion").
Substantial weight loss due to very poor appetite.
Feeling that depression "crept upon him" and "came out of the
(d) Wakes very early in the morning and can't get back to sleep.
(e) Feels worse in the morning and improves as the day goes on.
Does not react to the environment.
(3) Evaluation. The evaluation of the symptom clusters requires you to
inquire about specific symptoms such as weight loss and the amount of loss over a
given period, sleeping patterns, and feeling of hopelessness. Arrange the symptoms
into appropriate clusters if indicated. Patients may have components of more than one
type of depression or other complicating mental illness.
e. Management of Depression. Types of medications used with severely
disturbed depressive patients include antidepressant, tranquilizing, and antianxiety
drugs. Usually, drug treatment is combined with other forms of therapy such as
individual or group psychotherapy. Medications given to treat depression are classified
in three groups: antianxiety, antidepressant, and antipsychotic agents.