Depression Guide

Depression in ICD 10

The Depression Problem

We will discuss how depression in ICD 10 helps doctors diagnose and treat depression, types of depression, treatments for depression, and more.

Did you know that depression affects more than 25 million Americans each year?

Depression can affect someone on a mental, physical, and spiritual level. It’s quite common, but depression is something many people struggle to talk about. It’s a lonely disorder that compels a person to isolate themselves from others.

Yet, there’s hope even in the face of depression. According to the American Foundation for Suicide Prevention, depression is one of the most treatable psychological disorders with 80 to 90% of people being able to recover. People suffering from this disorder can find help through medication, talk therapies, and natural remedies for depression such as yoga and meditation.

Social Connection Can Help

The results of a research study conducted by Massachusetts General Hospital found that social connection was the greatest protecting factor against different types of depression.1 The study results were published in August in the American Journal of Psychiatry and analyzed data from over 100,000 patients.

The results were hopeful in that people suffering from depression can make long-lasting recoveries with the help of others. By staying connected to others and resisting the urge to self-isolate, treatment options were found to be more effective.

What is Depression?

How do medical professionals know if someone is really suffering from depression or just feeling a bit down? Are there different types of depression? When does a person need depression medication?

In general, mild depression often follows life-changing events such as loss of employment, a serious illness, bereavement, or domestic upheavals like divorce or a break-up. Experiencing some level of discontentment or mild dysphoria in life is normal. If those feelings persist for many weeks or months and there is also a sense of hopelessness, then it could be a case for clinical depression.

A Clear Definition of Depression

The American Psychiatric Association makes an important distinction between sadness and depression . . .

“Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home.”

Notice if you will, that depression can cause feelings of sadness. Yet, these feelings must impair the ability to function and persist over a long period to be a true case for clinical depression.

What are the different types of depression? And can someone have more than one type of depression? Well, the answers to those questions come from the World Health Organization and its International Classification of Diseases or ICD. Let’s take a closer look at what’s inside the ICD.

What Are the Risk Factors for Depression?

Several factors contribute to the onset and development of depression. Depression has a lot to do with family history. If your father or mother suffered from depression, then you are 3 times as likely to develop depression.

Women experience depression more often than men. In fact, 11 to 20% of women who give birth experience post-partum or post-natal depression. Childhood trauma is also a key risk factor for depression. That includes problems at home with family as well as elements of a troubled environment such as economic disparity.

Other risk factors for depression include:

Chronic and/or serious illness

Loneliness and isolation 

Bereavement

Hormonal imbalances due to puberty 

High-stress levels

Drug and alcohol abuse

Depression in ICD 10

Depression is a disorder that has always plagued humanity. The Greek physician Hippocrates viewed it as an imbalance of fluids called humors in the body. Hippocrates might not have had the benefits of modern medicine, but he recognized that something unique was taking place on a biological level.

Today, medical professionals use specific sets of criteria to diagnose depression.

Criteria and Categories of Depression in ICD 10

Doctors and therapists turn to the International Classification of Disease (ICD) to make an accurate diagnosis after a depression screening. There is a specific list of criteria for different types of depression. However, classifying depression in ICD can be challenging because symptoms often overlap and there are many complexities involved in describing how a person feels.

Atypical Depression

For example, with atypical depression, a person might feel better one day and feel worse the next. Their mood can improve but they still might feel a loss of appetite, feel disinterested in activities, and have trouble coping with day to day activities.

Atypical depression is a subtype of Major Depressive Disorder (MDD) and affects 3 times more women than men. Because of the way a person’s mood can fluctuate, this makes it difficult for clinicians to pinpoint the specific diagnosis without a guide.

Luckily, depression in ICD 10 has clear classifications based on a cluster of symptoms and categories for different types of depression. Depression in ICD is not a one-size-fits-all disorder.

Categorizing Depressive Episodes

Depression in ICD 10 begins with depressive episodes and further categorizes these episodes as mild, moderate, and severe. As you can probably gather from the name, depressive episodes are not continuous. These episodes take place periodically with symptoms of depression that vary along the lines of severity. When these episodes are persistent, then medical experts classify this as Recurrent Depressive Disorder.

Persistent Mood Affective Disorders

Depression in ICD 10 is then broken down into persistent mood affective disorders. These include cyclothymia and dysthymia. Cyclothymia is a mild mood swing depression that is similar to bipolar disorder. Dysthymia is also referred to as Persistent Depressive Disorder or PPD. It can start with a major depressive episode and progress into something more long-lasting.

Psychotic Depression

One of the most challenging forms of depression in ICD 10 is psychotic depression. According to the UK National Health Service, people who suffer from psychotic depression have an increased risk of suicide and most suffer from traumatic childhood events.

Psychotic depression has all the symptoms of severe clinical depression coupled with terrible hallucinations and delusions. It’s possible to not even recognize these hallucinations and delusions, so it is doubly important for a strong support system to be in place. Connection with others helps to ground people and alert medical service providers to changes in condition.

Residual Categories

There are other residual categories for depression in ICD 10. These categories are for types of depression that do not easily fall into other categories. It’s also important to note that the depression in ICD 10 is constantly being updated as new advances in psychology bring better clarity to mental health conditions.

The ICD is a guidebook and covers more than just depression. Just one glance at the ICD and one can tell that mental health disorders come in a wide range of types. Classifying depression in ICD 10 helps mental health practitioners work within a set framework, but they must still use their best judgment to make the right diagnosis.

What Are the Symptoms of Depression?

The Diagnostic and Statistical Manual for Mental Disorders (DSM) is a handbook for diagnosing and classifying depression. It also contains a list of symptoms for major depressive disorder. If you look up depression in the ICD, you’ll also find some symptoms. Healthcare professionals look for these symptoms during a depression screening.

In general, the symptoms are broken down into categories. Of course, there are some different types of depression, but these are the main symptoms. Depression doesn’t just affect the mind. There are psychological and physical symptoms. Here are some of the symptoms from the DCM and ICD.

Psychological Symptoms

Continuous low mood

Feelings of hopelessness or helplessness

Low self-esteem

Feelings of irritability 

The desire to isolate 

Lack of motivation 

Anxiety 

Not enjoying activities in life

Suicidal thinking 

Physical Symptoms

Changes in appetite 

Unexplained aches and pains

Low sex drive

Excessive weight loss or weight gain

Disturbed sleep patterns 

Lethargy 

What is Happening in the Brain of a Depressed Person?

Depression alters the neurochemistry of the brain. It works on three different areas – the hippocampus, prefrontal cortex, and the amygdala. So, depression is an intangible that only relates to a person’s feelings and emotions.

Stress and Depression

Depression is closely related to stress. According to the American Psychological Association, 1 in 5 people in the US experience extreme levels of stress.2 Also, 3 out of 4 doctor visits are stress-related. Stress raises the cortisol levels in the brain which can cause depression and make symptoms of depression much worse. Nearly all forms of depression are stress-related.

Depression and the Brains Neurotransmitters

Depression affects neurotransmitters such as dopamine, norepinephrine, and serotonin. These neurotransmitters send signals between neurons and are responsible for regulating our mood. When a person takes a bite of chocolate, for example, they get an immediate hit of dopamine.

During depression, neurotransmitter levels are exceptionally low. This has a ripple effect by disrupting sleep, appetite, and mood. Therefore, most pharmacological treatments for depression focus on regulating neurotransmitters.

People who suffer from depression often turn to drugs and alcohol as a coping mechanism, incorrectly believing substances help address symptoms. The presence of drugs or alcohol makes diagnosing depression extremely difficult. That’s because many symptoms of depression can be worsened through substance abuse.

1 in 3 Adults Who Have Depression Also Have Addictions

The results of a study published in the Journal of Clinical Psychiatry found that 1 in 3 adults who suffer from depression also have and addictions to drugs and alcohol.1 People who live with economic disparity, childhood traumas, and histories of abuse are also prone to depression and substance abuse.

Drug Make it Hard to Diagnose Depression

How can a doctor tell if someone is having trouble sleeping due to depression when they are regularly taking excessive amounts of drugs? Therefore, it’s important for any treatment plan for depression to also take into consideration your relationship with substances. The two must be faced together if a full recovery is to be made.

Treatment Options for Depression and Addiction

Treating depression can seem like a difficult journey, but most people make a complete and long-lasting recovery over time. There are a variety of treatment options available. There are medications, various talking therapies such as CBT or counseling, or a combination of both. There are also some natural remedies for depression that have been proven effective for mild to moderate cases.

Can the Mind Change?

That’s an important question when discussing treatments for depression, especially when coupled with addiction. It was once believed that cognitive patterns and the neurological functions of the brain were fixed since birth and that brain patterns couldn’t be altered.

However, advances in neurology have proven that through a process of neurogenesis, the development and formation of neural pathways continue to develop throughout our entire life cycle.

This is related to the concept of neuroplasticity. This is a big term that basically means that thought patterns and neurological functions can change over time. You can affect the way that your brain works, and that is great news when exploring depression medication.

Different Types of Antidepressants

Antidepressants work in a couple of different ways as they target different things in the brain. Most, if not all, focus on stimulating neurogenesis and the production of neurotransmitters such as serotonin.

Monoamine Oxidase Inhibitors (MOI)

MOIs are a type of depression medication that shuts down the enzyme monoamine oxidase. This enzyme breaks down neurotransmitters, so by blocking the work of this enzyme, more neurotransmitters are available in the nervous system.

MOIs are usually the last resort of psychiatrists when other treatment methods have proven ineffective. It’s not suitable for children and adolescents and MOIs pack some heavy side effects. These include nausea, dry mouth, dizziness, and headaches. MOIs are indiscriminate and can block other important enzymes, as well.

Selective Serotonin Reuptake Inhibitors (SSRI)

SSRIs are designed to only target serotonin. Most patients respond favorably to this depression medication with only mild side effects. SSRIs work by preventing serotonin from being re-absorbed (reuptake) by neurons, making more of these neurotransmitters available at higher concentration levels in the nervous system.

SSRIs are marketed under the names Zoloft, Paxil, Prozac, Celexa, and Lexapro. Usually, the benefits of this medication can be recorded between 2 and 4 weeks. It’s important if you are taking SSRIs to avoid other drugs or foods that also increase serotonin levels.

Are There Natural Remedies for Depression?

St. John’s Wort

St. John’s Wort is a natural remedy for depression, anxiety, OCD, and many other psychological ailments. It has been proven effective in mild to moderate cases of depression, but not in moderate to severe cases.

St. John’s Wort works as an SSRI, meaning that it makes more serotonin available in the nervous system. Although there are different dosages that a person can take, an effective dosage would be 300mg taken 3 times a day.

It should be noted, St John’s Wort can make hormonal birth control less effective and should not be taken by women looking to prevent pregnancy.

Yoga

Yoga has been proven to be an effective natural remedy for depression. It has well-documented antidepressant effects plus additional benefits such as improved circulation, posture, and overall sense of well-being.

Yoga is generally safe for people of all ages and classes can be even be found online at no cost. Movements can range from very easy to quite challenging, making yoga a lifelong practice. When paired with other therapies, yoga can complement a full depression treatment plan.

Mindfulness and Meditation

Mindfulness and meditation are helpful natural remedies for depression. They help manage stress and anxiety. These meditative practices put a person’s mental wellbeing in their own hands and can be a powerful component of a comprehensive treatment strategy.

Meditation teaches how to calm the storm, so to speak. If anxiety or depression is triggered by specific events such as going to the doctor’s office or taking a flight, then meditation could help reign in negative, destructive thought patterns.

The Future of Depression Treatment

Depressive disorders affect so many people, mainly due to high levels of stress. Yet, more and more people are learning ways to alleviate stress and recognize signs of depression in their life. By staying well connected with other people and practicing self-care, you have a greater chance of avoiding the onset of depression and can make treatment efforts more successful.

It’s difficult to gauge what the future holds for depression treatment. However, the International Classification of Disease (ICD) is in its tenth revision. It’s constantly being updated. Medical professionals will continue to use it as a guide for identifying depression to make it easier for people to get the right treatment that they need.

If you or anybody that you know is suffering from depression, then seek guidance from a medical professional or recovery expert. Don’t face this battle alone.


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