00:01
Now what are some of the
more significant features
that we're going to see
when we look at a person,
and we are interacting with a person
who may have major depressive disorder?
So a person,
as I've said before,
there are typical and atypical features.
00:19
So the typical features this
sadness, this anhedonia,
or losing any kind of enjoyment
and things that you used to enjoy,
this not being able to
get up and get out of bed.
00:33
But sometimes, we see very
critical later stage features.
00:42
A person might start hallucinating,
they might become delusional.
00:48
What's the difference there?
So hallucinations are sensory,
hearing, feeling, touching,
smelling, tasting,
and seeing things that are not there.
01:00
And what is a delusion?
How does that switch
over from hallucination?
What is the difference there?
When you're thinking about
delusion, it is a thought.
01:12
A delusion is a thought
that is not true,
that you believe 100%.
01:18
You may believe that you are the king of
the world, if you are extremely grandiose.
01:25
But if you are very,
very depressed,
you might have delusions that maybe people
are telling you that you're worthless,
you may have the delusion that everyone is
out there to prove how worthless you are.
01:40
And you don't need to have
any kind of evidence for that.
01:45
That's what makes it a delusion.
01:47
In the face of evidence
a delusion persists.
01:51
A delusion is in your thoughts.
01:55
It is something that
we have to work with,
we have to find medication and
therapy to help lift these thoughts.
02:04
Also, when you think about how a person
might feel so guilty, so inadequate.
02:11
They might think that they
deserve to be punished,
they might think that
they deserve to be,
you know,
taken outside and hurt.
02:22
And that increases that likelihood
that this person with depression
might put themselves with people
who are willing to hurt them.
02:31
And they might feel that
they deserve that hurt.
02:34
And they need protection.
02:36
Remember,
violence is usually not perpetrated
by a person with mental illness.
02:42
They are usually the
victims of a violent action.
02:47
Finally, there are two
other words that come up.
02:51
One is echolalia.
02:53
And the other is echopraxia.
02:56
So when you were
thinking about this,
I want you just to break
up that word for a second.
03:01
Think about echo,
what is an echo?
If I'm on the top of a mountain,
and I shout "Hello", what happens?
You hear hello, hello, hello.
03:11
So that's the repetition.
03:13
An echo is a repetition.
03:15
Echolalia is a feature
where when you're talking
to a person who is
significantly depressed,
you say, how are you and the person
looks right at you and says, how are you?
You say, are you doing better?
And they look at you and they
say, are you doing better?
Now, where does this come
from, this echolalia?
It may come from a
poverty of words,
it may come from a brain that
really can't find any new words.
03:49
And so they just repeat
exactly what is said to them.
03:54
Echopraxia, on the other hand,
is when they imitate what you're doing.
04:02
So if you are standing
there like this,
they might stand up like this.
04:08
It is not one of those
typical features.
04:12
It is atypical feature.
04:15
We also have to worry about
if depression continues.
04:20
And it becomes really critical.
04:22
They may have catatonia
or non responsiveness.
04:28
And I have had patients who
are totally unresponsive,
you almost think
they're in a coma.
04:35
But nothing medically demonstrates
that they're in a coma.
04:39
They are just simply
not responsive.
04:42
And it looks like they are incapable,
which they are, it's almost...
04:49
paralysis,
an emotional paralysis.
04:53
And you may see that
they have waxy stiffness
where you actually move their
hand and it's stays there.
05:02
And even when you
don't move it down,
it will stay there as long as they have
this kind of catalepsy or catatonia,
and it is against gravity, you would
think this would get very heavy for them,
but they will hold it.
05:23
Again, these are not
your typical symptoms.
05:26
Your typical symptoms with most people
who have major depressive disorder,
are going to be
this lack of energy,
this change in appetite,
this amazing sadness,
this inability to have any kind
of joy in what they're doing.
05:45
If they're moving forward and
they are not getting help.
05:49
And this depression
becomes something that is
so weighty in their body that
they no longer can get out of bed,
they no longer can eat or drink,
they are sleeping all the time.
06:03
It is critical,
it is critical that they get help.