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Jul 22, 2024, 8:13:22 AM7/22/24
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An episode is also a narrative unit within a continuous larger dramatic work. It is frequently used to describe units of television or radio series that are broadcast separately in order to form one longer series.[2] An episode is to a sequence as a chapter is to a book. Modern series episodes typically last 20 to 50 minutes in length.[3]

The definition of a depressive episode is a period of depression that persists for at least two weeks. 1 During a depressive episode, a person will typically experience low or depressed mood and/or loss of interest in most activities, as well as a number of other symptoms of depression, such as tiredness, changes in appetite, feelings of worthlessness and recurrent thoughts of death. The length of a depressive episode varies, but the average duration is thought to be six to eight months. 2

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Depression is a common illness, and many people will experience one or more episodes of depression in their lifetime. While people of all races and ages can experience depressive episodes, they tend to be more common among women than men. 3 4 People who have a history of depression, other mental health conditions such as bipolar disorder or anxiety, or chronic physical conditions such as diabetes, chronic pain or multiple sclerosis 5, also have a higher risk of experiencing a depressive episode. 2

The severity of a depressive episode varies; it may be classified as major or minor, depending on the number of symptoms and degree of impairment (social, domestic and work) experienced. 6 Regardless of the severity, all depressive episodes should be taken seriously and treated promptly by a professional healthcare provider. 7 Effective treatment, which typically involves medication and/or therapy, for depression is available. 4

Without appropriate treatment, the risk of experiencing further episodes of depression is thought to be higher. The risk of another depressive episode occurring seems to increase with every new episode, with each one likely to last longer and be more severe than the previous one. Timely treatment can alleviate the symptoms of depression and help shorten the duration of any future episodes. 8

The symptoms of a depressive episode typically include a depressed mood, i.e. feeling sad, empty or hopeless, and/or loss of interest or enjoyment in most activities, together with any number of the following: 1 9

If only two to four of the above symptoms are present, instead of major depressive episode, a diagnosis of minor depressive episode may be made. At least one of the symptoms needs to be depressed mood or loss of interest in most activities. 14 This may occur as part of a minor depressive disorder.

It may take a few weeks for an antidepressant to take effect and alleviate the symptoms of a depressive episode. A doctor will advise on how long the medication should be taken and what to do if a person wishes to stop taking it. While antidepressants are not considered to be addictive, stopping them suddenly may cause discontinuation symptoms, so the process needs to be managed by a medical practitioner. 15

Acupuncture, spiritual practice and nutritional changes may also be suggested as complementary therapies to help in the treatment of depressive episodes, though there is insufficient scientific evidence to support their efficacy. 3

If the depressive episode is mild, a doctor may suggest waiting for two weeks to see if it clears on its own. In addition, they may recommend self-help resources, relaxation therapies and a small number of psychotherapy sessions. Antidepressants are not usually prescribed for mild depression unless it persists or is causing complications. 2 13

Q: How long does a depressive episode last?
A: The duration of a depressive episode varies and is influenced by its severity, as well as treatment and individual factors. However, the average length of a depressive episode is thought to be six to eight months. 2

Q: If a loved one is experiencing a depressive episode, what is the best thing to do?
A: If a friend or partner shows signs of being depressed, the following behaviors may be helpful: 12

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It's been almost two years since we learned about CRISPR, a ninja-assassin-meets-DNA-editing-tool that has been billed as one of the most powerful, and potentially controversial, technologies ever discovered by scientists. In this episode, we catch up on what's been happening (it's a lot), and learn about CRISPR's potential to not only change human evolution, but every organism on the entire planet.

Mixed features refers to the presence of high and low symptoms occurring at the same time, or as part of a single episode, in people experiencing an episode of mania or depression. In most forms of bipolar disorder, moods alternate between elevated and depressed over time. A person with mixed features experiences symptoms of both mood "poles" -- mania and depression -- simultaneously or in rapid sequence.

Mixed episodes are common in people with bipolar disorder -- half or more of people with bipolar disorder have at least some mania symptoms during a full episode of depression. Those who develop bipolar disorder at a younger age, particularly in adolescence, may be more likely to have mixed episodes. People who develop episodes with mixed features may also develop "pure" depressed or "pure" manic or hypomanic phases of bipolar illness. People who have episodes of major depression but not full episodes of mania or hypomania also can sometimes have low-grade mania symptoms. These are symptoms that are not severe or extensive enough to be classified as bipolar disorder. This is referred to as an episode of "mixed depression" or a unipolar (major) depressive episode with mixed features.

For example, a person in an episode with mixed features could be crying uncontrollably while announcing they have never felt better in their life. Or they could be exuberantly happy, only to suddenly collapse in misery. A short while later they might suddenly return to an ecstatic state.

Mood episodes with mixed features can last from days to weeks or sometimes months if untreated. They may recur ,and recovery can be slower than during episodes of "pure" bipolar depression or "pure" mania or hypomania.

The most serious risk of mixed features during a manic or depressive episode is suicide. People with bipolar disorder are 10 to 20 times more likely to commit suicide than people without bipolar disorder. Tragically, as many as 10% to 15% of people with bipolar disorder eventually lose their lives to suicide.

Manic or depressive episodes with mixed features generally require treatment with medication. Unfortunately, such episodes are more difficult to control than an episode of pure mania or depression. The main drugs used to treat episodes with mixed features are mood stabilizers and antipsychotics.

While lithium is often considered a gold standard treatment for mania, it may be less effective when mania and depression occur simultaneously, as in a manic episode with mixed features. Lithium has been used for more than 60 years to treat bipolar disorder. It can take weeks to work fully, making it better for maintenance treatment than for acute manic episodes. Blood levels of lithium and other lab test results must be monitored to avoid side effects.

Valproic acid (Depakote) is an antiseizure medication that also levels out moods in bipolar disorder. It has a more rapid onset of action, and in some studies has been shown to be more effective than lithium for the treatment of manic episodes with mixed features.

Despite its frightening reputation, electroconvulsive therapy (ECT) is an effective treatment for any phase of bipolar disorder, including manic episodes with mixed features. ECT can be helpful if medication fails or can't be used.

Common antidepressants such as fluoxetine (Prozac, Sarafem), paroxetine (Paxil), and sertraline (Zoloft) have been shown to worsen mania symptoms without necessarily improving depressive symptoms when depressive and manic symptoms occur together. Most experts therefore advise against using antidepressants during episodes with mixed features. Mood stabilizers (particularly Depakote), as well as atypical antipsychotic drugs, are considered the first-line treatments for mood episodes with mixed features.

Bipolar disorder usually involves recurrences of mixed, manic, or depressed phases of illness. Therefore, it is usually recommended that medications be continued in an ongoing fashion after an acute episode resolves in order to prevent relapses. This is sometimes called maintenance treatment.

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