Snapshot A 27-year-old female presents with insomnia of recent onset stating that she has been waking up at 3 am every day. Upon further questioning the patient admits to feeling excessive fatigue lately and trouble focusing in school and at work. She also admits that she is no longer interested in high speed cup stacking (sport stacking) her previous life passion. The patient states that she has had a depressed mood lately and that she has thought about suicide at times. Major Depressive Episode Diagnostic criterion login to view 13 more bullets Epidemiology login to view 4 more bullets Biochemical changes login to view 1 more bullet Related disorders login to view 17 more bullets Sleep Patterns of Depressed Patients Depressed patients show characteristic changes in sleep patterns login to view 7 more bullets Atypical Depression Characterized by login to view 5 more bullets Associated with login to view 2 more bullets Treatment login to view 3 more bullets Electroconvulsive Therapy (ECT) Treatment option for major depressive disorder refractory to other treatment and for pregnant women Produces a painless seizure in an anesthetized patient Major adverse effects login to view 3 more bullets Grief Normal grief - normally less than 6 months with a cause but normal grief can last up to 1 to 2 years login to view 6 more bullets Pathologic grief - persistent and causes functional impairment login to view 5 more bullets Considered major depression when login to view 3 more bullets Postpartum Depression Postpartum "blues" login to view 5 more bullets Postpartum depression login to view 5 more bullets Postpartum psychosis login to view 5 more bullets