Henry Hellyer (1790 – c. 1 September 1832) was an English surveyor and architect who was one of the first explorers to visit the rugged interior of the north west of Tasmania , Australia and made the most comprehensive maps of the area up to that time.
84-549: Henry Hellyer was an explorer in north west Tasmania during the 1820s. Places in the region named after him include: Other notable people named Hellyer include: Henry Hellyer Henry Hellyer was descended from Hellyers living in the area of Portsmouth in England. Nothing is known about his early life or where he was trained as an architect and surveyor, but it seems that the family were able to afford to educate their children well. His older brother William Varlo Hellyer
168-634: A mental disorder characterized by at least two weeks of pervasive low mood , low self-esteem , and loss of interest or pleasure in normally enjoyable activities. Introduced by a group of US clinicians in the mid-1970s, the term was adopted by the American Psychiatric Association for this symptom cluster under mood disorders in the 1980 version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), and has become widely used since. The disorder causes
252-532: A metabolic disturbance ; and a full blood count including ESR to rule out a systemic infection or chronic disease. Adverse affective reactions to medications or alcohol misuse may be ruled out, as well. Testosterone levels may be evaluated to diagnose hypogonadism , a cause of depression in men. Vitamin D levels might be evaluated, as low levels of vitamin D have been associated with greater risk for depression. Subjective cognitive complaints appear in older depressed people, but they can also be indicative of
336-442: A 2019 study found 102 variants in the genome linked to depression. However, it appears that major depression is less heritable compared to bipolar disorder and schizophrenia. Research focusing on specific candidate genes has been criticized for its tendency to generate false positive findings. There are also other efforts to examine interactions between life stress and polygenic risk for depression. Depression can also arise after
420-796: A chronic or terminal medical condition, such as HIV/AIDS or asthma , and may be labeled "secondary depression". It is unknown whether the underlying diseases induce depression through effect on quality of life, or through shared etiologies (such as degeneration of the basal ganglia in Parkinson's disease or immune dysregulation in asthma). Depression may also be iatrogenic (the result of healthcare), such as drug-induced depression. Therapies associated with depression include interferons , beta-blockers , isotretinoin , contraceptives , cardiac agents, anticonvulsants , antimigraine drugs , antipsychotics , and hormonal agents such as gonadotropin-releasing hormone agonist (GnRH agonist). Celiac disease
504-506: A combination of medication and psychotherapy may be used. There is moderate-quality evidence that psychological therapies are a useful addition to standard antidepressant treatment of treatment-resistant depression in the short term. Psychotherapy has been shown to be effective in older people. Successful psychotherapy appears to reduce the recurrence of depression even after it has been stopped or replaced by occasional booster sessions. The most-studied form of psychotherapy for depression
588-424: A depressed state mediated by increased serotonin. Further countering the monoamine hypothesis is the fact that rats with lesions of the dorsal raphe are not more depressive than controls, the finding of increased jugular 5-HIAA in people who are depressed that normalized with selective serotonin reuptake inhibitor (SSRI) treatment, and the preference for carbohydrates in people who are depressed. Already limited,
672-474: A higher chance of developing depression, which shows the two are connected. There is even evidence suggesting that altering the microbes in the gut can have regulatory effects on developing depression. Theories unifying neuroimaging findings have been proposed. The first model proposed is the limbic-cortical model, which involves hyperactivity of the ventral paralimbic regions and hypoactivity of frontal regulatory regions in emotional processing. Another model,
756-411: A higher risk of developing clinical depression. There appears to be a link between air pollution and depression and suicide. There may be an association between long-term PM2.5 exposure and depression, and a possible association between short-term PM10 exposure and suicide. The pathophysiology of depression is not completely understood, but current theories center around monoaminergic systems,
840-486: A low mood, which pervades all aspects of life, and an inability to experience pleasure in previously enjoyable activities. Depressed people may be preoccupied with or ruminate over thoughts and feelings of worthlessness, inappropriate guilt or regret, helplessness or hopelessness. Other symptoms of depression include poor concentration and memory, withdrawal from social situations and activities, reduced sex drive , irritability, and thoughts of death or suicide. Insomnia
924-426: A major role in the development of depression. Family and twin studies find that nearly 40% of individual differences in risk for major depressive disorder can be explained by genetic factors . Like most psychiatric disorders, major depressive disorder is likely influenced by many individual genetic changes. In 2018, a genome-wide association study discovered 44 genetic variants linked to risk for major depression;
SECTION 10
#17327901230031008-771: A monoamine—can cause depression in those in remission or relatives of people who are depressed, suggesting that decreased serotonergic neurotransmission is important in depression. Second, the correlation between depression risk and polymorphisms in the 5-HTTLPR gene, which codes for serotonin receptors, suggests a link. Third, decreased size of the locus coeruleus , decreased activity of tyrosine hydroxylase , increased density of alpha-2 adrenergic receptor , and evidence from rat models suggest decreased adrenergic neurotransmission in depression. Furthermore, decreased levels of homovanillic acid , altered response to dextroamphetamine , responses of depressive symptoms to dopamine receptor agonists, decreased dopamine receptor D1 binding in
1092-415: A more noticeable slowing of movements. Depressed children may often display an irritable rather than a depressed mood; most lose interest in school and show a steep decline in academic performance. Diagnosis may be delayed or missed when symptoms are interpreted as "normal moodiness". Elderly people may not present with classical depressive symptoms. Diagnosis and treatment is further complicated in that
1176-482: A promising intervention in youth. Problem solving therapy , cognitive behavioral therapy, and interpersonal therapy are effective interventions in the elderly. Psychoanalysis is a school of thought, founded by Sigmund Freud , which emphasizes the resolution of unconscious mental conflicts. Psychoanalytic techniques are used by some practitioners to treat clients presenting with major depression. A more widely practiced therapy, called psychodynamic psychotherapy ,
1260-518: A range of related diagnoses, including dysthymia , which involves a chronic but milder mood disturbance; recurrent brief depression , consisting of briefer depressive episodes; minor depressive disorder , whereby only some symptoms of major depression are present; and adjustment disorder with depressed mood , which denotes low mood resulting from a psychological response to an identifiable event or stressor . The DSM-5 recognizes six further subtypes of MDD, called specifiers , in addition to noting
1344-464: A solicitor and was a member of the NSW Parliament for one day in 1861. Many Australian Hellyers are descended from William, whose son Thomas Henry Hellyer (1840–1889) was a member of the NSW Parliament from 1883 to 84. Henry Hellyer's surveys and maps Henry Hellyer's architecture Clinical depression Major depressive disorder ( MDD ), also known as clinical depression , is
1428-410: A stock-keeper who claimed to have killed 19 Aboriginal people with a swivel-gun and later wrote to his sister-in-law about Robinson's visit, saying, "I hope he will do some good, for at present a man's life is not safe if he stirs out without arms, but I have hitherto been lucky enough to escape." This probably refers to an incident on 25 January 1829 which he described in a report as "...a narrow escape,
1512-713: A surveyor (later Chief Surveyor) and Chief Architect. His achievements in Tasmania are well documented, and the Court of Directors of the VDL Co in London noted his resignation (March 1832) as follows: "Mr Hellyer, whose valuable services have been so great and whose name is so well known both to the Colonial Government and at home, by his unwearied exertions for the company, by his personal privation and risk in exploring
1596-691: A treatment comparing favorably to other psychotherapies. The most common and effective treatments for depression are psychotherapy, medication, and electroconvulsive therapy (ECT); a combination of treatments is the most effective approach when depression is resistant to treatment. American Psychiatric Association treatment guidelines recommend that initial treatment should be individually tailored based on factors including severity of symptoms, co-existing disorders, prior treatment experience, and personal preference. Options may include pharmacotherapy, psychotherapy, exercise, ECT, transcranial magnetic stimulation (TMS) or light therapy . Antidepressant medication
1680-446: Is CBT, which teaches clients to challenge self-defeating, but enduring ways of thinking (cognitions) and change counter-productive behaviors. CBT can perform as well as antidepressants in people with major depression. CBT has the most research evidence for the treatment of depression in children and adolescents, and CBT and interpersonal psychotherapy (IPT) are preferred therapies for adolescent depression. In people under 18, according to
1764-558: Is a history of prior episodes, with no history of mania). ICD-11 symptoms, present nearly every day for at least two weeks, are a depressed mood or anhedonia , accompanied by other symptoms such as "difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue." These symptoms must affect work, social, or domestic activities. The ICD-11 system allows further specifiers for
SECTION 20
#17327901230031848-446: Is a mood disturbance appearing as a psychological response to an identifiable event or stressor, in which the resulting emotional or behavioral symptoms are significant but do not meet the criteria for a major depressive episode. Other disorders need to be ruled out before diagnosing major depressive disorder. They include depressions due to physical illness, medications , and substance use disorders . Depression due to physical illness
1932-454: Is activated by stressful life events. The preexisting vulnerability can be either genetic , implying an interaction between nature and nurture , or schematic , resulting from views of the world learned in childhood. American psychiatrist Aaron Beck suggested that a triad of automatic and spontaneous negative thoughts about the self , the world or environment , and the future may lead to other depressive signs and symptoms. Genes play
2016-680: Is also a connection between the gut microbiome and the central nervous system, otherwise known as the Gut-Brain axis , which is a two-way communication system between the brain and the gut. Experiments have shown that microbiota in the gut can play an important role in depression as people with MDD often have gut-brain dysfunction. One analysis showed that those with MDD have different bacteria living in their guts. Bacteria Bacteroidetes and Firmicutes were most affected in people with MDD, and they are also impacted in people with irritable bowel syndrome . Another study showed that people with IBS have
2100-490: Is an assessment of the person's current mood and thought content, in particular the presence of themes of hopelessness or pessimism , self-harm or suicide, and an absence of positive thoughts or plans. Specialist mental health services are rare in rural areas, and thus diagnosis and management is left largely to primary-care clinicians. This issue is even more marked in developing countries. Rating scales are not used to diagnose depression, but they provide an indication of
2184-399: Is another possible contributing factor. Substance use in early age is associated with increased risk of developing depression later in life. Depression occurring after giving birth is called postpartum depression and is thought to be the result of hormonal changes associated with pregnancy . Seasonal affective disorder , a type of depression associated with seasonal changes in sunlight,
2268-705: Is common; in the typical pattern, a person wakes very early and cannot get back to sleep. Hypersomnia , or oversleeping, can also happen, as well as day-night rhythm disturbances, such as diurnal mood variation . Some antidepressants may also cause insomnia due to their stimulating effect. In severe cases, depressed people may have psychotic symptoms. These symptoms include delusions or, less commonly, hallucinations , usually unpleasant. People who have had previous episodes with psychotic symptoms are more likely to have them with future episodes. A depressed person may report multiple physical symptoms such as fatigue , headaches, or digestive problems; physical complaints are
2352-444: Is diagnosed as a mood disorder due to a general medical condition . This condition is determined based on history, laboratory findings, or physical examination . When the depression is caused by a medication, non-medical use of a psychoactive substance, or exposure to a toxin , it is then diagnosed as a specific mood disorder (previously called substance-induced mood disorder ). Preventive efforts may result in decreases in rates of
2436-444: Is either depressed mood or loss of interest or pleasure. Depressed mood occurs nearly every day as subjective feelings like sadness, emptiness, and hopelessness or observations made by others (e.g. appears tearful). Loss of interest or pleasure occurs in all, or almost all activities of the day, nearly every day. These symptoms, as well as five out of the nine more specific symptoms listed, must frequently occur for more than two weeks (to
2520-784: Is equivalent to the use of medications or psychological therapies in most people. In older people it does appear to decrease depression. Sleep and diet may also play a role in depression, and interventions in these areas may be an effective add-on to conventional methods. In observational studies, smoking cessation has benefits in depression as large as or larger than those of medications. Talking therapy (psychotherapy) can be delivered to individuals, groups, or families by mental health professionals, including psychotherapists, psychiatrists, psychologists, clinical social workers , counselors, and psychiatric nurses. A 2012 review found psychotherapy to be better than no treatment but not other treatments. With more complex and chronic forms of depression,
2604-412: Is in a person's 20s, with females affected about twice as often as males. The course of the disorder varies widely, from one episode lasting months to a lifelong disorder with recurrent major depressive episodes . Those with major depressive disorder are typically treated with psychotherapy and antidepressant medication . Medication appears to be effective, but the effect may be significant only in
Hellyer - Misplaced Pages Continue
2688-456: Is in the tradition of psychoanalysis but less intensive, meeting once or twice a week. It also tends to focus more on the person's immediate problems, and has an additional social and interpersonal focus. In a meta-analysis of three controlled trials of Short Psychodynamic Supportive Psychotherapy, this modification was found to be as effective as medication for mild to moderate depression. Conflicting results have arisen from studies that look at
2772-484: Is not adequate as a diagnosis tool, because its sensitivity is only 44%. These stress-related abnormalities are thought to be the cause of hippocampal volume reductions seen in people who are depressed. Furthermore, a meta-analysis yielded decreased dexamethasone suppression, and increased response to psychological stressors. Further abnormal results have been obscured with the cortisol awakening response , with increased response being associated with depression. There
2856-456: Is often described as a visionary. The Chief agent of the VDL Co wrote of him, "He is exceedingly chimerical in all his ideas... He would have mansions where I would have cottages", and elsewhere, "...he may he said to look upon everything with a painter's eye and upon his own discoveries in particular with an affection which is blind to all faults". If Henry Hellyer was prone to "attacks" of depression after periods of over-exertion and fatigue,
2940-562: Is often difficult. Development of mental health services is minimal in many countries; depression is viewed as a phenomenon of the developed world despite evidence to the contrary, and not as an inherently life-threatening condition. There is insufficient evidence to determine the effectiveness of psychological versus medical therapy in children. Physical exercise has been found to be effective for major depression, and may be recommended to people who are willing, motivated, and healthy enough to participate in an exercise program as treatment. It
3024-564: Is particularly beneficial in preventing relapse. Cognitive behavioral therapy and occupational programs (including modification of work activities and assistance) have been shown to be effective in reducing sick days taken by workers with depression. Several variants of cognitive behavior therapy have been used in those with depression, the most notable being rational emotive behavior therapy , and mindfulness-based cognitive therapy . Mindfulness-based stress reduction programs may reduce depression symptoms. Mindfulness programs also appear to be
3108-663: Is recommended as an initial treatment choice in people with mild, moderate, or severe major depression, and should be given to all people with severe depression unless ECT is planned. There is evidence that collaborative care by a team of health care practitioners produces better results than routine single-practitioner care. Psychotherapy is the treatment of choice (over medication) for people under 18, and cognitive behavioral therapy (CBT), third wave CBT and interpersonal therapy may help prevent depression. The UK National Institute for Health and Care Excellence (NICE) 2004 guidelines indicate that antidepressants should not be used for
3192-430: Is recommended. People with chronic depression may need to take medication indefinitely to avoid relapse. SSRIs are the primary medications prescribed, owing to their relatively mild side-effects, and because they are less toxic in overdose than other antidepressants. People who do not respond to one SSRI can be switched to another antidepressant , and this results in improvement in almost 50% of cases. Another option
3276-434: Is some evidence for a similar effect in mild depression. Similarly, a Cochrane systematic review of clinical trials of the generic tricyclic antidepressant amitriptyline concluded that there is strong evidence that its efficacy is superior to placebo. Antidepressants work less well for the elderly than for younger individuals with depression. To find the most effective antidepressant medication with minimal side-effects,
3360-634: Is thought to be triggered by decreased sunlight. Vitamin B 2 , B 6 and B 12 deficiency may cause depression in females. Adverse childhood experiences (incorporating childhood abuse , neglect and family dysfunction ) markedly increase the risk of major depression, especially if more than one type. Childhood trauma also correlates with severity of depression, poor responsiveness to treatment and length of illness. Some are more susceptible than others to developing mental illness such as depression after trauma, and various genes have been suggested to control susceptibility. Couples in unhappy marriages have
3444-528: Is to augment the atypical antidepressant bupropion to the SSRI as an adjunctive treatment. Venlafaxine , an antidepressant with a different mechanism of action, may be modestly more effective than SSRIs. However, venlafaxine is not recommended in the UK as a first-line treatment because of evidence suggesting its risks may outweigh benefits, and it is specifically discouraged in children and adolescents as it increases
Hellyer - Misplaced Pages Continue
3528-612: The American Psychiatric Association 's Diagnostic and Statistical Manual of Mental Disorders (DSM) and the World Health Organization 's International Statistical Classification of Diseases and Related Health Problems (ICD). The latter system is typically used in European countries, while the former is used in the US and many other non-European nations, and the authors of both have worked towards conforming one with
3612-508: The Internet . The Netherlands mental health care system provides preventive interventions, such as the "Coping with Depression" course (CWD) for people with sub-threshold depression. The course is claimed to be the most successful of psychoeducational interventions for the treatment and prevention of depression (both for its adaptability to various populations and its results), with a risk reduction of 38% in major depression and an efficacy as
3696-470: The National Institute for Health and Clinical Excellence , medication should be offered only in conjunction with a psychological therapy, such as CBT , interpersonal therapy , or family therapy . Several variables predict success for cognitive behavioral therapy in adolescents: higher levels of rational thoughts, less hopelessness, fewer negative thoughts, and fewer cognitive distortions. CBT
3780-484: The circadian rhythm , immunological dysfunction, HPA-axis dysfunction and structural or functional abnormalities of emotional circuits. Derived from the effectiveness of monoaminergic drugs in treating depression, the monoamine theory posits that insufficient activity of monoamine neurotransmitters is the primary cause of depression. Evidence for the monoamine theory comes from multiple areas. First, acute depletion of tryptophan —a necessary precursor of serotonin and
3864-462: The striatum , and polymorphism of dopamine receptor genes implicate dopamine , another monoamine, in depression. Lastly, increased activity of monoamine oxidase , which degrades monoamines, has been associated with depression. However, the monoamine theory is inconsistent with observations that serotonin depletion does not cause depression in healthy persons, that antidepressants instantly increase levels of monoamines but take weeks to work, and
3948-626: The Surveyor-General in Hobart Town, a highly coveted position that might have generated some envy among his colleagues. It is not known if the brothers had plans to work together, if they met, or if Henry Hellyer attended the wedding. He could have done so, since the VDL Co operated a cutter that made the trip regularly for mail and supplies, but his name is not listed amongst the witnesses. Henry's nephew William Hellyer migrated from New Zealand to New South Wales about 1838, and became
4032-783: The VDL Co view that their royal charter from King George IV made the Aboriginal people of North West Tasmania trespassers on company land. In August 1830, while building a footbridge over the River Wey, his camp at Weybridge was visited by George Augustus Robinson and the "friendly mission" whose intent was to investigate claims of killings, including the Cape Grim massacre by VDL Co employees, and to remove all Aboriginal people from their land and relocate them to an offshore island. The party that visited Hellyer's camp included Truganini and her husband Woorady . Hellyer told Robinson of
4116-591: The area. A special issue of the local newspaper provided a detailed account of his life. Henry Hellyer explored most of North Western Tasmania for his employer, the Van Diemen's Land Company (VDL Co), and wrote extensive journals and reports which are held in various archives. His best known journey was with Richard Frederick Isaac Cutts , from Circular Head to St Valentines Peak and back, in February 1827. Overall, it seems clear that Henry Hellyer accepted
4200-417: The concentration of quinolinic acid correlates to the severity of depressive symptoms. A diagnostic assessment may be conducted by a suitably trained general practitioner , or by a psychiatrist or psychologist , who records the person's current circumstances, biographical history, current symptoms, family history, and alcohol and drug use. The assessment also includes a mental state examination , which
4284-863: The condition of between 22 and 38%. Since 2016, the United States Preventive Services Task Force (USPSTF) has recommended screening for depression among those over the age 12; though a 2005 Cochrane review found that the routine use of screening questionnaires has little effect on detection or treatment. Screening the general population is not recommended by authorities in the UK or Canada. Behavioral interventions, such as interpersonal therapy and cognitive-behavioral therapy , are effective at preventing new onset depression. Because such interventions appear to be most effective when delivered to individuals or small groups, it has been suggested that they may be able to reach their large target audience most efficiently through
SECTION 50
#17327901230034368-445: The cortico-striatal model, suggests that abnormalities of the prefrontal cortex in regulating striatal and subcortical structures result in depression. Another model proposes hyperactivity of salience structures in identifying negative stimuli, and hypoactivity of cortical regulatory structures resulting in a negative emotional bias and depression, consistent with emotional bias studies. The newer field of psychoneuroimmunology ,
4452-526: The country, and by the admirable maps and plans which have been exhibited, has been recently appointed to an important situation under the Surveyor-General of the Colony". There are no portraits of Henry Hellyer. However, for the sesquicentenary of the town of Burnie in 1977, a portrait was created by local artist Casey McGrath from descriptions, and used as the basis for 200 silver medallions and 4,000 anodised aluminium ones that were given to school children in
4536-484: The criteria for a major depressive episode. A major depressive episode is characterized by the presence of a severely depressed mood that persists for at least two weeks. Episodes may be isolated or recurrent and are categorized as mild (few symptoms in excess of minimum criteria), moderate, or severe (marked impact on social or occupational functioning). An episode with psychotic features—commonly referred to as psychotic depression —is automatically rated as severe. If
4620-439: The crust would support them...". Although Henry Hellyer had no descendants, his younger brother Thomas Hellyer (1801–41) migrated to New Zealand with his son William (1821–1885) by way of Hobart Town, Tasmania, where Thomas married his second wife on 11 June 1832. Henry Hellyer had by then advised the Court of Directors of the VDL Co that he would be leaving their service at the end of his contract, to accept an appointment with
4704-411: The current depressive episode: the severity (mild, moderate, severe, unspecified); the presence of psychotic symptoms (with or without psychotic symptoms); and the degree of remission if relevant (currently in partial remission, currently in full remission). These two disorders are classified as "Depressive disorders", in the category of "Mood disorders". According to DSM-5, at least one of the symptoms
4788-454: The dosages can be adjusted, and if necessary, combinations of different classes of antidepressants can be tried. Response rates to the first antidepressant administered range from 50 to 75%, and it can take at least six to eight weeks from the start of medication to improvement. Antidepressant medication treatment is usually continued for 16 to 20 weeks after remission, to minimize the chance of recurrence, and even up to one year of continuation
4872-427: The effectiveness of antidepressants in people with acute, mild to moderate depression. A review commissioned by the National Institute for Health and Care Excellence (UK) concluded that there is strong evidence that SSRIs , such as escitalopram , paroxetine , and sertraline , have greater efficacy than placebo on achieving a 50% reduction in depression scores in moderate and severe major depression, and that there
4956-421: The elderly are often simultaneously treated with a number of other drugs, and often have other concurrent diseases. The etiology of depression is not yet fully understood. The biopsychosocial model proposes that biological, psychological, and social factors all play a role in causing depression. The diathesis–stress model specifies that depression results when a preexisting vulnerability, or diathesis ,
5040-569: The evidence concerning depression, in a letter to his sister-in-law in 1830 he wrote that he had been in excellent health ever since arriving in the Colony, "...except for two or three short attacks occasioned by over-exertion and fatigue after some of my long excursions in the bush". There is no hint of what these "attacks" may have been, but there is no doubt that his explorations were marked by extraordinary energy and copious note-taking on everything that took his interest, from cicadas, through "young centipedes white as snow" to land-crab chimneys. He
5124-479: The existence of atypical antidepressants which can be effective despite not targeting this pathway. One proposed explanation for the therapeutic lag, and further support for the deficiency of monoamines, is a desensitization of self-inhibition in raphe nuclei by the increased serotonin mediated by antidepressants. However, disinhibition of the dorsal raphe has been proposed to occur as a result of decreased serotonergic activity in tryptophan depletion, resulting in
SECTION 60
#17327901230035208-659: The experimental treatment of ketamine with treatment-resistant depression. With this, in MDD, people will more likely have a Th-1 dominant immune profile, which is a pro-inflammatory profile. This suggests that there are components of the immune system affecting the pathology of MDD. Another way cytokines can affect depression is in the kynurenine pathway , and when this is overactivated, it can cause depression. This can be due to too much microglial activation and too little astrocytic activity. When microglia get activated, they release pro-inflammatory cytokines that cause an increase in
5292-493: The extent in which it impairs functioning) for the diagnosis. Major depressive disorder is classified as a mood disorder in the DSM-5. The diagnosis hinges on the presence of single or recurrent major depressive episodes . Further qualifiers are used to classify both the episode itself and the course of the disorder. The category Unspecified Depressive Disorder is diagnosed if the depressive episode's manifestation does not meet
5376-697: The following line: Alas my mother, in agony I fly to my saviour. His suicide was the inspiration for a 1998 play. Most theories about the suicide are speculation, except for a thorough investigation involving the well-validated technique of LIWC (Linguistic Inquiry and Word Count). An analysis of his diaries from the day he left England, suggests he was suffering from ever-increasing depression . An alternative view has been advanced that he may have suffered from bipolar disorder . Baddeley, Daniel and Pennebaker's analysis suggests that his final extreme distress could have been occasioned by gossip circulated about illegal sexual relationships with convict associates. There
5460-553: The initial treatment of mild depression because the risk-benefit ratio is poor. The guidelines recommend that antidepressants treatment in combination with psychosocial interventions should be considered for: The guidelines further note that antidepressant treatment should be continued for at least six months to reduce the risk of relapse , and that SSRIs are better tolerated than tricyclic antidepressants . Treatment options are more limited in developing countries, where access to mental health staff, medication, and psychotherapy
5544-637: The length, severity and presence of psychotic features: To confirm major depressive disorder as the most likely diagnosis, other potential diagnoses must be considered, including dysthymia , adjustment disorder with depressed mood, or bipolar disorder . Dysthymia is a chronic, milder mood disturbance in which a person reports a low mood almost daily over a span of at least two years. The symptoms are not as severe as those for major depression, although people with dysthymia are vulnerable to secondary episodes of major depression (sometimes referred to as double depression ). Adjustment disorder with depressed mood
5628-450: The monoamine hypothesis has been further oversimplified when presented to the general public. A 2022 review found no consistent evidence supporting the serotonin hypothesis, linking serotonin levels and depression. HPA-axis abnormalities have been suggested in depression given the association of CRHR1 with depression and the increased frequency of dexamethasone test non-suppression in people who are depressed. However, this abnormality
5712-566: The most common presenting problem in developing countries, according to the World Health Organization 's criteria for depression. Appetite often decreases, resulting in weight loss, although increased appetite and weight gain occasionally occur. Major depression significantly affects a person's family and personal relationships , work or school life, sleeping and eating habits, and general health. Family and friends may notice agitation or lethargy . Older depressed people may have cognitive symptoms of recent onset, such as forgetfulness, and
5796-416: The most severely depressed. Hospitalization (which may be involuntary ) may be necessary in cases with associated self-neglect or a significant risk of harm to self or others. Electroconvulsive therapy (ECT) may be considered if other measures are not effective. Major depressive disorder is believed to be caused by a combination of genetic , environmental, and psychological factors, with about 40% of
5880-532: The natives having set fire to a thicket which we were struggling to get through. We rushed through the flames... We saw the natives with fire and tried to shoot them, but although not ten yards off they all escaped..." In 1831 he became the first European to reach the summit of Cradle Mountain . In the same year, he began the design of the residence, Highfield House, for the Chief Agent of the VDL Co, but he did not live to see it built. He committed suicide on
5964-558: The night of 1/2 September 1832, leaving a note which is held in the Tasmanian Archives. Hellyer travelled extensively along the north of the island. Parts of his journey have been recorded by Brian J Rollins, who followed precisely parts of this journey. His article, "Henry Hellyer, esquire, 1790/1832: Van Diemen's Land Company surveyor: in his footsteps." was published in 1988 by Australian Surveyor. Hellyer suicided on 9 September 1832, his incoherent suicide note ending with
6048-502: The onset of a dementing disorder , such as Alzheimer's disease . Cognitive testing and brain imaging can help distinguish depression from dementia. A CT scan can exclude brain pathology in those with psychotic, rapid-onset or otherwise unusual symptoms. No biological tests confirm major depression. In general, investigations are not repeated for a subsequent episode unless there is a medical indication . The most widely used criteria for diagnosing depressive conditions are found in
6132-689: The other. Both DSM and ICD mark out typical (main) depressive symptoms. The most recent edition of the DSM is the Fifth Edition, Text Revision (DSM-5-TR), and the most recent edition of the ICD is the Eleventh Edition (ICD-11). Under mood disorders, ICD-11 classifies major depressive disorder as either single episode depressive disorder (where there is no history of depressive episodes, or of mania ) or recurrent depressive disorder (where there
6216-406: The person has had an episode of mania or markedly elevated mood , a diagnosis of bipolar disorder is made instead. Depression without mania is sometimes referred to as unipolar because the mood remains at one emotional state or "pole". Bereavement is not an exclusion criterion in the DSM-5, and it is up to the clinician to distinguish between normal reactions to a loss and MDD. Excluded are
6300-475: The person, provider, and/or the medical system. Non-psychiatrist physicians have been shown to miss about two-thirds of cases, although there is some evidence of improvement in the number of missed cases. A doctor generally performs a medical examination and selected investigations to rule out other causes of depressive symptoms. These include blood tests measuring TSH and thyroxine to exclude hypothyroidism ; basic electrolytes and serum calcium to rule out
6384-531: The production of COX 2 . This, in turn, causes the production of PGE 2 , which is a prostaglandin , and this catalyzes the production of indolamine , IDO. IDO causes tryptophan to get converted into kynurenine and kynurenine becomes quinolinic acid . Quinolinic acid is an agonist for NMDA receptors, so it activates the pathway. Studies have shown that the post-mortem brains of patients with MDD have higher levels of quinolinic acid than people who did not have MDD. With this, researchers have also seen that
6468-430: The risk being genetic. Risk factors include a family history of the condition, major life changes, childhood traumas, certain medications, chronic health problems , and substance use disorders . It can negatively affect a person's personal life, work life, or education, and cause issues with a person's sleeping habits, eating habits, and general health. A person having a major depressive episode usually exhibits
6552-410: The second-most years lived with disability , after lower back pain . The diagnosis of major depressive disorder is based on the person's reported experiences, behavior reported by relatives or friends, and a mental status examination . There is no laboratory test for the disorder, but testing may be done to rule out physical conditions that can cause similar symptoms. The most common time of onset
6636-900: The severity of symptoms for a time period, so a person who scores above a given cut-off point can be more thoroughly evaluated for a depressive disorder diagnosis. Several rating scales are used for this purpose; these include the Hamilton Rating Scale for Depression , the Beck Depression Inventory or the Suicide Behaviors Questionnaire-Revised . Primary-care physicians have more difficulty with underrecognition and undertreatment of depression compared to psychiatrists. These cases may be missed because for some people with depression, physical symptoms often accompany depression. In addition, there may also be barriers related to
6720-597: The study between the immune system and the nervous system and emotional state, suggests that cytokines may impact depression. Immune system abnormalities have been observed, including increased levels of cytokines -cells produced by immune cells that affect inflammation- involved in generating sickness behavior , creating a pro-inflammatory profile in MDD. Some people with depression have increased levels of pro-inflammatory cytokines and some have decreased levels of anti-inflammatory cytokines. Research suggests that treatments can reduce pro-inflammatory cell production, like
6804-452: The winter of 1832 provided an occasion. He wrote: "...The snow is so deep that we are completely hemmed in by it. It forms such hard lumps on my overalls... that I was completely fettered by it and in the greatest pain imaginable. One hour of this weather would kill any man if he were stuck fast and remained inactive. The poor dogs were literally plated with coats of mail formed by the ice on their hair, but they traveled better than we could, as
6888-623: Was a lawyer in London and Secretary of the Royal Institution in 1841. A copy of a letter written by Henry in 1830 to William Varlo's Hellyer's wife, Mary Vuliamy was deposited by a Canadian descendant of William and Mary in the Hellyer Regional Library in Burnie, Tasmania . Henry himself had no direct descendants. When the Van Diemen's Land Company was formed in 1825 he was one of the first officers to sign on, as
6972-549: Was in fact merely thoughtless teasing. A further LIWC analysis of the internal inquiry conducted into his suicide, on behalf of the Van Diemen's Land Company, suggests there was a whitewash by those who might have been seen as involved in negative behaviour towards Hellyer. Gwyneth Daniel's detailed exposition of these and other points can be seen in Utmost Extrication. Why Henry Hellyer Shot Himself . Despite
7056-496: Was no concrete evidence available at the time for this. It is more likely that this gossip was malicious and intended to blacken his name. There could well have been some envy at Stanley (the base for the Van Diemen's Land Company) that Hellyer could look forward to a government appointment. As a devout Christian, he would have been devastated by this. A further suggestion is that he may have suffered from gelotophobia , an inability to deal with what he perceived as bullying, even if this
#2997