![]() However, calling the pediatrician multiple times each day for weeks on end is atypical parenting behavior. Obviously, it is quite normal for parents to be concerned about their new babies and their parenting skills. Common symptoms include mood fluctuations and excessive preoccupation with the infant's well-being. Postpartum Onset - this specifier is used if the onset of MDD occurs in close proximity (within 4 weeks) to childbirth.For example, people who seem happy to be included in office outings, but always feel excluded from inter-office jokes and rejected by their peers may be depressed with atypical features. Atypical Features - this specifier is used for people who display the following "unusual" depressive symptoms: mood reactivity (a person's mood brightens in response to positive events) significant weight gain or increase in appetite hypersomnia (sleeping excessively) leaden paralysis (a heavy, leaden feelings in arms or legs) and a long-standing pattern of being highly sensitive to interpersonal slights (not limited to episodes of mood disturbance) that results in significant social or occupational impairment.For example, someone's lack of excitement at being promoted might be a manifestation of Major Depression with melancholic features. In addition, the person does not feel better (even temporarily), when something good happens. Melancholic Features - a person demonstrates one or more distinct qualities of depressed mood such as: mood that is regularly worse in the morning early morning awakening (at least two hours before the usual time) marked psychomotor retardation (a generalized slowing of psychological and physical activity) or agitation (speeding up of physical activity) significant anorexia (loss of appetite) or unplanned weight loss and excessive or inappropriate guilt.For example, a person sitting on a park bench who seems unable to stop imitating gestures and words of passers-by might be suffering from Major Depression with catatonic features. Catatonic Features - a person demonstrates one or many unusual movements and mannerisms, including: motoric immobility (periods during which they do not move) or excessive movement extreme negativism (resisting instructions or maintaining a rigid posture against attempts to be moved) mutism (an inability to speak) posturing (taking up inappropriate or bizarre body positions and holding them for periods of time) stereotyped movements (repeating behaviors over and over) prominent grimacing and/or the compulsive repetition of someone else's words or movements.Chronic - as mentioned previously, this specifier is used when a person meets the criteria for a Major Depressive Episode continuously for the past two years.The following specifiers may be applied to the current or most recent Major Depressive Episode: Thus, specifiers provide a means of establishing sub-categories or variations within the mood disorder diagnoses. Seasonal depressions are often responsive to light therapy, whereas other forms of depression may be less so. ![]() The diagnosis of Major Depressive Disorder, Recurrent, with a Seasonal Pattern provides information about a type of treatment that may be useful. For example, the diagnosis of Major Depressive Disorder, Recurrent with Catatonic Features suggests that a person has experienced repeated Major Depressive Episodes with associated periods where they were immobile or demonstrated peculiar postures (see our discussion below). Specifiers may also be used to provide information about a person's anticipated disorder course and their prognosis (outcome). Clinicians' careful application of diagnostic specifiers can help them narrow down which treatments may work best for a given patient. Once a diagnosis of a particular mood disorder is made, more detailed information about the person's condition can be provided in the form of "specifiers," which are additional standardized tags that can be appended to the primary diagnosis.
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