Depression: background, practice and pathophysiology

Depression: Background, paractice, essential and pathophysiology *Outlines* Introduction Historical background and definition Types of depression Diagnosis and management Pathophysiology Conclusion *Introduction* Depression affects 264 millions globally and is a major cause of disability (WHO, 2020). Depression is a multifactorial disorder (Hu _et al.,_ 2021). *Historical background* Recognized since ancient times with Hippocrates and minimal advancement is made in it's understanding (Bourin, 2020; Hindmarch, 2021). The amine hypothesis defined as imbalanced of monamine neurotransmitters in the brain (Joel _et al.,_ 2014). *Types of depression* Common types are as follows Major depression. Dysthymic depression. Bipolar depression. Psychotic depression. Seasonal affective depression and parietal depression (APA, 2013; Mayoclinic, 2020). *Diagnosis and management* Diagnosis: Diagnosis are carried out by means of screening mayerial such PHQ-9, ZRS and CES-D Management: includes psychotherapy and pharmacotherapy. *Pathophysiology* ETIOLOGY: *Brain networks* : Prefrontal cortex, includes by depression lead to hyperactiviion of prefrontal cortex (Hu _et al,._ 2021). Amygdala, abnormal increase in volume has been found (Hamilton _et al,._ ). Basal ganglia, exhibit reduced in motivation and anhedonia (Savitz and Drevet, 2013). Hippocampus, depression induced a reduce in hippocampal volume (Eleni, 2012; Campbell _et al,._ 2004). Neurotransmitter system, Tryptophan depletion, lead to development of depressive symptoms (Hu _et al,._ 2021). *Gut microbimes* ; their dysregulation induces depression (Hu _et al.,_ 2021). *Immunological factor* : Proinflammatory cytokines causing peripheral to tryptophan depletion, may lead to depressive symptoms (Hu _et al.,_ 2021). *Environmental factor* : elevate depression risk in genetically vulnerable individual (Hu _et al.,_ 2021). *Early life trauma* : Traumatic childhood may lead to depressive symptoms (Hu _et al.,_ 2021). *Neurodegenerative disease* : Alzheimer's disease (AD): Lead to cognition impairment. Lewy body disease: is associated with cognition impairment and dysfunction in mator control leading to depressive symptoms. Parkinson's diseases: dysregulation in dopamine, noradrenaline and serotinin neurosecretory neurons induce depressive symptoms. *Neuroendocrine abnormalities* Dysfunction of serotinin activity has been observed in depression. The dysregulation of the HPA-axis inducing serotinin function (Holsboer, 2000). *Vascular diseases* A Hypothesis suggest that vascular disease may impact both cognition and emotional processing. *Conclusion* Depression is a complex multifactorial condition. While has been made in understanding the depression, more research is needed for better understanding and management of the disorder 

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