Guillermo Rivera Arroyo, MD, MHPS, PhD.

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▪Also known as a psychiatric disorder, is a
condition that affects a person's thinking,
feeling, behavior, or mood.
▪Mental disorders are typically associated with
distress, impaired functioning, and a
decreased ability to cope with the ordinary
demands of life.
▪ There are many different types of mental disorders,
including
▪ anxiety disorders,
▪ mood disorders (such as depression and bipolar disorder),
▪ psychotic disorders (such as schizophrenia),
▪ personality disorders, and
▪ eating disorders, among others.
▪ Mental disorders can have a variety of causes, including
▪ genetic factors,
▪ environmental factors, and
▪ life experiences.
▪ They can be diagnosed by a mental health professional
through a clinical interview and assessment, and can be
treated with a variety of interventions, such as
psychotherapy, medication, and lifestyle changes.
▪ Depression is a mood disorder that is characterized by persistent
feelings of sadness, hopelessness, and loss of interest or pleasure in
activities. It affects people of all ages, genders, and backgrounds and
can significantly impair daily functioning and quality of life.

▪ Other common mental disorders include anxiety disorders (such as

generalized anxiety disorder, panic disorder, and obsessive-
compulsive disorder), substance use disorders, and bipolar disorder.
However, it's worth noting that mental health conditions are complex
and can vary widely from person to person.
▪ Depressive disorders are a type of mood disorder that affect a
person's thoughts, feelings, and behavior. Depression is
characterized by persistent feelings of sadness, hopelessness, and
loss of interest or pleasure in activities that were once enjoyable. The
symptoms of depression can vary in intensity and duration and can
impact a person's ability to function in daily life.

▪ Depressive disorders can be caused by a variety of factors, including

genetic, biological, environmental, and psychological factors. Life
events such as trauma, loss, and stressful situations can also trigger or
exacerbate depression.
▪ Persistent feelings of sadness, emptiness, or hopelessness
▪ Loss of interest or pleasure in activities that were once
enjoyable
▪ Difficulty sleeping or oversleeping
▪ Fatigue or lack of energy
▪ Changes in appetite and weight
▪ Feelings of worthlessness or excessive guilt
▪ Difficulty concentrating or making decisions
▪ Thoughts of death or suicide
▪ Treatment options may include medication,
▪ psychotherapy, or a combination of both.
▪ Lifestyle changes, such as regular exercise, healthy eating,
and stress management techniques
▪ According to the World Health Organization, the prevalence of
depressive disorders in Bolivia is estimated to be around 7.6% of
the population. However, it's worth noting that depression may be
underreported in Bolivia due to stigma, lack of access to mental
health services, and cultural factors that discourage seeking help for
mental health issues.

▪ One study found that factors associated with depression in Bolivia

include being female, having a low level of education, living in rural
areas, and experiencing poverty or discrimination. Other risk factors
for depression in Bolivia include exposure to violence, chronic
illness, and stressful life events.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02143-
7/fulltext?fbclid=IwAR1eC4gXcD_9iFI2puZNCtolJ1S8d3vEIG45uT-
wcyutepf_uazlBo0DgRs
▪ Depressed mood or loss of interest or pleasure in nearly all
activities (anhedonia) for at least two weeks.
▪ The presence of at least four additional symptoms, which
may include changes in appetite or weight, sleep
disturbances, fatigue, feelings of worthlessness or guilt,
difficulty concentrating, and thoughts of death or suicide.
▪ The symptoms cause significant distress or impairment in
social, occupational, or other important areas of
functioning.
▪ The symptoms are not due to a medical condition or the effects of a
substance, such as medication or drug abuse.
▪ The symptoms are not better explained by a different mental
disorder.
To receive a diagnosis of major depressive disorder, a person must
meet criteria 1 and 2, and to receive a diagnosis of persistent
depressive disorder, a person must experience a chronic depressive
state lasting at least two years.
1. Depressive episode: This is characterized by a two-week period of low mood or
loss of pleasure, along with at least three other symptoms, such as reduced energy,
decreased concentration, or changes in appetite and sleep. The symptoms
should cause significant distress or impairment in social, occupational, or other
important areas of functioning.
2. Persistent depressive disorder: This is characterized by a chronic or persistent
depressive state that lasts for at least two years. The symptoms are similar to those
of a depressive episode, but they are less severe and more chronic in nature.
3. Recurrent depressive disorder: This is characterized by two or more episodes of
major depression separated by at least two months of remission.
4. Other specified depressive disorder: This category includes depressive symptoms
that do not meet the criteria for the other depressive disorders, or that have atypical
features, such as a seasonal pattern or postpartum onset.
5. Unspecified depressive disorder: This category includes depressive symptoms
that do not fit into any of the specific diagnostic categories, but still cause significant
distress or impairment in social, occupational, or other important areas of
functioning.

It's important to note that these diagnostic criteria are used by mental health
professionals to guide their assessment, diagnosis, and treatment of depressive
disorders. A comprehensive evaluation by a qualified mental health professional is
necessary to make a formal diagnosis of depression, as well as to rule out other
potential causes of the symptoms.
▪ Genetics: There is evidence to suggest that depression can run in families,
and individuals with a family history of depression may be more likely to
develop the condition.
▪ Brain chemistry: Chemical imbalances in the brain, such as a deficiency in
serotonin or dopamine, can contribute to the development of depression.
▪ Environmental factors: Trauma, stressful life events, social isolation, and
chronic illness can all contribute to the onset of depression.
▪ Personality traits: Individuals with certain personality traits, such as low self-
esteem, pessimism, or a tendency to worry, may be more prone to
developing depression.
▪ Substance abuse: Substance abuse, including alcohol and drug use, can also
increase the risk of depression.
▪ Medical conditions: Certain medical conditions, such as thyroid disorders or
chronic pain, can contribute to the development of depression.
Zhuo, C., Li, G., Lin, X. et al. The rise and fall of MRI studies in major depressive disorder. Transl Psychiatry 9, 335
(2019). https://doi.org/10.1038/s41398-019-0680-6
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