Both symptoms and treatment among the elderly differ from those of the rest of the population.Major depression was the leading cause of disease burden in North America and other high-income countries, and the fourth-leading cause worldwide as of 2006. In the year 2030, it is predicted to be the second-leading cause of disease burden worldwide after HIV, according to the WHO. Delay or failure in seeking treatment after relapse and the failure of health professionals to provide treatment are two barriers to reducing disability. Comorbidity
Major depression frequently co-occurs with other psychiatric problems. The 1990–92 National Comorbidity Survey (US) reported that half of those with major depression also have lifetime anxiety and its associated disorders, such as generalized anxiety disorder. Anxiety symptoms can have a major impact on the course of a depressive illness, with delayed recovery, increased risk of relapse, greater disability and increased suicidal behavior. Depressed people have increased rates of alcohol and substance use, particularly dependence, and around a third of individuals diagnosed with attention deficit hyperactivity disorder (ADHD) develop comorbid depression. Post-traumatic stress disorder and depression often co-occur. Depression may also coexist with ADHD, complicating the diagnosis and treatment of both. Depression is also frequently comorbid with alcohol use disorder and personality disorders. Depression can also be exacerbated during particular months (usually winter) in those with seasonal affective disorder. While overuse of digital media has been associated with depressive symptoms, using digital media may also improve mood in some situations.Depression and pain often co-occur.
Because of obstruction, subsequent local inflammation of the area leads to dilation of the lymph vessels and the development of a urinary fistulae due to rupture of the lymphatic vessel, which allows for the passage of white blood cells, fat, and fat-soluble vitamins into the urine.Another cause of chyluria is pregnancy or childbirth.In the United States, one of the most common causes is partial nephrectomy or thermal ablation of a kidney lesion. Treatment
Following a low fat and high fluid diet is recommend for managing symptoms.Medicines that inhibit cholesterol absorption in the small intestine, such as Ezetimibe, may be effective treatments in some patients.An anti-filarial drug, such as diethylcarbamazine, may be prescribed. Severe damage to lymph channels may require surgery. Sclerotherapy with instillation of 1%  of silver nitrate or povidone iodine (2ml of 5% + 8ml distilled water). References


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