6욕천(六欲天, 산스크리트어: ṣaḍ kāmadeva)은 욕계6천(欲界六天) · 욕계천(欲界天) 또는 욕천(欲天)이라고도 하며, 줄임말로 6욕(六欲) 또는 6천(六天)이라고도 한다. 6욕천(六欲天)은 욕계(欲界) · 색계(色界) · 무색계(無色界)의 3계 가운데 욕계에 속한 여섯 하늘[天]을 뜻하는데, '욕천(欲天)'은 이 여섯 하늘의 유정들은 모두 욕(欲, 산스크리트어: kāma)을 지니고 있다는 것을 의미한다.[1] 욕(欲)의 뜻 불교 용어 목록/온 § 욕, 탐, 3계탐, 욕탐, 색탐 및 무색탐 문서를 참고하십시오. 《구사론》 제8권에 따르면, 욕계(欲界, 산스크리트어: kāma-dhātu)와 6욕천(六欲天, 산스크리트어: ṣaḍ kāmadeva)에서의 욕(欲, 산스크리트어: kāma)은 간략히 말하면, 즉, 욕계에서의 욕구와 쾌락 중 가장 지속적이고 강렬한 것을 들어 말하자면, 단식음소인탐(段食婬所引貪) 즉 '단식(段食)과 음욕(淫慾)에 의해 인기된 탐(貪)'을 말한다. 여기서 단식(段食)은 단식(段食) · 촉식(觸食) · 사식(思食) · 식식(識食)의 4식(四食) 가운데 하나로 밥 · 국수 · 나물 · 기름 · 장 따위와 같이 형체가 있는 음식을 말한다.[25] 음욕[婬]은 성욕(性慾) 즉 남녀 간의 정욕(情慾)을 말한다. 즉, 욕(欲)은 간략히 말하면 식욕과 성욕을 말한다. 즉, 카마(kāma) 즉 욕계의 욕(欲)이란, 간략히 말해, 식욕과 성욕이라고 할 수 있다. 식욕은 생존의 욕구와 긴밀히 관련된 것이고 성욕은 종족 보존의 욕구 즉 번식욕과 긴밀히 관련된 것이다. 그리고 쾌락이라는 관점에서는 식도락과 성적 쾌락이 욕계의 쾌락 중 가장 지배적인 쾌락이며, 또한 욕계에 속박된 중생(인간과 동물 등)이 가장 널리 추구하고 탐닉하는 쾌락이라는 것을 의미한다. 하지만, 보다 엄밀히 말하자면, 카마(kāma) 즉 욕계의 욕(欲)은 욕탐(欲貪), 즉 욕계의 탐, 즉 욕계의 온갖 처소에서 아직 탐을 떠나지 못한 자의 탐을 말한다.[26][27] 즉, 색욕(色欲) · 성욕(聲欲) · 향욕(香欲) · 미욕(味欲) · 촉욕(觸欲)의 5욕(五欲)을 떠나지 못한 즉 극복하지 못한 유정의 5욕을 말한다.[28][29] 6욕천(六欲天)이라는 명칭에 대해 보다 자세히 설명하자면, 6욕천 즉 '욕계(欲界)에 속한 여섯 하늘[天]'이라고 할 때, 《구사론》 제8권에 따르면, 욕계라는 명칭에는 3가지 뜻이 있다. 첫째, 욕계(欲界)는 욕소속계(欲所屬界) 즉 '욕(欲)이 소속된 세계'를 뜻한다. 즉, 욕(欲) 즉 '단식(段食)과 음욕(淫慾)에 의해 인기된 탐(貪)'을 본질적 성질[自相]로 갖는 세계[界]를 뜻한다. 달리 말하면, 욕계는 욕(欲)이 소속된 세계[欲所屬界]의 줄임말이다.[30][31] 둘째, 욕계(欲界)는 욕지계(欲之界) 즉 '욕(欲)의 세계'를 뜻한다. 즉, 욕계라고 불리는 세계가 능히 유정의 온갖 욕(欲) 즉 '단식(段食)과 음욕(淫慾)에 의해 인기된 탐(貪)'을 임지(任持: 맡아서 유지 · 보전함)하는 힘을 가지고 있다는 것을 뜻한다.[32][33] 셋째, 욕계(欲界)는 욕계계(欲界繫) 즉 '욕계에 종속되는 법'를 뜻한다. 즉, 욕탐 즉 욕계의 탐에 의해 수증(隨增)되거나 욕탐을 수증(隨增)시키는 온갖 법들을 뜻한다. 따라서 무루법은 욕계의 탐은 물론이요, 색계 · 무색계의 탐에 그 어느 것에 의해서도 수증(隨增)되거나 이것들을 수증(隨增)시키지 않으며 오히려 이것들을 단멸시키므로, 3계 가운데 그 어디에도 종속되지 않기 때문에 불계(不繫)이다. 즉, 무루법은 비록 3계에서 일어날지라도 욕계계(欲界繫) · 색계계(色界繫) 혹은 무색계계(無色界繫)가 아니며 불계(不繫)이다.[34][35][36][37] 천(天)의 뜻 6욕천(六欲天, 산스크리트어: ṣaḍ kāmadeva)에서의 천(天, 산스크리트어: deva)은 자신이 지은 업에 따라 지옥취 · 아귀취 · 방생취 · 인취 · 천취의 5취(五趣) 또는 지옥도 · 아귀도 · 축생도 · 아수라도 · 인간도 · 천상도의 6도(六道) 가운데 가장 상위의 상태인 천취 즉 천상도에 태어나는 유정들을 말하며, 또는 그 유정들이 태어나 거주하는 처소 즉 기세간으로서의 하늘들을 말한다. 또는 이들 유정과 기세간 둘 다를 말한다.[18] 즉, 천취 즉 천상도의 유정들을 천(天)이라고 하는데, 이 경우 천인(天人) · 천중(天衆) · 비천(飛天) · 제바(提婆, 산스크리트어: deva, 데바) 등으로도 부른다.[18][19][20][21] 불교의 우주론에 따르면, 천인(天人)이 거주하는 처소 즉 기세간으로서의 하늘[天]에 대하여, 욕계에 여섯 하늘[天] 즉 6욕천이 있다는 것에 경전과 논서들 거의 대다수에서 의견이 일치한다. 뒤집어 말하자면, 《장아함경》 제18권과 제20권 그리고 《기세경》 제1권처럼, 6욕천 가운데 가장 높은 하늘인 타화자재천(他化自在天) 외에 천마(天魔) 즉 악마(惡魔)들의 우두머리인 대마왕(大魔王) 파순(波旬, 산스크리트어: Pāpiyas)의 거주처인 마천(魔天, 산스크리트어: Māra-deva)이 별도로 존재한다고 보아 7욕천(七欲天)을 설정하는 경우가 있다. 《장아함경》 제18권과 《기세경》 제1권에 따르면 마천은 마천(摩天) · 마라파순천(魔羅波旬天) 또는 마라파순천(摩羅波旬天)이라고도 하는데, 욕계의 가장 높은 하늘인 타화자재천과 색계의 제1천인 범중천(梵衆天)의 중간에 위치한다.

 6욕천(六欲天, 산스크리트어: ṣaḍ kāmadeva)은 욕계6천(欲界六天) · 욕계천(欲界天) 또는 욕천(欲天)이라고도 하며, 줄임말로 6욕(六欲) 또는 6천(六天)이라고도 한다.

6욕천(六欲天)은 욕계(欲界) · 색계(色界) · 무색계(無色界)의 3계 가운데 욕계에 속한 여섯 하늘[天]을 뜻하는데, '욕천(欲天)'은 이 여섯 하늘의 유정들은 모두 욕(欲, 산스크리트어: kāma)을 지니고 있다는 것을 의미한다.[1]

욕(欲)의 뜻

<nowiki /> 불교 용어 목록/온 § 욕, 탐, 3계탐, 욕탐, 색탐 및 무색탐 문서를 참고하십시오.

《구사론》 제8권에 따르면, 욕계(欲界, 산스크리트어: kāma-dhātu)와 6욕천(六欲天, 산스크리트어: ṣaḍ kāmadeva)에서의 욕(欲, 산스크리트어: kāma)은 간략히 말하면, 즉, 욕계에서의 욕구와 쾌락 중 가장 지속적이고 강렬한 것을 들어 말하자면, 단식음소인탐(段食婬所引貪) 즉 '단식(段食)과 음욕(淫慾)에 의해 인기된 탐(貪)'을 말한다. 여기서 단식(段食)은 단식(段食) · 촉식(觸食) · 사식(思食) · 식식(識食)의 4식(四食) 가운데 하나로 밥 · 국수 · 나물 · 기름 · 장 따위와 같이 형체가 있는 음식을 말한다.[25] 음욕[婬]은 성욕(性慾) 즉 남녀 간의 정욕(情慾)을 말한다. 즉, 욕(欲)은 간략히 말하면 식욕과 성욕을 말한다. 즉, 카마(kāma) 즉 욕계의 욕(欲)이란, 간략히 말해, 식욕과 성욕이라고 할 수 있다. 식욕은 생존의 욕구와 긴밀히 관련된 것이고 성욕은 종족 보존의 욕구 즉 번식욕과 긴밀히 관련된 것이다. 그리고 쾌락이라는 관점에서는 식도락과 성적 쾌락이 욕계의 쾌락 중 가장 지배적인 쾌락이며, 또한 욕계에 속박된 중생(인간과 동물 등)이 가장 널리 추구하고 탐닉하는 쾌락이라는 것을 의미한다.

하지만, 보다 엄밀히 말하자면, 카마(kāma) 즉 욕계의 욕(欲)은 욕탐(欲貪), 즉 욕계의 탐, 즉 욕계의 온갖 처소에서 아직 탐을 떠나지 못한 자의 탐을 말한다.[26][27] 즉, 색욕(色欲) · 성욕(聲欲) · 향욕(香欲) · 미욕(味欲) · 촉욕(觸欲)의 5욕(五欲)을 떠나지 못한 즉 극복하지 못한 유정의 5욕을 말한다.[28][29]

6욕천(六欲天)이라는 명칭에 대해 보다 자세히 설명하자면, 6욕천 즉 '욕계(欲界)에 속한 여섯 하늘[天]'이라고 할 때, 《구사론》 제8권에 따르면, 욕계라는 명칭에는 3가지 뜻이 있다.

첫째, 욕계(欲界)는 욕소속계(欲所屬界) 즉 '욕(欲)이 소속된 세계'를 뜻한다. 즉, 욕(欲) 즉 '단식(段食)과 음욕(淫慾)에 의해 인기된 탐(貪)'을 본질적 성질[自相]로 갖는 세계[界]를 뜻한다. 달리 말하면, 욕계는 욕(欲)이 소속된 세계[欲所屬界]의 줄임말이다.[30][31]

둘째, 욕계(欲界)는 욕지계(欲之界) 즉 '욕(欲)의 세계'를 뜻한다. 즉, 욕계라고 불리는 세계가 능히 유정의 온갖 욕(欲) 즉 '단식(段食)과 음욕(淫慾)에 의해 인기된 탐(貪)'을 임지(任持: 맡아서 유지 · 보전함)하는 힘을 가지고 있다는 것을 뜻한다.[32][33]

셋째, 욕계(欲界)는 욕계계(欲界繫) 즉 '욕계에 종속되는 법'를 뜻한다. 즉, 욕탐 즉 욕계의 탐에 의해 수증(隨增)되거나 욕탐을 수증(隨增)시키는 온갖 법들을 뜻한다. 따라서 무루법은 욕계의 탐은 물론이요, 색계 · 무색계의 탐에 그 어느 것에 의해서도 수증(隨增)되거나 이것들을 수증(隨增)시키지 않으며 오히려 이것들을 단멸시키므로, 3계 가운데 그 어디에도 종속되지 않기 때문에 불계(不繫)이다. 즉, 무루법은 비록 3계에서 일어날지라도 욕계계(欲界繫) · 색계계(色界繫) 혹은 무색계계(無色界繫)가 아니며 불계(不繫)이다.[34][35][36][37]

천(天)의 뜻

6욕천(六欲天, 산스크리트어: ṣaḍ kāmadeva)에서의 천(天, 산스크리트어: deva)은 자신이 지은 업에 따라 지옥취 · 아귀취 · 방생취 · 인취 · 천취의 5취(五趣) 또는 지옥도 · 아귀도 · 축생도 · 아수라도 · 인간도 · 천상도의 6도(六道) 가운데 가장 상위의 상태인 천취 즉 천상도에 태어나는 유정들을 말하며, 또는 그 유정들이 태어나 거주하는 처소 즉 기세간으로서의 하늘들을 말한다. 또는 이들 유정과 기세간 둘 다를 말한다.[18]

즉, 천취 즉 천상도의 유정들을 천(天)이라고 하는데, 이 경우 천인(天人) · 천중(天衆) · 비천(飛天) · 제바(提婆, 산스크리트어: deva, 데바) 등으로도 부른다.[18][19][20][21]

불교의 우주론에 따르면, 천인(天人)이 거주하는 처소 즉 기세간으로서의 하늘[天]에 대하여, 욕계에 여섯 하늘[天] 즉 6욕천이 있다는 것에 경전과 논서들 거의 대다수에서 의견이 일치한다. 뒤집어 말하자면, 《장아함경》 제18권과 제20권 그리고 《기세경》 제1권처럼, 6욕천 가운데 가장 높은 하늘인 타화자재천(他化自在天) 외에 천마(天魔) 즉 악마(惡魔)들의 우두머리인 대마왕(大魔王) 파순(波旬, 산스크리트어: Pāpiyas)의 거주처인 마천(魔天, 산스크리트어: Māra-deva)이 별도로 존재한다고 보아 7욕천(七欲天)을 설정하는 경우가 있다. 《장아함경》 제18권과 《기세경》 제1권에 따르면 마천은 마천(摩天) · 마라파순천(魔羅波旬天) 또는 마라파순천(摩羅波旬天)이라고도 하는데, 욕계의 가장 높은 하늘인 타화자재천과 색계의 제1천인 범중천(梵衆天)의 중간에 위치한다.


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Major depressive disorder (MDD), also known as clinical depression, is a mental disorder[10] 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,[11] 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 the second-most years lived with disability, after lower back pain.[12] The diagnosis of major depressive disorder is based on the person's reported experiences, behavior reported by family or friends, and a mental status examination.[13] There is no laboratory test for the disorder, but testing may be done to rule out physical conditions that can cause similar symptoms.[13] The most common time of onset is in a person's 20s,[3][4] with females affected about three times as often as males.[14] 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.[1] While a mainstay of treatment, the clinical efficacy of antidepressants is controversial.[15][16][17][18] 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.[1] Major depressive disorder is believed to be caused by a combination of genetic, environmental, and psychological factors,[1] with about 40% of the risk being genetic.[5] Risk factors include a family history of the condition, major life changes, childhood traumas, environmental lead exposure,[19] certain medications, chronic health problems, and substance use disorders.[1][5] 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.[1][5] Signs and symptoms See also: Digital media use and mental health § Depression An 1892 lithograph of a woman diagnosed with melancholia A person having a major depressive episode usually exhibits a low mood, which pervades all aspects of life, and an inability to experience pleasure in previously enjoyable activities.[20] Depressed people may be preoccupied with or ruminate over thoughts and feelings of worthlessness, inappropriate guilt or regret, helplessness or hopelessness.[21] Other symptoms of depression include poor concentration and memory,[22] withdrawal from social situations and activities, reduced sex drive, irritability, and thoughts of death or suicide. Insomnia is common; in the typical pattern, a person wakes very early and cannot get back to sleep. Hypersomnia, or oversleeping, can also happen,[23] as well as day-night rhythm disturbances, such as diurnal mood variation.[24] Some antidepressants may also cause insomnia due to their stimulating effect.[25] In severe cases, depressed people may have psychotic symptoms. These symptoms include delusions or, less commonly, hallucinations, usually unpleasant.[26] People who have had previous episodes with psychotic symptoms are more likely to have them with future episodes.[27] A depressed person may report multiple physical symptoms such as fatigue, headaches, or digestive problems; physical complaints are the most common presenting problem in developing countries, according to the World Health Organization's criteria for depression.[28] Appetite often decreases, resulting in weight loss, although increased appetite and weight gain occasionally occur.[29] Major depression significantly affects a person's family and personal relationships, work or school life, sleeping and eating habits, and general health.[30] Family and friends may notice agitation or lethargy.[23] Older depressed people may have cognitive symptoms of recent onset, such as forgetfulness,[31] and a more noticeable slowing of movements.[32] Depressed children may often display an irritable rather than a depressed mood;[23] most lose interest in school and show a steep decline in academic performance.[33] Diagnosis may be delayed or missed when symptoms are interpreted as "normal moodiness".[34] Elderly people may not present with classical depressive symptoms.[35] Diagnosis and treatment is further complicated in that the elderly are often simultaneously treated with a number of other drugs, and often have other concurrent diseases.[35] Cause Further information: Biology of depression and Epigenetics of depression A cup analogy demonstrating the diathesis–stress model that under the same amount of stressors, person 2 is more vulnerable than person 1, because of their predisposition[36] The etiology of depression is not yet fully understood.[37][38][39] The biopsychosocial model proposes that biological, psychological, and social factors all play a role in causing depression.[5][40] The diathesis–stress model specifies that depression results when a preexisting vulnerability, or diathesis, is activated by stressful life events. The preexisting vulnerability can be either genetic,[41][42] implying an interaction between nature and nurture, or schematic, resulting from views of the world learned in childhood.[43] 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.[44][45] Genetics Genes play a major role in the development of depression.[46] Family and twin studies suggest that genetic factors account for nearly 40% of the variation in risk for major depressive disorder. Like most psychiatric disorders, major depression is likely shaped by a combination of many individual genetic influences.[47] In 2018, a genome-wide association study discovered 44 genetic variants linked to risk for major depression;[48] a 2019 study found 102 variants in the genome linked to depression.[49] However, it appears that major depression is less heritable compared to bipolar disorder and schizophrenia.[50][51] Research focusing on specific candidate genes has been criticized for its tendency to generate false positive findings.[52] There are also other efforts to examine interactions between life stress and polygenic risk for depression.[53] Other health problems Depression can also arise after a chronic or terminal medical condition, such as HIV/AIDS or asthma, and may be labeled "secondary depression".[54][55] 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).[56] Depression may also be iatrogenic (the result of healthcare), such as drug-induced depression. Therapies associated with depression include interferons, beta blockers,[57] isotretinoin,[58] contraceptives,[57] cardiac agents,[59] anticonvulsants,[60] and hormonal agents.[61] Celiac disease is another possible contributing factor.[62] Substance use in early age is associated with increased risk of developing depression later in life.[63] Depression occurring after giving birth is called postpartum depression and is thought to be the result of hormonal changes associated with pregnancy.[64] Seasonal affective disorder, a type of depression associated with seasonal changes in sunlight, is thought to be triggered by decreased sunlight.[65] Vitamin B2, B6 and B12 deficiency may cause depression in females.[66] A 2025 study found that, among more than 172,500 adults in the UK aged 39 and older, those with a history of depression experienced the onset of chronic illnesses approximately 30% earlier than those without depression.[67] Environmental Adverse childhood experiences (incorporating childhood abuse, neglect and family dysfunction) markedly increase the risk of major depression, especially if more than one type.[68] Childhood trauma also correlates with severity of depression, poor responsiveness to treatment and length of illness.[69] Some are more susceptible than others to developing mental illness such as depression after trauma, and various genes have been suggested to control susceptibility.[70] Couples in unhappy marriages have a higher risk of developing clinical depression.[71] 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.[72] Living alone has been found to increase the risk of depression by 42%.[6] Pathophysiology Further information: Biology of depression and Epigenetics of depression The pathophysiology of depression is not completely understood, but current theories center around monoaminergic systems, 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 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.[73] Second, the correlation between depression risk and polymorphisms in the 5-HTTLPR gene, which codes for serotonin receptors, suggests a link.[74] Third, decreased size of the locus coeruleus, reduced activity of tyrosine hydroxylase, increased density of alpha-2 adrenergic receptor, and evidence from rat models suggest decreased adrenergic neurotransmission in depression.[75] Furthermore, decreased levels of homovanillic acid, altered response to dextroamphetamine, responses of depressive symptoms to dopamine receptor agonists, decreased dopamine receptor D1 binding in the striatum,[76] and polymorphism of dopamine receptor genes implicate dopamine, another monoamine, in depression.[77][78] Lastly, increased activity of monoamine oxidase, which degrades monoamines, has been associated with depression.[79] 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 the existence of atypical antidepressants which can be effective despite not targeting this pathway.[80] 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.[81] However, disinhibition of the dorsal raphe has been proposed to occur as a result of decreased serotonergic activity in tryptophan depletion, resulting in 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.[82] Already limited, the monoamine hypothesis has been further oversimplified when presented to the general public.[83] A 2022 review found no consistent evidence supporting the serotonin hypothesis linking serotonin levels and depression.[84] 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 is not adequate as a diagnosis tool because its sensitivity is only 44%.[85] These stress-related abnormalities are thought to be the cause of hippocampal volume reductions seen in people who are depressed.[86] Furthermore, a meta-analysis yielded decreased dexamethasone suppression, and increased response to psychological stressors.[87] Further abnormal results have been obscured with the cortisol awakening response, with increased response being associated with depression.[88] There 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 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.[89] Another study showed that people with IBS have a higher chance of developing depression, which shows the two are connected.[90] There is even evidence suggesting that altering the microbes in the gut can have regulatory effects on developing depression.[89] 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.[91] Another model, the cortico-striatal model, suggests that abnormalities of the prefrontal cortex in regulating striatal and subcortical structures result in depression.[92] 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.[93] Immune pathogenesis theories on depression The newer field of psychoneuroimmunology, 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.[94][95][96] Some people with depression have increased levels of pro-inflammatory cytokines and some have decreased levels of anti-inflammatory cytokines.[97] Research suggests that treatments can reduce pro-inflammatory cell production, like the experimental treatment of ketamine with treatment-resistant depression.[98] 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.[99] 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 the production of COX2. This, in turn, causes the production of PGE2, 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.[100] 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 the concentration of quinolinic acid correlates to the severity of depressive symptoms.[101] Diagnosis Assessment Further information: Rating scales for depression Caricature of a man with depression A diagnostic assessment may be conducted by a suitably trained general practitioner, or by a psychiatrist or psychologist,[30] 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 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.[30] Specialist mental health services are rare in rural areas, and thus diagnosis and management is left largely to primary-care clinicians.[102] This issue is even more marked in developing countries.[103] Rating scales are not used to diagnose depression, but they provide an indication of 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;[104] these include the Hamilton Rating Scale for Depression,[105] the Beck Depression Inventory[106] or the Suicide Behaviors Questionnaire-Revised.[107] 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 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 th

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  Major depressive disorder   ( MDD ), also known as   clinical depression , is a   mental disorder [ 10 ]   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, [ 11 ]   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 the second-most   years lived with disability , after   lower back pain . [ 12 ] The diagnosis of major depressive disorder is based on the person's reported experiences, behavior reported by family or friends, and a  mental status examination . [ 13 ]  There is no laboratory test for the diso...
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Psychology is the scientific study of the mind and behavior.[1][2] Its subject matter includes the behavior of humans and nonhumans, both conscious and unconscious phenomena, and mental processes such as thoughts, feelings, and motives. Psychology is an academic discipline of immense scope, crossing the boundaries between the natural and social sciences. Biological psychologists seek an understanding of the emergent properties of brains, linking the discipline to neuroscience. As social scientists, psychologists aim to understand the behavior of individuals and groups.[3][4] A professional practitioner or researcher involved in the discipline is called a psychologist. Some psychologists can also be classified as behavioral or cognitive scientists. Some psychologists attempt to understand the role of mental functions in individual and social behavior. Others explore the physiological and neurobiological processes that underlie cognitive functions and behaviors. As part of an interdisciplinary field, psychologists are involved in research on perception, cognition, attention, emotion, intelligence, subjective experiences, motivation, brain functioning, and personality. Psychologists' interests extend to interpersonal relationships, psychological resilience, family resilience, and other areas within social psychology. They also consider the unconscious mind.[5] Research psychologists employ empirical methods to infer causal and correlational relationships between psychosocial variables. Some, but not all, clinical and counseling psychologists rely on symbolic interpretation. While psychological knowledge is often applied to the assessment and treatment of mental health problems, it is also directed towards understanding and solving problems in several spheres of human activity. By many accounts, psychology ultimately aims to benefit society.[6][7][8] Many psychologists are involved in some kind of therapeutic role, practicing psychotherapy in clinical, counseling, or school settings. Other psychologists conduct scientific research on a wide range of topics related to mental processes and behavior. Typically the latter group of psychologists work in academic settings (e.g., universities, medical schools, or hospitals). Another group of psychologists is employed in industrial and organizational settings.[9] Yet others are involved in work on human development, aging, sports, health, forensic science, education, and the media.

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 Psychology is the scientific study of the mind and behavior.[1][2] Its subject matter includes the behavior of humans and nonhumans, both conscious and unconscious phenomena, and mental processes such as thoughts, feelings, and motives. Psychology is an academic discipline of immense scope, crossing the boundaries between the natural and social sciences. Biological psychologists seek an understanding of the emergent properties of brains, linking the discipline to neuroscience. As social scientists, psychologists aim to understand the behavior of individuals and groups.[3][4] A professional practitioner or researcher involved in the discipline is called a psychologist. Some psychologists can also be classified as behavioral or cognitive scientists. Some psychologists attempt to understand the role of mental functions in individual and social behavior. Others explore the physiological and neurobiological processes that underlie cognitive functions and behaviors. As part of an interd...
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