Major Depressive Disorder

What is Major Depressive Disorder?

According to the American Psychiatric Association (APA), major depressive disorder (MDD) is a mental health condition that affects how a person feels, thinks, and behaves. Someone suffering from major depressive disorder will often experience prolonged periods of sadness and loss of interest in hobbies or daily activities.

Unlike someone who might experience sadness on occasion or not be in the mood to do something, when you suffer from major depressive disorder, you can’t just “snap out of it.” Major depressive episodes will occur without warning or explanation and can last for weeks or more, causing significant distress and impairment.

Situational Depression VS Major Depressive Disorder

While everyone feels sadness and depression from time to time, these feelings don’t necessarily mean that there is a more significant mental health issue.

Situational depression describes occasions where you might experience sadness and depression due to something that occurred, such as losing your job or going through a breakup. These feelings will dissipate, and you will return to feeling normal.

Major depressive disorder is a mental illness where these feelings of sadness and depression don’t go away. They can also occur for seemingly no reason and can be debilitating.

Symptoms of Major Depressive Disorder

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), to be diagnosed with major depressive disorder, you must meet the following criteria:

• Five or more symptoms must persist for at least two weeks
• At least one symptom must be either a depressed mood or a loss of interest
• There must be a change in your previous functioning

Symptoms associated with major depressive disorder include:

• Irritability
• Outbursts
• Changes in sleep patterns
• Sadness
• Feelings of worthlessness
• Hopelessness
• Emptiness
• Lack of energy
• Always feeling tired
• Changes in eating habits
• Fluctuation in weight, such as weight loss or gain
• Anxiety
• Restlessness
• Slowed speaking and body movements
• Feeling worthless
• Fixating on past failures
• Having trouble concentrating or making decisions
• Unexplained physical ailments
• Thoughts of death
• Suicide attempts

Depression Symptoms in Adolescents and Teens

While in many cases, depression symptoms in children and teens are the same as in adults, there can be some unique symptoms, including:

• Initial use or increased use of substances of abuse
• Poor performance at school
• Refusing to go to school or skipping school
• Eating or sleeping either too much or not enough
• Social withdrawal or isolation
• Having trouble with peers

Depression Symptoms in Older Adults

Unfortunately, depression is common in those with Alzheimer’s and other dementias. Some common symptoms of depression in older people include:

• Having trouble remembering things
• Personality changes
• Not wanting to go out of the house
• Fatigue
• Loss of appetite
• Sleep problems
• Physical aches and pains
• Health problems
• Suicidal thoughts
• Self-harm

Types of Depression

Major depressive disorder is one of many different types of depression that doctors may diagnose. Frequently, other depressive disorders share similar symptoms and side effects, making it challenging to differentiate without being diagnosed by a mental health professional.

Perinatal and Postpartum Depression

The process of childbirth often brings on both Perinatal and Postpartum Depression. Perinatal depression can occur during pregnancy and last up to a year after the baby is born. Alternatively, Postpartum Depression traditionally begins once the baby has been born.

While many assume the mother can only experience perinatal and postpartum depression, it is not gender-specific, and one or both parents can experience this condition.

Bipolar Depression

Someone suffering from bipolar depression will often alternate between “low” moods and high-energy periods. During those low periods, it is not uncommon for the person to experience depression symptoms.

Seasonal Affective Disorder (SAD)

Seasonal affective disorder usually occurs during the fall and winter, particularly in locations where the weather changes drastically and sunlight becomes sparse. During these weather changes, someone suffering from SAD may experience depression symptoms.

Psychotic Depression

Someone suffering from psychotic depression will often experience both severe depression and psychotic episodes, such as delusions or hallucinations.

Persistent Depressive Disorder

Also known as dysthymia, persistent depressive disorder (PDD) symptoms are often less severe than those of major depression. People suffering from PDD often deal with their symptoms for years.

Major Depressive Disorder Causes and Risk Factors

While the exact cause of major medical depression is unknown, there are a variety of causes and risk factors that can increase the chances that someone might suffer from MDD, such as genetics, brain chemistry, and gender.

Causes of MDD

There are a variety of biological and physical factors that may increase the chance of developing MDD, including:

• Genetics: Someone with a family history of major depressive disorder is more likely to develop it.
• Hormones: Changes in a person’s hormones can cause or trigger depression.
• Brain Chemistry: Research indicates that changes in the function of the neurotransmitters in the brain and how they interact can play a significant role in the development of depression.
• Environment: Certain life events can increase the risk of depression, including trauma, abuse, isolation, lack of support, or the death of a loved one.
• Medical Conditions: Certain medical conditions can increase the risk of depression as well, including cancer, thyroid issues, diabetes, Parkinson’s, and Alzheimer’s.

MDD Risk Factors

Certain groups are more susceptible to depression than others, potentially because of genetic makeup or how society perceives and treats them.

Groups that are particularly vulnerable include:

• LGBTQ+
• Those with a history of mental health disorders such as:
  • Anxiety disorder
  • Psychosis
  • Psychiatric disorder
  • Schizophrenia
  • Unipolar depression
• Women
• Racial minorities
• Those suffering from a serious or chronic illness
• Those suffering from substance use disorder

Related Conditions to Depression

Several conditions share many of the same characteristics and symptoms as depression but are slightly different. In some cases, these conditions might get misdiagnosed as depression.

Vitamin D Deficiency

When someone is not getting enough Vitamin D, they might experience symptoms that are similar to depression, including:

• Mood changes
• Fatigue
• Pain
• Weakness

Anemia

Anemia occurs when you don’t have enough healthy red blood cells to carry oxygen to the organs. Like someone suffering from depression, someone suffering from anemia might also experience symptoms such as fatigue and weakness.

They might also suffer from additional features such as:

• Shortness of breath
• Dizziness
• Headaches
• Sore tongue
• Restless leg syndrome
• Skin problems

Attention Deficit Hyperactivity Disorder (ADHD)

The stress that goes along with having ADHD can lead to depression. When depression happens as a result of other challenges, it is called situational depression.

Often, depression symptoms will go away when the person with ADHD receives adequate treatment.

Fibromyalgia

Fibromyalgia is a condition that causes muscle pain and fatigue. Many people with fibromyalgia also have depression.

Symptoms that are unique to fibromyalgia include:

• Burning pain
• Numbness and tingling in your extremities
• Increased sensitivity
• Muscle spasms

How Depression Can Cause Addiction

Not everyone that suffers from addiction seeks professional help right away. Some people might not fully understand what they are going through, or they don’t think anyone will care or listen.

Those who are treatment-resistant (i.e., medication and therapy don’t adequately help with symptoms) might turn to substance abuse to feel better and self-medicate. In some cases, it might even appear to be working.

Using and abusing drugs and alcohol as a way of self-medicating can make your depression symptoms worse and increase your chances of developing an addiction.

Major Depressive Disorder Treatment Options

There are many options available for those seeking treatment for their depression. Standard treatment options for those suffering from MDD include:

• Medications
• Therapy
• Home remedies

Medications

There are a wide variety of medications currently on the market that can help with the treatment of depression.

Medications that have been FDA approved to treat major depressive disorder include:

• Selective Serotonin Reuptake Inhibitors (SSRIs)
• Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
• Atypical and Tricyclic antidepressant medication
• Monoamine Oxidase Inhibitors (MAOIs)

Some popular name brands of these types of medications include:

• Lexapro
• Prozac
• Paxil
• Zoloft
• Pristiq
• Wellbutrin

Psychotherapy

Also known as talk therapy, psychotherapy allows patients to identify the causes of their depression and ways to lessen the MDD symptoms. Next, the therapist can teach you better ways of handling these triggers in the future.

Psychotherapy can also help someone suffering from depression boost their self-esteem and teach them better communication skills.

Typical forms of psychotherapy include:

• Cognitive Behavioral Therapy (CBT)
• Dialectical Behavioral Therapy (DBT)
• Interpersonal Therapy

Brain Stimulation Therapy

Those who suffer from such a severe form of depression that neither psychotherapy nor medication will work might receive brain stimulation therapy.

During brain stimulation therapy, a mild electrical current is sent through the brain, which will trigger a brief seizure. The seizure helps to restore normal balance in the chemicals of the brain.

Examples of brain stimulation therapy include:

• Electroconvulsive Therapy (ECT)
• Transcranial Magnetic Stimulation (TMS)
• Vagus Nerve Stimulation (VNS)

Home Remedies

In addition to therapy and medication, there are certain things that you can do on your own to help with your depression symptoms.

These home remedies include:

• Adopting a healthy and well-balanced diet
• Avoiding drugs and alcohol (other than prescribed medications)
• Getting plenty of sleep
• Exercising
• Yoga
• Meditation
• Mindfulness

Find Help For Major Depressive Disorder

If you or someone you know is struggling with depression, you deserve to receive support and treatment for this disorder.

Contact your primary care physician or licensed therapist to discuss treatment options. If you don’t have a healthcare provider or want a list of treatment professionals in your area, you can visit the SAMHSA online Behavioral Health Treatment Services Locator.