Major Depressive Disorder

A mood disorder that causes a prolonged feeling of sadness and loss of interest is called depression (also known as major depressive disorder or clinical depression). It negatively affects your feelings, thoughts, and behavior and may cause multiple physical and emotional issues. Depression may interact with your daily activities and you may feel that life is not worth living.

However, this condition is not simply a bout of the blues or a weakness that you can get rid of easily. Sometimes, this mood disorder requires long-term treatment but you should not get discouraged because many people feel better with psychotherapy and medicines. In most cases, people need both treatment options.

Symptoms

While some people experience this condition at least once during their lifetime, others may have multiple episodes. Thus, symptoms usually happen nearly every day and include the following ones. Examples include:

A feeling of tearfulness, sadness, emptiness, or hopelessness
Frustration, irritability, or angry outbursts
Loss of pleasure or interest in certain activities once enjoyed (such as sex, sports, or hobbies)
Insomnia (sleeping disturbances) or sleeping too much
Tiredness
Lack of energy
Decreased appetite or increased cravings
Weight loss
Anxiety
Agitation or restlessness
Thinking, speaking, or body movement problems
Difficulty focusing, concentrating, or remembering things
Recurrent suicidal thoughts or attempts
Unusual physical issues (including headaches, back pain, and others)

Commonly, in people with depression, the symptoms are enough severe to cause problems at work, school, in social activities, or in relationships. Sometimes, people may feel miserable without any obvious reason.

Symptoms in Children and Teenagers

Depression symptoms are similar to those of adults but there are some differences. Check below the most common depression symptoms in children and teens:

Children with depression usually experience sadness, irritability, clinginess, worry, aches, and pains and may refuse to go to school.
Teenagers often experience irritability, sadness, feeling worthless, anger, poor attendance and performance at school, sensitivity, and may use recreational drugs and alcohol. They also may eat and sleep too much and experience problems with social interaction and loss of interest in activities once enjoyed.

Symptoms in Older Adults

Depression is a normal part of aging and it usually is not diagnosed and untreated in older adults. As a result, they may experience the following symptoms. Examples include:

Memory problems
Personality changes
Physical pain or aches
Extreme tiredness (fatigue)
Loss of appetite
Insomnia (sleeping disturbances)
Reduced sexual drive that is not caused by a disease or medicine
Suicidal thoughts or even attempts
Avoid socializing or doing new things

If you think you have depression symptoms, it is advised to see a doctor or mental health professional for a diagnosis and treatment. However, you should seek emergency help if you or a loved person have suicidal thoughts or attempts.

Causes

Experts do not know the exact cause of this mental disorder but there may be multiple factors that contribute to the condition like other mental health problems. For example:

Biological differences – Some people with depression have certain changes in their brains. However, this does not cause the condition but may contribute to its development.
Brain chemistry – Healthcare providers believe that certain brain chemicals (neurotransmitters) play an important role in depression. As per studies, mood stability depends on neurotransmitters function and how they interact with neurocircuits.
Hormones – Hormonal changes also may contribute to depression. It often happens due to pregnancy, health conditions, thyroid conditions, menopause, and others.
Inherited traits – People with a family history of depression also develop it. Nowadays, researchers try to find genes that are involved in depression.

Risk Factors

In most cases, this mood disorder occurs between 20 and 30 years old but it may happen at any age as well. Moreover, depression happens mostly in women but it may be because females are more likely to seek treatment.

There are some factors that elevate your risk of developing depression. Check some examples below:

Some personality traits (such as low self-esteem, being too self-critical or pessimistic, and others)
Stressful or traumatic life events (such as sexual or physical abuse, death of a loved person, financial problems, and others)
Family history of mental disorders (including alcoholism, suicide, bipolar disorder, or depression)
People who are lesbian, gay, bisexual, or transgender are more likely to develop this mood disorder.
A medical history of anxiety disorders, eating disorders, or post-traumatic stress disorder (PTSD).
Misuse of alcohol or illegal drugs
Severe chronic diseases (such as stroke, chronic pain, heart disease, cancer, and others)
Administering some medicines (including hypertensives, sleeping medicines, chemotherapy drugs, and others)

Complications

This mental condition may worsen without treatment and cause serious problems. Check below some complications often associated with depression:

Excessive body weight or obesity (this condition may cause heart problems and diabetes)
Physical conditions or pain
Misuse of recreational drugs or alcohol
Problems with family, relationships, work or school
Isolation
Suicidal thoughts or attempts
Self-harm (including cutting)
Premature death caused by health conditions

How to Prevent Major Depressive Disorder?

It is not possible to prevent this mood disorder but the following tips may reduce the risk of developing it. Examples include:

Manage stress and chronic conditions (such as diabetes)
Administer medicines exactly as prescribed by your doctor to prevent a recurrence of the symptoms
Quit smoking or never begin
Limit or avoid alcoholic beverages
Do not use recreational drugs without your doctor’s approval

Diagnosis

Commonly, physicians perform the following tests to diagnose major depressive disorder. These include:

Physical examination – During this procedure, doctors will check for physical problems that may cause depression and will ask some questions about your medical history and symptoms.
Laboratory tests – These include blood tests to check for thyroid function.
Psychiatric evaluation – During this evaluation, mental health professionals may ask questions about your thoughts, feelings, and behavior patterns.
DSM-5 – Your doctor may use depression criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Depression Types

The symptoms of depression usually are different among people. That’s why physicians need to add one or more specifiers to determine the depression type you have. Therefore, specifiers are specific features of the depression you experience. For example:

Anxious distress – This involves unusual restlessness, loss of control, or worry about potential events.
Mixed features – In such cases, mania happens along with depression including increased self-esteem and energy.
Melancholic features – Severe depression usually with a lack of response to something that previously brought pleasure.
Atypical features – These include increased appetite, excessive sleeping, sensitivity to rejection, and others.
Psychotic features – In such cases, depression happens along with delusions or hallucinations.
Catatonia – This includes motor activity involving uncontrollable and purposeless movement.
Peripartum onset – This depression type happens during pregnancy and if it occurs after delivery it is called postpartum.
Seasonal pattern – In such cases, people experience depression linked with season changes and reduced sunlight exposure.

Mental Disorders that cause Symptoms Similar to Depression

There are multiple disorders that may cause symptoms similar to major depressive disorders. That’s why you should visit a doctor for diagnosis if suspect you experience depression symptoms. Check below some examples:

Bipolar I and II disorders – Sometimes, it is difficult to determine what condition a person experiences.
Cyclothymic disorder – This is a condition that causes symptoms milder than those of bipolar disorder.
Disruptive mood dysregulation disorder – This is a mood disorder in children that causes chronic and severe irritability and anger and often develops into depressive disorder or anxiety disorder.
Persistent depressive disorder – In some cases, this condition is called dysthymia and it is less severe but chronic depression form.
Premenstrual dysphoric disorder – It is associated with hormonal changes that happen before periods. However, the symptoms improve after the menstrual period.
Other depression disorders – For example depression due to misuse of recreational drugs or other prescription medications.

Treatment

The most effective treatments for people with major depressive disorders are psychotherapy (also called talk therapy) and medicines. In case you experience a severe form of depression, you may need to stay in a hospital until the symptoms improve.

Medicines

Check below some antidepressants often prescribed by doctors:

SSRIs (selective serotonin reuptake inhibitors) – Healthcare providers usually begin depression treatment with these medications. Generally, SSRIs are considered safe and cause fewer adverse reactions compared to other antidepressants. Doctors usually prescribe Escitalopram, Citalopram, Paroxetine, Sertraline, Fluoxetine, and Vilazodone.
SNRIs (serotonin-norepinephrine reuptake inhibitors) – For example Venlafaxine, Levomilnacipran, Desvenlafaxine, and Duloxetine.
Atypical antidepressants – These include Mirtazapine, Vortioxetine, Bupropion, Trazodone, and Nefazodone.
Tricyclic antidepressants – This category of antidepressants may cause more severe adverse reactions and usually are recommended when SSRIs are not effective. For example Imipramine, Nortriptyline, Amitriptyline, Doxepin, Trimipramine, Protriptyline, and others.
MAOIs (monoamine oxidase inhibitors) – Commonly, a strict diet is required for those who use MAOIs because it may cause life-threatening or even deadly interactions with foods (such as some cheeses, pickles, and wines). Doctors commonly prescribe Tranylcypromine, Phenelzine, and Isocarboxazid.
Other medicines – In some cases, your doctor may prescribe additional medicines to improve antidepressant effectiveness. For example a combination of two antidepressants, mood stabilizers, or antipsychotics.

Psychotherapy

This treatment option also is called talk therapy or psychological therapy. Depending on the severity and type of the depression, your age, and other factors, doctors will recommend the best psychotherapy type (such as cognitive behavioral therapy or interpersonal therapy) for you. Generally, this treatment option helps people with depression cope with symptoms and improve their quality of life. For example:

Adjust to current problems
Determine negative beliefs and behaviors and cope with them
Explore experiences and relationships with others
Find problems that contribute to your mood disorder
Ease symptoms such as anger and hopelessness
Learn techniques to tolerate and accept distress

Other Treatments

Sometimes, people need one of the following procedures to treat the condition. For example:

ECT (electroconvulsive therapy) – This treatment involves an electrical current that passes through the brain to the neurotransmitters. ECT may help ease depression. This procedure is usually recommended for people with an increased risk of suicide or who do not notice improvements after medicines.
TMS (transcranial magnetic stimulation) – This is another effective procedure for people who do not respond to medications. It involves stimulation of the nerve cells in the brain that are responsible for mood regulation and major depressive disorder.

Frequently Asked Questions

What are the primary symptoms of major depressive disorder?

These include:

Poor focusing and concentrating
The feeling of guilt, low self-esteem, sadness, irritability, or hopeless
Sleeping problems
Suicidal thoughts or even attempts
Extreme tiredness
Lack of energy
Loss of pleasure or interest in activities once enjoyed

If you or a loved person experiences any of the previous symptoms, immediately visit a mental health professional.

What are the most effective treatment options for major depressive disorder?

Commonly, most people get better with psychotherapy (also called talk therapy) and medications. However, sometimes may require additional treatments such as ECT and TMS. For more details, discuss it with your healthcare professional.

What happens if the major depressive disorder is left untreated?

If you do not treat this condition, you may experience dangerous and even life-threatening complications. Examples include:

Physical health problems – These include loss of appetite, sleeping problems, cardiovascular problems, and others
Increased suicide risk
Social isolation
Functional impairment
More severe and intense depression symptoms

If any of the previous complications occur in a loved person immediately call 911 in the U.S. or the emergency number in your region. If you have additional questions, ask your healthcare professional.