Understanding Major Depressive Disorder Symptoms, Causes, and Treatment

Understanding Major Depressive Disorder

Major depressive disorder, commonly known as depression, is a serious medical illness that negatively affects how an individual feels, thinks and acts. Depression causes feelings of sadness and/or loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person's ability to function at work and in social activities.

Depression is one of the most common mental disorders in the United States. According to the National Institute of Mental Health, over 17 million American adults have had at least one major depressive episode. While depression can develop at any age, the average onset is during the late teens to mid-20s.

Symptoms of Major Depressive Disorder

The symptoms of depression can vary from mild to severe. To receive a diagnosis of major depressive disorder, an individual must experience five or more of the following symptoms over a two-week period:

• Depressed mood most of the day
• Diminished interest or loss of pleasure in activities
• Significant weight loss or gain when not dieting
• Insomnia or increased desire to sleep
• Visible agitation or physical restlessness
• Fatigue and loss of energy
• Feelings of worthlessness or excessive guilt
• Inability to think, concentrate or make decisions
• Recurrent thoughts of death or suicide

The symptoms must represent a change from previous functioning and cause significant distress or impairment in important areas of functioning, such as work, social activities or relationships.

Causes of Major Depressive Disorder

There is no single cause of major depressive disorder. Instead, it likely arises from a combination of biological, psychological and social sources. Some key factors believed to play a role include:

• Biological differences - People with depression may have physical changes in their brains and neurotransmitter function.
• Hormones - Changes in reproductive hormones or the body's response to stress hormones may contribute.
• Genetics - Having a family history of depression increases risk, suggesting a possible genetic component.
• Childhood trauma or stress - Negative childhood experiences, like trauma or loss, may increase vulnerability.
• Personality traits - Having a more pessimistic outlook or low self-esteem may play a role.
• Drug and alcohol abuse - Heavy drinkers and drug users are at increased risk of depression.

In many cases, depression develops from a mix of genetic tendencies, imbalances in neurotransmitters, hormonal changes, and the way an individual copes with stresses in life.

Risk Factors for Depression

While the exact cause of depression is unclear, certain factors seem to increase the risk of developing this condition. Factors that may make someone more likely to experience depression include:

• Having a family history of depression
• Going through major life stresses like divorce, serious illness, financial troubles or death of a loved one
• Physical or sexual abuse, especially as a child
• Having a serious medical condition like cancer, heart disease, Alzheimer's or Parkinson's
• Use and abuse of recreational drugs or alcohol
• Taking certain prescription medications, like sleeping pills or blood pressure medications
• Having personality traits like low self-esteem, being overly dependent or self-critical

Women are diagnosed with depression about twice as often as men. Hormonal factors may contribute, as women are especially vulnerable to developing postpartum depression or depression during menopause. However, men tend to be less likely to seek help or recognize symptoms of depression in themselves.

Major Depressive Disorder Treatment

The good news about depression is that it is a highly treatable condition. Over 80-90% of people with depression can experience significant relief of symptoms by using psychological counseling and/or antidepressant medications.

Psychotherapy

Cognitive behavioral therapy (CBT) is one of the most effective and commonly used treatments for major depressive disorder. CBT helps patients identify distorted thinking patterns that contribute to their depression and replace them with healthier, more constructive thoughts and behaviors.

Interpersonal therapy focuses on improving communication and relationships that may trigger or worsen depression. Other types of talk therapy can help individuals work through traumatic experiences or understand conflicted feelings that underlie the depression.

Medications

Antidepressant medications influence neurotransmitters like serotonin and norepinephrine to regulate mood and alleviate symptoms of depression. Selective serotonin reuptake inhibitors (SSRIs) like Zoloft, Prozac and Lexapro are typically well tolerated and safe to use for long-term treatment.

Other medications used to treat depression include SNRIs like Effexor and Cymbalta, atypical antidepressants like Wellbutrin, and MAOIs like Emsam. Patients sometimes try different medications or combinations to find the most effective option with tolerable side effects.

Other Treatments

For patients with severe depression who do not improve sufficiently from standard treatments, brain stimulation therapies may be an option. Electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS) and vagus nerve stimulation (VNS) are technologies currently in use.

Lifestyle adjustments like getting regular exercise, maintaining a consistent sleep schedule, eating a nutritious diet, avoiding alcohol and recreational drugs, practicing relaxation techniques and participating in support groups can also help manage depressive disorders.

Coping with Depression in Daily Life

Living with depression presents an ongoing challenge. Even with treatment, relapses can occur. Certain strategies may help individuals cope on a daily basis when dealing with the symptoms of major depressive disorder:

• Set a gentle daily routine with attainable goals
• Break bigger tasks into smaller steps
• Exercise in moderate amounts
• Spend time outdoors and get sunlight exposure
• Challenge negative thinking and be kind to yourself
• Stay connected to supportive friends and family
• Avoid overworking or isolating yourself
• Make time for enjoyable hobbies and activities
• Join a depression support group to share experiences

It can be hard to take steps to manage depression, but gradually increasing pleasurable activities and feeling connected to others can relieve symptoms. Seeking professional help via therapy, medication, or other treatment options can also make a major difference in improving mood and quality of life.

The Outlook for People with Depression

The course of depression varies among individuals. Some people only experience one depressive episode in their lifetime. For others, episodes may recur periodically over the years. Chronic, persistent depression lasting 2 or more years affects about 20% of people with major depressive disorder.

With proper treatment and self-care, the prognosis is good for recovery from major depression. About 80% of people will feel significantly better with the right interventions. However, depression can be life-threatening in its most serious forms. People who struggle with suicidal thoughts need urgent assistance.

While depression is highly treatable, many cases go undiagnosed and untreated. On average, there is a 6-8 year delay between when symptoms first appear and when individuals obtain professional help. Better awareness, screening and access to mental health services are needed to ensure people get the help they need as early as possible.

With compassionate professional care and personal perseverance, even severe depression can be overcome. The stigma surrounding mental illness causes many to suffer alone in silence. However, those affected by depression deserve support and understanding while embarking on the challenging but rewarding road to recovery.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.