Major Depressive Disorder

2024/11/20

What is Major Depressive Disorder?

A depressive disorder is not the same as a passing blue mood. It is not a sign of personal weakness or a condition that can be willed or wished away. People with a depressive illness cannot merely "pull themselves together" and get better. Without treatment, symptoms can last for weeks, months, or years. Depression is a common but serious illness, and most people who experience it need treatment to get better.

Major depression is manifested by a combination of symptoms (see symptom list) that interfere with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. Such a disabling episode of depression may occur only once but more commonly occurs several times in a lifetime. A depressive disorder is an illness that involves the body, mood, and thoughts. It interferes with daily life, normal functioning, and causes pain for both the person with the disorder and those who care about him or her.

Symptoms

Not everyone who is depressed experiences every symptom. Some people experience only a few symptoms, while others may experience many. Severity of symptoms varies with individuals and also varies over time.

Symptoms of depression may include:

Appetite and/or weight loss, or overeating and weight gain
Decreased energy, fatigue, being "slowed down"
Difficulty concentrating, remembering, or making decisions
Feelings of guilt, worthlessness, or helplessness
Feelings of hopelessness or pessimism
Insomnia, early morning awakening or oversleeping
Loss of interest or pleasure in hobbies and activities that were once enjoyed
Restlessness, irritability
Persistent physical symptoms that do not respond to treatment, such as headaches, digestive disorders and chronic pain
Persistent sad, anxious, or empty mood
Thoughts of death or suicide, attempts at suicide

Treatment

Depression, even the most severe cases, is a highly treatable disorder. As with many illnesses, the earlier that treatment can begin, the more effective it is and the greater the likelihood that recurrence can be prevented.

Appropriate treatment for depression starts with a physical examination by a physician. Certain medications, as well as some medical conditions such as viral infections or a thyroid disorder, can cause the same symptoms as depression, and the physician should rule out these possibilities through examination, interview and lab tests. If a physical cause for the depression is ruled out, a psychological evaluation that includes a mental status examination should be done either by the physician or by referral to a mental health professional.

The doctor and patient should discuss any family history of depression (including treatment) along with a complete history of the patient's symptoms – when they started, how long they have lasted, how severe they are, whether the patient has had them before, whether the symptoms were treated and what treatment was given. The doctor should ask about alcohol or drug use, and whether the patient has had any thoughts about death or suicide.

Once diagnosed, a person with depression can be treated with a number of methods. The most common treatments are medication and psychotherapy.

Doctors