Major depressive disorder is a type of mood disorder that is not the same as the common feeling of sadness that each and every person experiences at some point in their lives. Major depressive disorder is a condition that is characterized by a sustained emotional state of depression and loss of interest that persists for weeks or until months that is severe enough that it has detrimental effects already on the person’s day-to-day functioning, work performance and interpersonal relationships. Some people even report that it is as if the total sense of control over actions and mood is lost. Some people may develop depression without any apparent trigger while others develop this condition from obvious triggers such as a loss of loved one, financial difficulties or family problems. When a person develops major depressive disorder, their reactions to these triggers are more intense and long lasting than the usual feeling of sadness that normal people experience.
Major depressive disorder is a common illness with an estimate count of 10% of a given population has had or will have this illness. Onset of this condition can occur at any time but is most commonly seen during early adulthood. Women are shown to be more prone than men, especially in divorced or separated individuals. Alcoholism and substance abuse is also commonly seen co-existing with depression.
Causes of Major Depressive Disorder
The main causes of major depressive disorder are postulated to be a combination of genetic and environmental factors.
- Biochemical imbalance in the brain particularly, a low level of the following hormones – norepinephrine, serotonin and dopamine
- Genetics
- Sleep abnormalities such as insomnia or having increased sleepiness
- Other neurological and medical disorders that also present with depression. Some examples are:
- Neurological such as Parkinson’s disease, Alzheimer’s disease and stroke
- Endocrine related such as thyroid disease
- Cardio-pulmonary diseases
- Cancer
- Pharmacologic effect as some drugs have depression as a side effect
- Personality styles that is more predisposed to developing depressions such as:
- Those with high risk personality as they always blame themselves such as those that are dependent or those that are obsessive compulsive
- Those with low risk personality as they always blame others such as those that are anti social or paranoid
Criteria for Major Depressive Disorder
In order to be diagnosed as having a major depressive disorder, the person must have at least 5 or more of the following symptoms that persists for at least 2 weeks. This criterion is taken from the Diagnostic and Statistical Manual for Mental Disorders, 5th edition.
- Depressed or irritable mood
- Low energy
- Lack of pleasure or interest in activities
- Motor retardation or restlessness
- Increase or decrease in appetite
- Increase of decrease in sleep
- Self blame such as the feeling of guilt and worthlessness
- Decreased ability to concentrate and focus or has poor memory
- Suicidal thoughts
Treatment of Major Depressive Disorder
The treatment for major depressive disorders involves a combination of psychosocial and pharmacologic treatments. Examples of psychosocial treatment are as follows:
- Psychoanalytic treatment which has the goal of uncovering childhood trauma and improving awareness of self
- Cognitive therapy which makes the person aware of distorted cognitions and replacing it with realistic and adaptive ones
- Interpersonal therapy which focuses on the here and now by uncovering personal resources and strengths
- Family therapy
Examples of pharmacologic therapy:
- Selective Serotonin Reuptake Inhibitors
- Serotonin-Norepinephrine Reuptake Inhibitors
- Tricyclic Antidepressants
- Monoamine Oxidase Inhibitors
Major depressive disorder, or clinical depression, is characterized by mood depression and obvious change in affect for a prolonged period of time.