Major Depressive Disorder (MDD), also known as unipolar, major, or clinical depression, is a mood disorder that can have a serious impact on a person’s mental and emotional wellbeing.
Feeling sad or blue from time to time is completely normal and not something to worry about for most people. However, when these feelings persist or interfere with daily life, an underlying mental health condition could be to blame.
There are many different types of depression that have all overlapping similarities, although major depressive disorder is the one most people refer to when thinking about depression.
Understanding the causes, symptoms, and treatments for major depression can help people seek treatment as soon as possible before the condition becomes more difficult to manage and causes problems with daily living.
Creating awareness about this condition can also be helpful for those who don’t struggle with depression to have a better understanding and compassion for those affected by it.
What is Major Depressive Disorder (MDD)?
One of the first things to understand about major depressive disorder is that it’s a very common condition. An estimated 21 million adults, about 8.4 percent of the U.S. population in 2020, experienced at least one episode of major depression, according to the National Institute of Mental Health.
Major depressive disorder, or major depression, is usually recognized as a period of at least two weeks where a person experiences a majority of the symptoms – depressed mood, problems sleeping, loss of interest or pleasure in in activities – all associated with this form of depression.
The onset of major depressive disorder symptoms generally leads to a significant impact on a person’s mood, physical energy, overall mental health, and ability to carry out routine responsibilities.
Recognizing the symptoms of MDD when they first appear can help a person seek help as soon as possible and start self care strategies that may reduce the intensity and duration of the condition.
Major Depressive Disorder Symptoms
While symptoms will vary for each individual, the Diagnostic and Statistical Manual of Mental Health Disorders (DSM 5), considered the “bible of psychiatric disorders,” requires that five or more symptoms of major depression be present for a period of two weeks or more for diagnosis.
The symptoms of major depressive disorder can include the following:
- Extreme sadness or irritability for most of the day, almost every day
- Restlessness and the inability to experience joy from activities, friends, or loved ones normally cherished and enjoyed
- Feelings of worthlessness, guilt, or shame
- Changes in appetite and eating, associated with sudden weight gain or weight loss
- Experiencing sleep issues, such as sleeping too little or too much
- Fatigue, exhaustion, or an overall lack of physical energy
- Difficulty concentrating, focusing, or making decisions
- Suicidal thoughts or ideations
In some cases, loved ones may notice that a person battling with depression will isolate themselves from others.
People dealing with MDD may also find they are drinking alcohol more frequently, or using marijuana and other substances as a way to self-medicate and cope with the symptoms.
This can lead to a substance use disorder that eventually makes the symptoms of depression worse over time.
Causes of Major Depressive Disorder
Research has shown that factors such as stress, brain chemistry, hormone imbalance, and a family history of mental illness can lead to major depressive disorder in many people.
However, the exact cause of major depression is not totally understood.
There are other risk factors, though, that may increase the likelihood of MDD.
Common risk factors and causes of major depressive disorder can include:
- Drug and alcohol abuse
- Recent or past trauma, such as physical or sexual abuse, the loss of a loved one, a toxic relationship, or even serious financial troubles
- Sudden or chronic illness, such as cancer, a stroke, or heart disease
- Certain medications, like some high blood pressure prescriptions, sleeping pills, or steroids
- Personality traits like low self-esteem, being overly dependent on others, extreme pessimism, or highly self-critical
Whatever the underlying cause of major depression, it’s important to know that depression is a treatable condition.
Major Depressive Disorder Treatments
The most effective major depressive disorder treatments usually include a combination of counseling and medications, as well as lifestyle changes.
Counseling and Psychotherapy
One-on-one counseling and psychotherapy is often the first approach to identify the causes and symptoms of major depression and create a successful treatment plan that might include medications.
Psychotherapy will include talk therapy and implement evidence-based therapies for depression such as Cognitive Behavioral Therapy (CBT) or Dialectical Behavior Therapy (DBT), among others.
While counseling and psychotherapy can be successful for treating major depression on their own, many times they are more successful when combined with antidepressant medications that help regulate neurotransmitters like serotonin to reduce symptoms and improve mood.
Medications used for major depression include:
- Selective Serotonin Reuptake Inhibitors (SSRIs) – Lexapro, Zoloft, Prozac, Celexa, and Paxil
- Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) – Cymbalta, Effexor, and Pristiq
- Serotonin Modulators – Trazodone, Nefazodone, and Vilazodone
- Tricyclic Antidepressants (TCAs) – Norpramin and Tofranil
- Monoamine Oxidase Inhibitors (MAOIs) – Nardil, Marplan, and Emsam
- Atypical Antidepressants, Antipsychotics, and Mood Stabilizers
Lifestyle changes can be more helpful than many people realize for reducing depression symptoms and promoting better mental health.
Exercising regularly, eating healthy foods, and getting adequate sleep each night are considered the three pillars of health and have a positive impact on both physical and mental health.
All three of these have shown to decrease stress and boost the production of neurotransmitters that enhance mood and the way we feel.
It is also recommended to avoid using drugs or alcohol because they are known to increase many depressive symptoms.
TMS Therapy (Transcranial Magnetic Stimulation)
TMS Therapy stands for Transcranial Magnetic Stimulation, which is a treatment approach that has shown to be effective for people who failed to find relief for depression symptoms when using traditional methods like antidepressant medications.
Dual Diagnosis Treatment
Using drugs or alcohol to deal with depression is common for many people. If substance use helps reduce depressive symptoms, it is usually short-lived and will make the symptoms worse over time.
In addition, becoming dependent on drugs or alcohol can lead to a co-occurring disorder of addiction and depression.
Dual diagnosis treatment addresses both issues of depression and addiction at the same time for a successful recovery.
Even though major depressive disorder makes life difficult for millions of Americans each year, following a proper treatment plan can dramatically improve the mental health and daily life of those who seek help.