Clinical depression, also referred to as major depressive disorder (MDD), is a frequent and severe mental health illness that has an impact on feelings, thoughts, and behavior. It may result in protracted depressive, disinterested, hopeless, guilty, and worthless sentiments. Additionally, it may disrupt your regular activities, including relationships, job, education, and physical health.
The exact causes of MDD are not fully understood, but they are likely to involve a combination of biological, psychological, and environmental factors. Some of the possible causes include:
Genetics: MDD can run in families, suggesting that some people may inherit a higher risk of developing it.
Brain chemistry: MDD may be associated with an imbalance of certain neurotransmitters, such as serotonin, dopamine, and norepinephrine, which are involved in regulating mood, motivation, and reward.
Hormones: MDD may be triggered or worsened by changes in hormone levels, such as during puberty, pregnancy, menopause, or thyroid disorders.
Stress: MDD may be caused or exacerbated by stressful life events, such as trauma, loss, abuse, illness, or conflict.
Personality: MDD may be more likely to affect people who have low self-esteem, pessimistic outlook, perfectionist tendencies, or difficulty coping with stress.
Medical conditions: MDD may be a complication of or co-occur with other medical conditions, such as chronic pain, diabetes, heart disease, cancer, or neurological disorders.
The symptoms of MDD can vary from person to person, but they generally include:
Depressed mood: Feeling sad, empty, or tearful most of the day, nearly every day.
Anhedonia: Losing interest or pleasure in activities that you used to enjoy, such as hobbies, sports, or sex.
Changes in appetite or weight: Eating too much or too little, leading to significant weight gain or loss.
Changes in sleep: Having trouble falling asleep, staying asleep, or waking up too early, or sleeping too much.
Changes in energy: Feeling tired, sluggish, or restless, having difficulty concentrating, or moving or speaking slowly.
Feelings of worthlessness or guilt: Having a negative view of yourself, your abilities, or your situation, or feeling excessively guilty or responsible for things that are not your fault.
Trouble thinking or making decisions: Having difficulty remembering, focusing, or solving problems, or being indecisive or confused.
Suicidal thoughts or behaviors: Thinking about death, harming yourself, or ending your life, or making plans or attempts to do so.
To be diagnosed with MDD, you must have at least five of these symptoms, including depressed mood or anhedonia, for at least two weeks, and they must cause significant distress or impairment in your social, occupational, or other important areas of functioning.
If you think you may have MDD, the first step is to seek professional help from a qualified mental health provider, such as a psychiatrist, psychologist, or counselor. They can conduct a comprehensive evaluation, which may include:
Medical history: Asking about your symptoms, when they started, how they affect you, and whether you have any other medical conditions or medications that could be related to your mood.
Physical exam: Checking your vital signs, such as blood pressure, heart rate, and temperature, and looking for any signs of physical illness or injury that could explain your symptoms.
Lab tests: Ordering blood tests, urine tests, or other tests to rule out any underlying medical causes of your symptoms, such as thyroid problems, anemia, or infections.
Psychological assessment: Asking about your personal and family history of mental health problems, your stressors, your coping skills, your personality, and your thoughts and feelings. They may also use standardized questionnaires or scales to measure the severity and impact of your depression.
Diagnostic criteria: Comparing your symptoms and history to the criteria for MDD and other mental disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the official guide for diagnosing mental health conditions.
The good news is that MDD is treatable, and there are various options available to help you manage your symptoms and improve your quality of life. The most common treatments for MDD are:
Psychotherapy: Also known as talk therapy or counseling, psychotherapy involves meeting with a qualified therapist who can help you understand your thoughts, feelings, and actions, and give you coping skills and techniques to deal with your depression. There are different types of psychotherapy, such as cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), or dialectical behavior therapy (DBT), which have different goals and methods, but they all aim to help you change your negative patterns and enhance your well-being.
Medication: Antidepressants are drugs that work to balance the chemistry of your brain and lessen the symptoms of depression. Different antidepressant classes exist, including tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), and serotonin and norepinephrine reuptake inhibitors (SNRIs). Each class has a unique mechanism of action and set of side effects, but they all function by making specific neurotransmitters more readily available in the brain. It may take a few weeks for antidepressants to start working for you; you may need to experiment with several kinds or dosages before deciding on the right one. Antidepressant medication should never be stopped abruptly without first talking to your doctor as this might result in relapse or withdrawal symptoms.
Additional therapies: In addition to psychotherapy and medicine, some patients with major depressive disorder (MDD) may benefit from additional therapies such ketamine infusion, transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT), or vagus nerve stimulation (VNS). To stimulate or control the activity of certain brain regions and elevate mood, these therapies administer electrical currents, magnetic fields, electrical impulses, or anesthetic medications to targeted brain regions. These medicines may have dangers or side effects that need to be well watched, and they are often only used for patients with severe, resistant to treatment, or suicidal depression.
While there is no sure way to prevent MDD, there are some steps you can take to reduce your risk or recurrence of depression, such as:
Getting assistance early: Do not be afraid to get in touch with a mental health expert or a reliable person if you see any indications or symptoms of depression. They can offer you support and assist in obtaining the necessary therapy. Your chances of recovering and averting more issues increase the sooner you receive assistance.
Adhering to your treatment plan: If you receive a diagnosis of major depressive disorder (MDD) and are given a treatment plan, be careful to adhere to it as directed by your physician or therapist. This might be going to treatment appointments, taking your prescription on time, and doing any assignments or exercises. Your progress or results may be impacted by stopping or altering your therapy without first speaking with your doctor or therapist.
Taking care of oneself is crucial since MDD may have an impact on both your physical and mental health. You should exercise frequently, eat a balanced diet, get enough sleep, abstain from alcohol and drugs, and learn how to manage your stress. These routines can improve your mood, vitality, and immune system in addition to preventing or lessening the effects of various medical conditions that can exacerbate your melancholy.
Remaining in touch: Major Depressive Disorder (MDD) can cause feelings of isolation, loneliness, or hopelessness. Therefore, it's critical to maintain contact with loved ones, friends, and other individuals who can provide you with emotional and practical assistance. You may also meet new people and form deep relationships by joining a club, support group, or community organization that aligns with your values or interests. You might feel less hopeless, more appreciated, and less sad by interacting with others.
Seeking meaning and purpose: Major Depressive Disorder (MDD) might cause you to lose motivation or interest in life, therefore it's critical to look for meaning and purpose in your pursuit of your objectives. You can do this via taking up enjoyable and challenging hobbies, passions, or projects; volunteering or providing aid to those in need; picking up new skills or taking advantage of new chances; or discovering or enhancing your spirituality or faith. You can feel more motivated, upbeat, and fulfilled by pursuing these interests.
