Major depressive disorder, or MDD, is characterized by at least two weeks of a low, depressed mood, along with four or more additional symptoms of depression, such as suicidal thoughts, a loss of physical energy, sleep disturbances, or feelings of low self-worth. MDD is one of the most common forms of mental illness. The National Institute of Mental Health states that in 2013, nearly 16 million American adults, or almost 7 percent of the adult population, had at least one major depressive episode.
Depression comes in many forms – If you believe you or a loved one is suffering from depression, contact a medical professional for an appropriate diagnosis.
Although substance abuse may be used to relieve symptoms, chemical intoxication can actually make depressive episodes more severe, increasing the frequency and intensity of negative thoughts and self-destructive behavior. A rehab program that addresses both depression and addiction may help to stop the progression of both disorders and empower the individual to build a healthy, sober life.
Recognizing Depression vs. the Blues
a person must experience five or more symptoms of the disorder almost every day for at least two weeks, and these symptoms must not be related to a coexisting medical condition or the effects of substance abuse:
A low, depressed mood
A loss of pleasure or interest in daily activities
Persistent feelings of self-hatred, worthlessness, or guilt
Sleep disturbances (sleeping too much or too little)
Unintentional weight loss or gain
Low energy levels, with slower than usual responses and movements
Problems with concentration or memory
Persistent, intrusive thoughts about death or dying
Suicidal ideation or suicide attempts
The symptoms of depression cause noticeable problems with work, school, family life, and social relationships. People experiencing a depressive episode may have trouble getting out of bed in the morning due to a lack of energy, fatigue, and a loss of motivation. They may lose interest in hobbies or pursuits that they were once passionate about or avoid activities that used to give them pleasure. They may be frequently tearful, talk about harming themselves, or become obsessed with thoughts and images of death.
For the loved ones of a depressed person, dealing with the symptoms can be both frightening and frustrating. It is normal to try to cheer up a friend or to encourage them to “snap out of itâ€; however, depressive symptoms do not respond to these offers of help. The only way to treat this serious disorder effectively is through professional therapeutic interventions, such as behavioral modification, support groups, motivational therapy, and antidepressant medications.
Types of Depressive Disorders
Depression can take several different forms based on the severity, duration, and cause of its symptoms. According to Dialogues in Clinical Neuroscience, depression may be best understood as a spectrum of moods rather than a series of separate, clearly defined categories. For the sake of diagnosing and treating this serious disorder, psychiatric experts have identified several categories. Along with these categories, there are a number of depressive disorders associated with specific life stressors, psychological conditions, or emotionally taxing situations. These situational disorders share many of the symptoms of general depression, but they occur under specific circumstances and may resolve once these situations are changed.
Listed below are the most common subtypes of depression:
Also known as dysthymic disorder, or dysthymia, this condition is marked by low moods and depressive symptoms that continue for two or more years. Individuals with persistent depressive disorder may appear to be chronically gloomy, irritable, or moody, but these traits could actually be signs of a mood disorder. Symptoms may not be as severe as the signs of a major depressive episode, but the effects on quality of life can be just as severe.
Depressive episodes alternating with periods of high energy, elation, or impulsive behavior may be signs of bipolar disorder. Many individuals with bipolar disorder experience episodes of major depression that last for weeks or months, with less frequent cycles of energetic activity and elevated mood. It can be difficult to diagnose an individual with bipolar disorder without tracking these mood changes over an extended period of time
Having a baby is a life-altering experience, but for many women, the transition to motherhood causes emotional difficulties. The American Psychological Association estimates that up to 16 percent of women will have depressive symptoms after giving birth. New mothers with a history of depression or anxiety, women under financial or personal stress, and women with inadequate social support are especially vulnerable to postpartum depression. Hormonal imbalances after pregnancy, nutritional deficiencies, and exposure to chemical toxins may also play a role in this form of depression.
Also known as seasonal affective disorder, or SAD, this condition is triggered by changes in light and temperature that accompany the seasons of the year. People with SAD may report lower moods, loss of energy, sleep disturbances, and weight changes at specific times of the year. Although most people with SAD experience depression in the darker winter months, some individuals are negatively affected by the transition from winter to spring.
In psychosis, the individual experiences a break with reality, in which the person may see or hear things that aren’t there (hallucinations), or believe things that aren’t real (delusional thoughts). People with other forms of depression may be affected by periods of psychosis, in which they feel persecuted or pursued by others, or believe that unseen entities are telling them to harm themselves. Psychotic depression is usually temporary, but it may result in hospitalization and the need for immediate, acute treatment.
All types of depression require prompt attention and intensive, specialized treatment. Recognizing the signs and symptoms of depression, and being willing to provide support to someone experiencing those symptoms, can prevent serious harm to the individual and loved ones.
Investigating the Causes of Depression
The National Institute of Mental Health notes that the brains of some individuals with depressive disorder are structurally different from those who do not have depression. MRI imaging studies reveal that the areas of the brain that are responsible for mood, cognition, metabolic function, and sleeping have a unique appearance in people who have serious mood disorders.
A disorderly home environment or a history of physical, sexual, or emotional abuse in childhood can increase the chances of developing depression in adolescence or adulthood. Trauma therapy can be extremely useful for processing unresolved memories and healing the suppressed emotional wounds that can contribute to depression later in life.
The neurological differences that distinguish people with depression are at least partly hereditary. According to Stanford University, genetic research shows that people who have a close relative, such as a parent or sibling, with depression are 20-30 percent more likely to suffer from depression themselves. Unlike diseases that are linked to a specific, defective gene, such as cystic fibrosis, depression is more likely to be linked to several genes.
Although the losses that we all experience do not necessarily cause depression, a severe setback can trigger a depressive episode. For instance, the death of a loved one or a bitter divorce could send a person into a period of grief and bereavement, which may turn into depression if the emotions surrounding that loss are not adequately resolved. Unlike bereavement, depression is often accompanied by feelings of worthlessness, self-loathing, or the desire to die.
Neurologists and pharmacologists have long pursued the connection between brain chemistry and depression in an effort to offer solutions to this disabling condition. Depression has been linked to imbalances in the brain chemicals, or neurotransmitters, that regulate emotional states, moods, energy levels, and appetite, such as serotonin, norepinephrine, and dopamine.