Major Depressive Disorder

Major Depressive Disorder

Major Depressive Disorder

Major depressive disorder (MDD), also known as clinical depression or simply depression, is a mental disorder characterized by the presence of a severely low mood that persists for at least two weeks and which pervades across most, if not all, aspects of life.

Prevalence

The onset of MDD can occur in children and adolescents and in younger and older adults. MDD most commonly occurs between 20 and 40 years of age, and women are twice as likely as men to be diagnosed with it. Lifetime rates of MDD are higher in the developed world (15%) compared to the developing world (11%). According to the Global Burden of Disease study, MDD causes the second-most years lived with a disability, after lower back pain.

Symptoms of Depression:

The two main symptoms of MDD are:
  • Low mood
  • Anhedonia – loss of interest or pleasure in activities

People with MDD may also:

  • Be preoccupied with, or ruminate over, thoughts and feelings of worthlessness, helplessness, hopelessness, and self-hatred
  • Withdraw from social situations and activities
  • Have a reduced sex drive

Physical symptoms – A person with MDD may report multiple physical symptoms such as fatigue, headaches, or digestive problems. Physical complaints are the most common presenting problem in developing countries.
Children and adolescents with MDD might often display an irritable mood rather than a depressed mood. Most lose interest in school, and their academic performance can plummet. Children in particular may be described as clingy, demanding, dependent, or insecure.
Older adults with MDD might have recent cognitive function issues such as memory problems. MDD in older adults often coexists with physical disorders such as stroke, Parkinson’s disease, chronic obstructive pulmonary disease, and cardiovascular diseases.

Diagnosing Depression:

For a diagnosis of MDD to be made, the symptoms above, as well as three out of seven of the following symptoms, must frequently occur for at least two weeks — and they must impair functioning:

  • Weight loss or gain – greater than a 5% change in a month
  • Insomnia or hypersomnia – sleeping too little or too much
  • Unintentional movements and restlessness or retardation
  • Tiredness or loss of energy
  • Feeling worthless or feeling excessive or inappropriate guilt
  • Decreased concentration
  • Thoughts of suicide

Episodes of MDD may be isolated or recurrent and are categorized as:

  • Mild — few symptoms in excess of minimum criteria,
  • Moderate, or
  • Severe — marked impact on social, academic, or occupational functioning. An episode with psychotic features — commonly referred to as psychotic depression — is automatically rated as severe.

Causes of Depression:

The cause of MDD is unknown, but it is thought that biological, psychological, and social factors all play a role in causing depression.

Risk factors for Depression:

Approximately 2 to 8% of adults with MDD die by suicide, and about 50% of people who die by suicide had MDD or another mood disorder.

Treatment of Depression:

  • Lifestyle modification – increased exercise and eating healthy food plays a role in prevention.
  • Antidepressant medications such as selective serotonin reuptake inhibitors like Prozac can help.
  • Talking therapies such as cognitive behavioral therapy are highly effective forms of treatment for many people with MDD.

Symptoms of Depression:

The two main symptoms of MDD are:
  • Low mood
  • Anhedonia – loss of interest or pleasure in activities

People with MDD may also:

  • Be preoccupied with, or ruminate over, thoughts and feelings of worthlessness, helplessness, hopelessness, and self-hatred
  • Withdraw from social situations and activities
  • Have a reduced sex drive

Physical symptoms – A person with MDD may report multiple physical symptoms such as fatigue, headaches, or digestive problems. Physical complaints are the most common presenting problem in developing countries.
Children and adolescents with MDD might often display an irritable mood rather than a depressed mood. Most lose interest in school, and their academic performance can plummet. Children in particular may be described as clingy, demanding, dependent, or insecure.
Older adults with MDD might have recent cognitive function issues such as memory problems. MDD in older adults often coexists with physical disorders such as stroke, Parkinson’s disease, chronic obstructive pulmonary disease, and cardiovascular diseases.

Diagnosing Depression:

For a diagnosis of MDD to be made, the symptoms above, as well as three out of seven of the following symptoms, must frequently occur for at least two weeks — and they must impair functioning:

  • Weight loss or gain – greater than a 5% change in a month
  • Insomnia or hypersomnia – sleeping too little or too much
  • Unintentional movements and restlessness or retardation
  • Tiredness or loss of energy
  • Feeling worthless or feeling excessive or inappropriate guilt
  • Decreased concentration
  • Thoughts of suicide

Episodes of MDD may be isolated or recurrent and are categorized as:

  • Mild — few symptoms in excess of minimum criteria,
  • Moderate, or
  • Severe — marked impact on social, academic, or occupational functioning. An episode with psychotic features — commonly referred to as psychotic depression — is automatically rated as severe.

Causes of Depression:

The cause of MDD is unknown, but it is thought that biological, psychological, and social factors all play a role in causing depression.

Risk factors for Depression:

Approximately 2 to 8% of adults with MDD die by suicide, and about 50% of people who die by suicide had MDD or another mood disorder.

Treatment of Depression:

  • Lifestyle modification – increased exercise and eating healthy food plays a role in prevention.
  • Antidepressant medications such as selective serotonin reuptake inhibitors like Prozac can help.
  • Talking therapies such as cognitive behavioral therapy are highly effective forms of treatment for many people with MDD.