Major depressive disorder is a serious mental health concern that affects many aspects of life including cognitive function and physical health conditions. Several factors cause this disorder including medical condition, genetics, and brain chemistry. The effects of experiencing a major depressive episode can be severe. Hence, it is equally important to look into the treatments available to those diagnosed with major depressive disorder.
Understanding Major Depressive Disorder
Major depressive disorder (major depression) is not a mere feeling of sadness. Characterized by persistent and intense feelings of sadness over a longer period, clinical depression can have a serious impact on life. Those diagnosed with clinical depression may find the disorder affecting their energy, mood, sleeping patterns, performance, relationships, and general interest in daily activities they otherwise enjoyed.
How common is a major depressive disorder?
The Anxiety & Depression Association of America points to major depressive disorder as the leading cause of disability among ages 15 to 44.3 in the U.S. The median age of onset of the disorder was 32.5 years old. Though, major depressive episodes were more prevalent among the ages of 18 to 25. While it can affect any gender, women are reported to be more at risk than men.
The National Institute of Mental Health further pointed out the prevalence of a major depressive disorder. According to the most recent published data in 2020, around 21.0 million adults reported at least one major depressive episode. This is a jump of nearly four million from the 2017 data which estimated 17.3 million U.S. adults ages 18 and older to be affected by major depressive disorder. With race as a factor, major depression was noticeably highest among those of multiple races.
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Major depressive disorder diagnosis
Depression poses challenges for health professionals to identify. There are several factors to consider when diagnosing the patient. These include financial and occupational stressors as well as life events.
On this note, depression is among the most likely misdiagnosed mental disorders. The National Library of Medicine noted poor detection of the disorder which warranted the need to enhance diagnostic screening. Apparently, 65.9% is the misdiagnosis rate for major depressive disorder.
Several disorders are misdiagnosed as clinical depression. One is Adult ADHD as depression and anxiety are linked to difficulties with brain functions. Another is hypothyroidism or an underactive thyroid that is causing symptoms that affect the emotions including insomnia, brain fog, and fatigue.
What are the symptoms of a major depressive disorder?
Life events like loss and grief can lead to short-term feelings of sadness. Further, phases in life like the quarter-life crisis can lead to feeling anxious or generally disinterested in life. Burnout can make one feel more tired over an extended period.
However, those diagnosed with major depressive disorder continue to feel these emotions for two weeks or even months at one time. More signs of a major depressive disorder include:
- A persistent negative mood and feeling of emptiness that is not dependent on what happens during the day.
- Minimized or lost interest in activities that one normally engages in or finds pleasure in taking part in.
- Noticeable increase in needless movements like fidgeting, inability to sit still, or wringing hands.
- Persistent reduced energy and feeling fatigued can affect physical performance.
- Bugging feeling of not being valuable or important. This feeling is accompanied by the outlook that your situation or life won’t get better no matter what. Hence, you continually go back to feeling pessimistic and hopeless.
- Sleeping difficulties include oversleeping, difficulty trying to go to sleep, or staying asleep during the night.
- Appetite, eating habits, and weight changes.
- Moving and speaking at a slower pace accompanied by a change in posture and expressions.
- Difficulties in cognitive functions like memory and concentration.
- Symptoms that do not improve with medication such as headaches, digestive issues, and cramps.
- Easily irritated or agitated about things that did not use to affect you. In contrast, men diagnosed with clinical depression tend to become aggressive and irritable in an attempt to hide their depressive emotions.
Factors that cause major depressive disorder
The above symptoms that characterize clinical depression may be caused by one or several of these factors:
- Life events – Stressors that trigger depression such as a lack of support or isolation during traumatic, upsetting experiences in life as well as a sudden major life change.
- Medical conditions – Ongoing chronic pain and illnesses may lead to depression. Difficulties managing diabetes, cancer, and other health conditions may cause depressive episodes.
- Medication side effects – Alcohol intake and the use of recreational drugs can lead to or worsen depression. Patients reported feeling depressed as a side effect of medications like anticonvulsants, barbiturates, benzodiazepines, beta-blockers, calcium-channel blockers, opioids, and even the acne-treating drug Isotretinoin (Sotret, Claravis).
- Genetics – Published research determined a significant role of genetics in the development of a major depressive disorder. The risk is up to three times more among first-degree relatives.
- Personality – Studies suggest a link between depression and traits like negative emotionality or neuroticism. Personality traits such as low self-esteem or being pessimistic may be a contributing factor in the onset of depression.
- Brain chemistry – abnormalities detected in brain chemicals may contribute to depression. A shortage in supply of certain neurotransmitters or in some cases too much of them may pave the way for major depressive episodes.
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How is Major Depressive Disorder treated?
The American Psychiatric Association reported that as many as 9 of 10 patients diagnosed with clinical depression are responsive to treatment. Significant improvements may be made with lifestyle changes while others respond to medication. Treatments for major depressive disorder include:
- Avoiding isolation
- Exercising to trigger the release of mood-boosting neurotrophic factors
- Taking antidepressants improves thought processes and behavior by changing neurotransmitter levels in the brain and body. Popular medications include serotonin reuptake inhibitors like fluoxetine (Prozac), tetracyclic antidepressants like mirtazapine (Remeron), and monoamine oxidase inhibitors like selegiline (Emsam).
- Talk therapy (psychotherapy) with a mental health professional may help in dealing with issues in behavior, feelings, and mood.
- Electroconvulsive therapy (ECT) for severe depression that does not respond to conventional treatments.
- Brain stimulation therapy, like repetitive transcranial magnetic stimulation (rTMS) or vagus nerve stimulation (VNS).
Thought to Consider
Major depression is not uncommon, especially among adults, particularly women. Genetics, personality, and health conditions may increase the risk of developing major depression. Still, this mental health issue is treatable with therapy, lifestyle habits, and medication. It is vital to reach out for help and support when dealing with the symptoms of depression.
