Major Depressive Disorder

PsychologyAbnormal Psychology

In everyday life, people keep facing favorable and unfavorable situations. Favorable conditions make people happy and healthy. On the contrary, unfavorable condition saddens people as long as it persists. Sometimes, such unfavorable condition stays for long and that affect people adversely. Some people able to cope up, but some people not able to cope up; one who could not cope up easily become victim of depressive disorder.

What is the meaning of Major Depressive Disorder?

"Depression is a mood condition characterized by chronic sadness and lost interest. It affects how one may feel, think, and behave and can lead to a variety of mental and physical difficulties. It is also known as major depressive disorder or clinical depression. One may find it difficult to perform daily activities and feel as though life is not worth living". Suicidal thoughts or suicide may result in severe cases. Sadness, emptiness, and worthlessness are all symptoms of depression. Sadness is a normal element of human existence. When a loved one departs or when they encounter a life crisis, such as a divorce or a serious disease, individuals feel sad or depressed. These sentiments are usually fleeting. When a person feels endless and intense sadness for a prolonged period, they may have a mood disorder such as major depressive disorder (MDD), commonly known as clinical depression, a major illness that can have a wide-ranging impact on one's life.

Symptoms

Symptoms of depression include :

• Sadness or a gloomy mood
• Lack of interest or enjoyment in previously appreciated activities
• Weight loss or gain irrelevant to dieting
• Sleeping troubles or excessive sleep
• Energy loss or increased exhaustion
• Increased purposeless physical activity or slow speech.
• Feeling inadequate or sorry.
• Problems in thinking, concentrating, or making decisions.
• Suicide or death thoughts

DSM-5 Criteria

One must meet the symptom criteria stated in the "Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5)" to be diagnosed with MDD.

According to its criteria :

• One must observe the change in their previous efficiency
• Symptoms must last at least two weeks
• At least one symptom, such as sadness or loss of interest or enjoyment, is noted.

The terminology depression is widely used to refer to a broad range of depressive disorders. Particular symptoms classify some as per DSM-5:

• Major depression disorder (often called major depression)
• Persistent depressive disorder (dysthymia)
• Other depressive disorders, specified or unspecified

Cause

MDD is believed to be caused by a mix of genetics, and stress can alter brain chemistry, impairing one's ability to maintain mood stability.

• Brain chemistry : Depression can be caused by changes in hormone balance and brain chemical levels.
• People with a family history of depression are likely to develop depression.
• Stress, losing a loved one, trauma, solitude, and an absence of support can all lead to depressive symptoms.
• Chronic physical discomfort and disorders might contribute to depression.
• Medication : Depression can be due to the side effect of some drugs. Recreational substances and alcohol can indeed cause or worsen depression.

People who are easily overwhelmed or have difficulty in coping likely to develop depression.

MDD can also be triggered further by the following reasons  :

Treatment

There is hardly any full-proof treatment for major depressive disorder. However, most people with major depressive disorder respond well to antidepressant medication, individual or group psychotherapy, or a combination of the two.

• Medication - Antidepressants can help change the chemistry of the brain that causes depression. Some drugs used for treatment are:
• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin modulators (5-HT2 blockers)
• Serotonin-norepinephrine reuptake inhibitors
• Norepinephrine-dopamine reuptake inhibitor
•  Psychotherapy - Cognitive behavioral therapy or interpersonal therapy can help in reducing the symptoms and are given as the first line of treatment in therapy. Cognitive therapy focuses on the negative beliefs that contribute to depression, whereas behavioral therapy focuses on modifying the habits that affect feelings. Behavioral activation is an important part of depression treatment, and dialectical behavior therapy is built on CBT. The key contrast is that those suffering from depression must admit and embrace negative thoughts and behaviors.
• Change in lifestyle - Regular exercise, eating healthy and balanced food, proper sleep schedule, self-care, etc., are some changes that one can apply in the daily routine to fight depression. Mindfulness, yoga, and other relaxation techniques are also being found to helpful in quick recovery.
• Brain stimulation therapy - Electroconvulsive therapy (ECT) is one of the techniques that is used in very critical condition, such as life-threatening depression. The brain is subjected to a moderate electrical current, resulting in a short seizure. Seizures, for reasons unknown, can restore the proper balance of chemicals in the brain and alleviate symptoms. Other methods of brain stimulation therapy include transcranial magnetic stimulation (TMS) and vagus nerve stimulation (VNS).

Conclusion

Major depressive disorder can cause significant problems in a person's life, interfering with work and social activities. Feelings of sadness, anxiety, or hopelessness are all depressive symptoms, and the illness can also impair thinking, memory, eating, and sleeping. A significant depressive illness (clinical depression) prognosis suggests that a person has felt sad, gloomy, or worthless on most days for at least two weeks, in addition to other symptoms such as insomnia, loss of interest in activities, or appetite changes. A single cause of major depression has yet to be established, nor can a single cause be recognized in a given depressed individual. However, research reveals that a combination of genetic, environmental, biochemical, and psychological variables, such as an imbalance in brain chemistry or dramatic fluctuations in hormone levels during certain times, such as pregnancy or menopause, can cause depression. There is no one treatment course for MDD. However, most people with major depressive disorder respond well to antidepressant medication, individual or group psychotherapy, or a combination of the two.

References

• Ronald J. Comer. Abnormal Psychology Eighth edition book
• American Psychiatric Association. DSM 5 development. Highlights of changes from DSM-IV-TR to DSM 5 (URL -http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf)