Depression - major depressive disorder : Causes-Symptoms-Diagnosis-Treatment
What is Depression / major depressive disorder ?
A natural part of life is feeling sadness. People may feel sad or depressed when a loved one dies or when they are going through a difficult life challenge, such as a divorce or serious illness.
These feelings usually last for a short time. If someone experiences intense, persistent sadness for an extended period of time, then they may have a mood disorder, such as major depressive disorder (MDD).
MDD is a serious medical condition that can affect many areas of your life. It can affect your mood and behavior as well as your physical abilities, such as your appetite and sleep.
MDD is one of the most common mental health conditions in the United States. It is estimated that more than 7.8 percent of U.S. adults experienced a major depressive episode in 2019.
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Depression / major depressive disorder |
Your doctor can diagnose major depressive disorder based on your symptoms, feelings, and behaviors.
Medical terms
Depression, also known as major depressive disorder, is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Symptoms include feelings of sadness, hopelessness, and emptiness, difficulty sleeping, changes in appetite, irritability, and reduced concentration. Depression is a real medical condition that can affect anyone, regardless of age, gender, or ethnicity and if left untreated can last for months or even years. Therefore, it is important to seek help if you feel symptoms of depression.
Major depressive disorder (MDD) is a common, yet serious, medical condition that affects one’s mood, thoughts, body and behavior. It is characterized by a persistent feeling of sadness, worthlessness and guilt, loss of interest in activities and hopelessness. Symptoms can be mild, moderate or severe and can interfere with a person’s ability to work, study, sleep, eat and enjoy life. Treatment options can include medication, psychotherapy or a combination of both.
Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. conjointly referred to as major clinical depression or clinical depression, it affects however you feel, assume and behave and may result in a range of emotional and physical problems. you will have to bother doing traditional regular activities, and typically you may feel as if life isn't worth living.
Quite simply a bout of the blues, depression isn't a weakness and you can't merely "snap out" of it. Depression may need long-run treatment. however don't get discouraged. The majority with depression feel higher with medication, psychotherapy or both.
Doctors will typically ask specific questions or give you a questionnaire to determine if you have MDD (major depressive disorder).
To be diagnosed with MDD, you must meet the symptom criteria listed in the "Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5)." This manual helps medical professionals identify mental health conditions.
According to its criteria:
You need to experience a change in your previous behavior in order to succeed with this new activity.
The symptoms must last for two or more weeks.
Depression can cause a feeling of sadness, loss of interest, or pleasure lessness.
You must experience at least 5 of the following symptoms during the 2-week period:
You feel sad or irritable most of the day nearly every day.
You are no longer as interested in doing most activities you used to enjoy.
You may suddenly lose or gain weight or have an appetite change.
You are having trouble falling asleep or want to sleep more than usual.
You may feel restless.
You feel very tired and have little energy.
You feel a lot of shame or guilt about things that wouldn't usually make you feel that way.
You have difficulty concentrating or making decisions.
You are thinking about harming yourself or committing suicide.
Some symptoms that parents should be aware of in their teens include:
Using substances (like cigarettes or alcohol) often begins or increases at this age.
poorer academic performance
problems with peers
increased social withdrawal/isolation
MDD is not understood completely. However, there are several factors that can increase your vulnerability to the condition.
Stress and genes can affect brain chemistry, which can reduce the ability to maintain mood stability.
Hormones can play a role in the development of MDD.
MDD may also be triggered by:
alcohol or drug use
Some medical conditions, such as cancer or hypothyroidism, can be treated with olive oil.
Some medications, including steroids, are only for certain types of people.
abuse during childhood
MDD is treated with medication and psychotherapy. Some lifestyle changes can also help ease symptoms.
Some people with MDD or thoughts of harming themselves may need to stay in a hospital during treatment. Some might also need to participate in an outpatient treatment program until symptoms improve.
Symptoms Depression / major depressive disorder
The symptoms of major depressive disorder can be grouped into three categories: 1. Depressed mood most of the time nearly every day as indicated by either subjective report (e.g. feeling sad or empty) or observation made by others (e.g. appears tearful) 2. Diminished interest or pleasure in all or almost all activities most of the time as indicated by either subjective account or observation made by others (e.g. no longer enjoys hobbies interests or social gatherings; shows a decline in work performance) 3. Significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day (It should be noted that what constitutes
Although depression may occur solely once throughout your life, folks usually have multiple episodes. throughout these episodes, symptoms occur most of the day, nearly on a daily basis and should include:
Anxiety, agitation or restlessness
Slowed thinking, speaking or body movements
Feelings of worthlessness or guilt, fixating on past failures or self-blame
Trouble thinking, concentrating, making decisions and remembering things
Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
Unexplained physical problems, such as back pain or headaches
Feelings of sadness, tearfulness, emptiness or hopelessness
Angry outbursts, irritability or frustration, even over small matters
Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
Sleep disturbances, including insomnia or sleeping too much
Tiredness and lack of energy, so even small tasks take extra effort
Reduced appetite and weight loss or increased cravings for food and weight gain
For many folks with depression, symptoms sometimes are severe enough to cause noticeable issues in everyday activities, cherish work, school, social activities or relationships with others. Some people might feel typically miserable or sad while not extremely knowing why.
Is major depressive disorder permanent?
Depression is a mood disorder that can vary in intensity over time Some people experience major depressive disorder once in their lifetime while others may have multiple episodes of depression throughout their lives A person with episodic major depressive disorder experiences depressive symptoms for less than two months whereas a person with chronic major depressive disorder experiences the symptoms for more than two months Both types of depression are treatable.
What is considered major depression?
Major depression is a common mental disorder that causes severe symptoms that interfere with your everyday life. It's also called clinical depression or major depressive disorder. The illness usually lasts several months but it can go on for years. Depression can be mild, moderate or severe.
Is major depressive disorder the same as bipolar?
If not, what is the difference? Major depressive disorder and bipolar disorder are two different mental disorders The main difference between the two is that bipolar disorder involves extreme mood swings A person with major depressive disorder experiences long-term feelings of sadness and hopelessness but does not experience periods of extreme happiness or exuberance People who have major depressive disorder can also feel exhausted irritable hopeless and worthless Because a manic episode involves feeling very high and happy it is typically followed by a period of depression.
Can you work with major depressive disorder?
In a word, Yes! People with major depressive disorder can and do work. The key is getting the right treatment and support to improve your ability to function at work. The good news is that many people with depression recover fully and enjoy satisfying careers.
How does major depressive disorder affect the brain?
Major depressive disorder (MDD) is a serious medical illness that causes severe symptoms that affect how you feel think and handle daily activities such as sleeping eating or working When you have MDD your brain isn't working properly But the good news is that treatments are available that can help This includes lifestyle changes counseling and medicines.
Diagnosis Depression / major depressive disorder
A health skilled -- equivalent to your medical aid doctor or a medical specialist -- will perform a radical medical evaluation. could} receive a screening for depression at an everyday doctor’s visit. The professional will raise regarding your personal and family psychiatric history and ask your queries that screen for the symptoms of major depression.
there's no blood take a look at, X-ray, or other laboratory test which will be accustomed to diagnose major depression. However, your doctor may run blood tests to assist discover the other medical issues that have symptoms similar to those of depression. For example, hypothyroidism will cause some of the similar symptoms as depression, as can alcohol or drug use and abuse, some medications, and stroke.
Your doctor may determine a diagnosis of depression based on:
Physical exam. Your doctor may do a physical exam and ask questions about your health. In some cases, depression may be linked to an underlying physical health problem.
Lab tests. For example, your doctor may do a blood test called a complete blood count or test your thyroid to make sure it's functioning properly.
Psychiatric evaluation. Your mental health professional asks about your symptoms, thoughts, feelings and behavior patterns. You may be asked to fill out a questionnaire to help answer these questions.
DSM-5. Your mental health professional may use the criteria for depression listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
Types of depression
Your doctor may add one or more specifiers to your medical records if you have depression with specific features These include:
Anxious distress— depression with unusual restlessness or worry about possible events or loss of control
Mixed features— simultaneous depression and mania that includes elevated self-esteem talking too much increased energy
Melancholic features— a severe depression that doesn’t respond to something that used to bring pleasure and is associated with early morning awakening and worsening mood in the morning major changes in appetite and feelings of guilt A person might feel sluggish or agitated
Atypical features— depression that includes the ability to temporarily be cheered by happy events increased appetite excessive sleepiness sensitivity to rejection and a heavy feeling in the arms or legs
Psychotic featuresDepression is accompanied by delusions or hallucinations Depression may include themes of inadequacy or other negative topics
Catatonia— motor activity that is either uncontrollable and purposeless or fixed and inflexible
Peripartum onsetPostpartum depression occurs after childbirth
Seasonal patternDepression is related to changes in seasons and reduced exposure to sunlight
Other disorders that cause depression symptoms include:
Other disorders such as those below include depression as a symptom If you get an accurate diagnosis you can get appropriate treatment
Bipolar I and II disorders.Mood swings can include mania and depression It is sometimes difficult to tell the difference between bipolar disorder and depression
Cyclothymic disorder.Cyclothymic Disorder involves milder highs and lows
Disruptive mood dysregulation disorder.This mood disorder in children includes chronic and severe irritability and anger with frequent extreme temper outbursts This disorder typically develops into depressive disorder or anxiety disorder during the teen years or adulthood
Persistent depressive disorder.Sometimes called dysthymia (dis-THIE-me-uh) this is a less severe but more chronic form of depression While it's usually not disabling persistent depressive disorder can prevent you from functioning normally in your daily routine and from living life to its fullest
Premenstrual dysphoric disorder.This involves symptoms of depression that begin a week before and improve within a few days after the onset of your period and are minimal or gone after completion of your period
Other depression disorders.Use a large flat spatula to spread the butter mixture over both sides of each leaf Butter is a type of fat that comes from animals and is used in cooking It can be made from either milk or cream
Treatment Depression / major depressive disorder
Medications and psychotherapy are effective for most people with depression Your primary care doctor or psychiatrist can prescribe medications to relieve symptoms However many people with depression also benefit from seeing a psychologist or other mental health professional
If you have severe depression you may need to stay in the hospital or participate in an outpatient treatment program until your symptoms improve
Here's a closer look at depression treatment options
Medications
There are many types of antidepressants available Make sure to discuss possible side effects with your doctor or pharmacist
Selective serotonin reuptake inhibitors (SSRIs) are medications that are used to treat depression Doctors often prescribe an SSRI These drugs are considered safer and generally cause fewer bothersome side effects than other types of antidepressants SSRIs include citalopram (Celexa) escitalopram (Lexapro) fluoxetine (Prozac) paroxetine (Paxil Pexeva) sertraline (Zoloft) and others Vilazodone (Viibryd)
Serotonin-norepinephrine reuptake inhibitors (SNRIs)Examples of SNRIs include duloxetine (Cymbalta) venlafaxine (Effexor XR) desvenlafaxine (Pristiq Khedezla) and levomilnacipran (Fetzima)
Atypical antidepressants.These medications do not fit neatly into any other antidepressant category They include bupropion (Wellbutrin XL Wellbutrin SR Aplenzin Forvo XL) mirtazapine (Remeron) nefazodone trazodone and vortioxetine (Trintellix)
Tricyclic antidepressants. These medications — such as Imipramine (Tofranil) Nortriptyline (Pamelor) Amitriptyline (Elavil) Doxepin (Sinequan) Trimipramine (Surmontil) Desipramine (Norpramin) and Protriptyline (Vivactil) — can be very effective but tend to cause more-severe side effects than newer antidepressants So tricyclics generally
Monoamine oxidase inhibitors (MAOIs). There are many medications that can be used to treat depression Some of these medications such as tranylcypromine (Parnate) phenelzine (Nardil) and isocarboxazid (Marplan) may be prescribed for people who have not responded to other medications MAOIs require a strict diet because of dangerous (or even deadly) interactions With foods such as certain cheeses pickles and wines and some medications and herbal supplements Selegiline (Emsam) a newer MAOI that sticks on the skin as a patch may cause fewer side effects than other MAOIs do These medications cannot be combined with SSRIs
Other medications.My second grader asked me what this passage means: I rephrased it for him in plain language a second grader can understand: The passage is about the health benefits of eating olives It mentions that they are good for your eyes skin and hair It also mentions that they help you lose weight I rephrased it for him in plain language a second grader can understand: The passage talks about the health benefits
Finding the right medication
If a family member has responded well to an antidepressant you may want to try it Or you may need to try several medications or a combination of medications before you find one that works This requires patience as some medications need several weeks or longer to take full effect and for some people the first medication does not work at all Side effects will lessen as your body adjusts
Genetics play a role in how antidepressants affect you In some cases the results of genetic tests may offer clues about how your body may respond to a particular antidepressant Other variables besides genetics can affect your body’s response to an antidepressant The medication helps with the pain The medication reduces the pain
Risks of abruptly stopping medication
Some antidepressants are not considered addictive but sometimes physical dependence (which is different from addiction) may occur
Stop taking your medication suddenly or miss several doses can cause withdrawal-like symptoms and quitting suddenly may result in a sudden worsening of depression Talk to your doctor about how to slowly taper off the medicine
Antidepressants and pregnancy
If you are pregnant or breast-feeding some antidepressants may pose an increased health risk to your unborn child or nursing child Talk with your doctor if you become pregnant or you're planning to become pregnant
Antidepressants can cause suicidal thoughts
Most antidepressants are generally safe but the Food and Drug Administration (FDA) requires all antidepressants to carry a black box warning for prescriptions for children, teenagers and young adults under age 25. Sometimes these people may have an increase in suicidal thoughts or behavior When taking antidepressants especially the first few weeks after starting or when the dose is changed watch for signs of depression
Anyone taking an antidepressant should be watched closely for worsening depression or unusual behavior If you or someone you know has suicidal thoughts contact a doctor right away Help
Antidepressants are not likely to reduce suicide risk in the long run but they may improve mood
Psychotherapy
Psychotherapy is a general term for treating depression by talking about your condition and related issues with a mental health professional Psychotherapy is also known as talk therapy or psychological therapy
Therapy can help you:
Adjust to a current difficulty or crisis
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Listen to others and explore relationships and experiences Develop positive interactions with others
Find better ways to solve problems Find better ways to cope with problems
Identify issues that contribute to your depression and change behaviors that make it worse
Reduce the symptoms of depression by regaining a sense of satisfaction and control in your life Help ease depression symptoms such as hopelessness and anger
Learn to set realistic goals for your life
Learn to tolerate distress using healthier behaviors
Alternate formats for therapy
Depression therapy is available in many formats such as online sessions or videos and workbooks These programs are guided by a therapist independent
Discuss with your therapist the different options for online therapy before you choose one Ask your therapist if he or she can recommend a trusted source or program Some may not be covered by your insurance and not all developers and online therapists have the same qualifications The proper credentials or training
Smartphones and tablets with apps that offer support and education about depression are not a substitute for seeing your doctor or therapist
Hospital and residential treatment
Some people have severe depression that requires hospitalization This may be necessary if you can't care for yourself properly or when you're in immediate danger of harming yourself or someone else Psychiatric treatment at a hospital can help keep you calm and safe until your mood improves decreases
Some people may benefit from partial hospitalization or day treatment programs These programs provide the outpatient support and counseling needed to get symptoms under control
Other treatment options
Brain stimulation therapies may be suggested for some people Other procedures sometimes called brain stimulation therapies may be suggested for some people
Electroconvulsive therapy (ECT). Electrical currents are passed through the brain to impact the function and effect of neurotransmitters in your brain to relieve depression ECT is usually used for people who do not get better with medications or cannot take antidepressants for health reasons or are at high risk of suicide suicide
Transcranial magnetic stimulation (TMS).Treatment for depression may include Transcranial Magnetic Stimulation (TMS) Treatment for depression may include Transcranial Magnetic Stimulation (TMS)
More Information
Select the antidepressant that is right for you Selecting one that is right for you will depend on the symptoms you may have and the severity of the problem
Antidepressants: Side effects
Atypical antidepressants
Monoamine oxidase inhibitors (MAOIs)
Selective serotonin reuptake inhibitors (SSRIs)
Serotonin and norepinephrine reuptake inhibitors (SNRIs)
Treatment-resistant depression
Tricyclic antidepressants and tetracyclic antidepressants
Depression withdrawal: Is there such a thing?
Antidepressants and alcohol: What's the concern?
Antidepressants and weight gain: What causes it?
Antidepressants: Can they stop working?
Electroconvulsive therapy (ECT)
Psychotherapy
Transcranial magnetic stimulation
Vagus nerve stimulation
Lifestyle and home remedies
Depression is not always a disorder that can be treated on your own But these self-care steps can help:
Stick to your treatment plan.Don't skip psychotherapy sessions or appointments even if you feel well Don't skip your medications even if you feel well Even if you stop depression symptoms may come back and you could also experience withdrawal-like symptoms Recognize that it will take time to feel better
Learn about depression.Teaching your family about depression can help them understand and support you Encourage your family to learn about depression to help them understand and support you
Pay attention to warning signs. Work with your doctor to learn what might trigger your depression symptoms Make a plan so that you know what to do if your symptoms get worse Contact your doctor or therapist if you notice any changes in symptoms or how you feel Ask relatives and friends to watch for warning signs
Avoid alcohol and recreational drugs.Alcohol and drugs may seem to make you feel better but they can actually worsen your symptoms and make depression harder to treat Talk with your doctor or therapist if you need help with alcohol or substance use
Take care of yourself.Eat healthy Eat a healthy diet and get enough exercise Consider walking jogging swimming gardening or another activity that you enjoy Sleeping well is important for both your physical and mental well-being If you are having trouble sleeping talk to your doctor about what you can do
Alternative medicine
Alternative medicine is the use of a nonconventional approach instead of conventional medicine Complementary medicine is a nonconventional approach used along with conventional medicine — sometimes called integrative medicine
Make sure you understand the risks as well as possible benefits of alternative or complementary therapies Don't replace conventional medical treatment or psychotherapy with alternative medicine When it comes to depression alternative treatments are not a substitute for medical treatment Take care
Supplements
Examples of supplements that are sometimes used for depression include:
St. John's wort. Although this herbal supplement isn't approved by the Food and Drug Administration (FDA) to treat depression in the U.S it may be helpful for mild or moderate depression If you choose to use it however be careful — St John's wort can interfere with a number of medications such as heart medication Don't take blood thinners when taking birth control pills or chemotherapy as the combination can cause serious side effects Don't take HIV/AIDS medications and drugs to prevent organ rejection after a transplant if you are taking antidepressants because the combination can result in serious side effects
SAMe. This dietary supplement is a synthetic form of a chemical that occurs naturally in the body The name is short for S-adenosylmethionine (es-uh-den-o-sul-muh-THIE-o-neen) SAMe isn't approved by the FDA to treat depression in the U.S It may be helpful but more research is needed SAMe may trigger mania in people with bipolar disorder
Omega-3 fatty acids. These healthy fats are found in cold-water fish flaxseed flax oil walnuts and some other foods Omega-3 supplements are being studied as a possible treatment for depression Although considered generally safe in high doses omega-3 supplements may interact with other medications More research is needed to determine whether eating foods with omega-3 fatty acids can help relieve depression
Nutritional and dietary supplements are not monitored by the FDA the same way medications are You cannot always be certain of what you are getting and whether it is safe Also because some herbal and dietary supplements can interfere with prescription medications or cause dangerous side effects Before taking supplements talk to your doctor or pharmacist
Mind-body connections
Integrative medicine practitioners believe mind and body must be in harmony for you to stay healthy Examples of mind-body techniques that may be helpful for depression include:
Acupuncture
Relaxation techniques such as yoga or tai chi
Meditation
Guided imagery
Massage therapy
Music or art therapy
Spirituality
Aerobic exercise
Medication and psychotherapy are generally not enough to treat depression They can be helpful when used in addition to other therapies
Coping and support
Talk with your doctor or therapist about how you can improve your coping skills and try these tips:
Simplify your life.Reduce obligations when possible and set reasonable goals for yourself Give yourself permission to do less when you feel down
Write in a journal.Writing in a journal may help improve mood by allowing you to express your pain anger fear or other emotions
Read reputable self-help books and websites Look for books that have been reviewed by other parents and read reviews posted on the internetYour doctor or therapist may be able to recommend books or websites that you can read
Locate helpful groups. Many organizations such as the National Alliance on Mental Illness (NAMI) and the Depression and Bipolar Support Alliance offer education support groups counseling and other resources to help with depression Employee assistance programs and religious groups also may offer help for mental health concerns
Don't become isolated.Participate in social activities and get together with family or friends regularly Support groups for people with depression can help you connect to others facing similar challenges and share experiences
Learn ways to relax and manage your stressExamples include meditation progressive muscle relaxation yoga and tai chi
Structure your time.Make a list of daily tasks Make sticky notes or use a planner to keep track of tasks and appointments
Don't make important decisions when you're downAvoid making decisions when you are feeling depressed because you may not be thinking clearly
Preparing for your appointment
Your doctor or a mental health professional may recommend you to get ready for your appointment Here's some information to help you get ready for your visit
What you can do
Before your appointment, make a list of:
Any symptoms you've had,
Key personal information,If you are under stress such as a recent life change or major stresses then you should not do the activity
All medications vitamins or other supplementsThat means you are taking a medication
Questions to askYour doctor or mental health professional should be consulted
Take someone along to help you remember everything you need to know
Some basic questions to ask your doctor include: What is the name of my illness? How long have I had this illness? How do you treat this illness? (You may want to ask about different treatments like chemotherapy or surgery.)
What are the possible causes of my symptoms?
What are other possible causes for my symptoms?
What kinds of tests will I need?
What type of treatment is likely to help me?
What are the alternatives to your suggested approach?
I have other health conditions. How can I best manage them together?
What restrictions should I follow?
Should I see a doctor or other health professional?
What are the most common side effects of the medications you're recommending?
Do you have a generic alternative to the medicine you're prescribing?
Do you have any brochures or other printed material that I can have? What websites do you recommend?
Ask lots of questions during your appointment
What to expect from your doctor
Your doctor will likely ask you a number of questions Be ready to answer them Your doctor may ask:
When did you or your family first notice symptoms of depression?
How long have you been depressed? Are you generally always sad or does your mood change from time to time?
Do you ever feel down then happy and energetic?
Do you ever feel suicidal when you are feeling down?
Do your symptoms interfere with your daily life or relationships?
Do you have any relatives with depression or another mood disorder?
What other health conditions do you have?
Do you drink alcohol or use recreational drugs?
How much sleep do you get at night? Does it change over time?
What do you think will help your symptoms?
What if anything appears to worsen your symptoms?
General summary
Major depressive disorder also known as clinical depression or major depression is a serious mood disorder that causes severe symptoms that can interfere with daily life Depression is common affecting about 16 million American adults every year Depression symptoms include: Losing interest in activities you once enjoyed feeling down or feeling hopeless Trouble sleeping eating or concentrating Feeling tired or irritable during the day being slowed down or having thoughts of suicide (suicidal thinking) or attempting suicide More than half of people who die by suicide have depression or another mental disorder.
(MDD) Major depressive disorder also known as clinical depression is a mental illness characterized by at least two weeks of low or depressed mood that can interfere with daily functioning Feelings of sadness emptiness and worthlessness may be present People experiencing this type of depression often have difficulty sleeping feel tired and lack interest in activities they normally enjoy.
Depression, or major depressive disorder, is a mental health condition that affects how people think, feel, and act. It is characterized by persistent feelings of deep sadness and loss of interest in activities that were once enjoyed. Symptoms of depression can vary in severity and may include difficulty concentrating, changes in appetite or weight, difficulty sleeping or sleeping too much, lack of energy or motivation, restlessness, and thoughts of death or suicide. While depression can affect anyone regardless of age, gender, or background, it is especially common among adolescents and young adults.