Experiencing prolonged and severe feelings of sadness and hopelessness, as described in major depressive disorder or clinical depression.

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Experiencing prolonged and severe feelings of sadness and hopelessness, as described in major depressive disorder or clinical depression.

"Clinical Depression," alternatively known as "major depressive disorder," is characterized by persistent low mood, sleep disturbances, difficulty focusing, reduced motivation, and other symptoms.

A person suffering from major depressive disorder (MDD) will endure a prolonged period of melancholy and a waning enthusiasm towards their usual favorite pastimes.

Individual symptoms might encompass sleep problems, exhaustion or energy depletion, altered appetite, and difficulty concentrating.

There are various categories of depression, with MDD featuring several subtypes that may appear at distinct stages in a person's life.

Types of Major Depressive Disorder

A diversity of MDD types exist, each exhibiting slightly distinct symptoms at different life stages.

Types of MDD comprise:

  • Major depression with seasonal pattern: A person may encounter this form of depression during the winter months due to insufficient sunlight exposure.
  • MDD with peripartum onset: Research shows that around 18% of women might experience a depression episode during pregnancy or within a year postpartum.
  • MDD with psychotic features: A person undergoes delusions or hallucinations in addition to other depression symptoms.

Symptoms

A diagnosis of MDD necessitates the presence of certain symptoms daily for at least two weeks:

  • changes in sleep patterns
  • persistent sad or low mood
  • alterations in appetite
  • diminished motivation
  • unexplained aches and pains
  • suicidal thoughts or actions
  • disinterest in usual activities
  • difficulty focusing

Depression Symptoms in Children and Teenagers

The manifestations of MDD in children and adolescents share similarities with those in adults, but some variations may apply:

  • Preschool-aged children: Diagnosis of depression is relatively uncommon in children this young, but excessive crying, loss of interest in play, and anxiety can be indicative of depression in this age group.
  • School-aged children: Reduced interest in hobbies, hostility towards others, irritability, sensitivity to frustration, and low self-esteem can be signs of depression in school-aged children.
  • Teenagers: Persistent feelings of sadness, weight changes, substance misuse, extreme lethargy, and suicidal thoughts can manifest as depression in teenagers.

Older Adults

As people age, they may develop dementia and other neurological disorders that resemble depression symptoms. Consequently, diagnosing depression in older adults can be challenging for medical professionals.

Help is Available

Individuals or someone they know in crisis, contemplating suicide or self-harm, may obtain support by:

  • Contacting or texting the 988 Lifeline at 988 or visiting 988lifeline.org. Trained counselors provide free, confidential support around the clock.
  • Texting HOME to the Crisis Text Line at 741741 to connect with a volunteer counselor for free and confidential support 24/7.
  • Locating a helpline in one's particular country through Befrienders Worldwide.
  • Calling 911 or the local emergency services number if feeling secure to do so.

If assisting someone else, remain with them until help arrives. Remove potential hazards like weapons or dangerous substances, if possible, in a secure manner.

If not residing in the same household, stay on the phone until help arrives.

Diagnosis

Clinical depression cannot be diagnosed using a physical test.

However, a doctor may conduct a physical examination and order urine or blood tests to eliminate underlying health conditions exhibiting similar symptoms to depression, such as an underactive thyroid.

A doctor uses a questionnaire to evaluate a person's symptoms, adhering to the diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Questionnaires are tailored to children and adults.

Causes

Depression may develop gradually or be triggered by specific events or a combination of factors. The ensuing sections discuss some possible causes.

Genetics, Biology, and Environment

  • Genetics: Genetic factors can enhance the likelihood of clinical depression and other mood disorders throughout families with a history of depression.
  • Biology: A 2021 study revealed that people with depression frequently have smaller or thinner areas in specific brain regions involved in emotions and decision making. These structural variations may contribute to an elevated risk for depression.
  • Environment: Environmental triggers such as trauma or significant loss may elicit stress, anxiety, and depression in genetically susceptible individuals.

Brain Chemistry

Research suggests that an imbalance in certain neurotransmitters (brain chemicals), including serotonin, dopamine, and norepinephrine, may contribute to depression in selected individuals.

While this theory has some support, more evidence is needed to fully comprehend its significance.

Hormones

Hormonal changes, specifically those related to progesterone or estrogen, can exacerbate the incidence of clinical depression in females, particularly during pregnancy, postpartum, around menstruation, and during menopause and perimenopause.

Dealing with depression often involves adjusting daily habits, undergoing various therapies, or using medications, or a mix of these solutions.

Pharmaceuticals

Based on an individual's symptoms, a physician might prescribe:

  • antidepressants
  • mood stabilizers
  • antipsychotics

Antidepressants come in various forms, and it might take several weeks before results start showing.

If a person's symptoms have not improved despite trying at least two types of antidepressants, their doctor may suggest the nasal spray known as esketamine. Individuals using esketamine usually continue taking oral antidepressants to maintain improvements in their symptoms.

Psychological Approaches

Psychotherapy plays a significant role in battling depression.

Several psychotherapies have shown effectiveness with depression. Examples include cognitive behavioral therapy, which helps individuals comprehend how their thoughts can impact their behavior and mood, and interpersonal therapy, which aims to improve people's ability to form strong relationships.

Some people overcome their depression through psychotherapy, while others require treatment for extended periods.

Alternative Therapies

If other strategies don't work, brain stimulation therapy techniques could be considered.

Possible options include:

  • electroconvulsive therapy
  • repetitive transcranial magnetic stimulation
  • vagus nerve stimulation

These methods might be helpful for individuals with symptoms that haven't responded to other treatments.

Lifestyle Changes

A balanced and active lifestyle might help a person manage depression. According to research, exercise - particularly yoga, jogging, and strength training - is an effective treatment option for depression. Studies show that more strenuous forms of exercise lead to better outcomes.

Risk Factors

Several factors can increase the risk of depression, such as:

  • genetic factors
  • significant life changes
  • trauma
  • work-related stress and other forms of stress
  • physical health conditions and recovery
  • medication use
  • insulin resistance

When to Consult a Doctor

Individuals should consult a physician if they notice depression symptoms such as persisting low mood for an extended period.

Although seeking help might seem intimidating for some people, depression is a common health issue, and a doctor can provide treatment recommendations. Failure to receive treatment could result in further complications.

Prevention

While it's not always possible to prevent depression, recognizing triggers and knowing the early signs of an episode might help individuals take early action.

As soon as a person notices signs of depression, they should seek medical help. Early intervention can help prevent depression from worsening.

Frequently Asked Questions

How does major depressive disorder (MDD) influence daily life?

MDD can significantly impact a person's day-to-day life, causing difficulties in various aspects, such as:

  • relationships
  • work and education
  • finances

People with this condition may also struggle with sleep and eating patterns.

Can a person recover from major depressive disorder?

MDD affects individuals differently. With proper treatment, some people might recover within weeks or months, while others may require treatment for several years.

Finding an effective treatment plan may take time, but many people see improvements with the right combination of therapy and medication.

Is major depressive disorder the most severe form of depression?

Yes, MDD can be one of the severest forms of depression, although it can range from mild to severe. Any type of depression can escalate if a person does not receive treatment.

Despite undergoing treatment, individuals with MDD may continue to experience cognitive impairments such as memory issues and difficulty focusing.

Moreover, depression can impact a person's overall physical health, exacerbating conditions like heart disease, obesity, and diabetes, due to persistent negative emotions and unhealthy lifestyle choices.

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