What is Major Depressive Disorder?
Major Depression, also known as Major Depressive disorder (MDD) or Clinical Depression, is a mood disorder that causes a persistent feeling of sadness and loss of interest in all life activities. It affects an individual emotionally, physically, and socially. MDD affects how an individual think, feels, and acts. Women are more prone to MDD, and twice as many women as men have MDD.
Unfortunately, the current Covid-19 pandemic is having a significant impact on MDD, with the trend of people contracting MDD getting higher.
How is Major Depressive Disorder different from sadness or grief?
Death of a loved one, losing a job, separation from an emotionally attached person, these events are challenging scenarios for an individual to experience. It is normal to develop feelings of sadness and grief in response to these situations. However, some individuals experiencing these scenarios may describe the condition as being depressed.
Feeling sad and having MDD is entirely different. A person can feel melancholy or grief and be depressed at the same time. Depression and grief share some standard features, but these emotions are not the same. They are different in many ways as:
1. In grief, painful feelings come in waves, sometimes along with positive memories of the deceased. But, for MDD, the mood is mostly negative for two or more weeks
2. In grief, self-esteem is usually maintained, but in MDD, feelings of worthlessness and low self-esteem is typically expected
3. In grief, thoughts of death may surface when thinking of or fantasizing about “joining” the deceased loved one. But in MDD, suicidal thoughts are common because of feelings of unworthiness
What are some types of Major Depressive Disorder?
MDD consists of 6 significant types of depressions, namely: –
1. Persistent Depressive Disorder: If an individual suffers from depression that lasts for two or more years, it is Persistent Depressive Disorder. The individual may have major depressive episodes with less severe symptoms, but the symptoms must last for at least two years.
2. Psychotic Depression: An individual with Psychotic depression has MDD along with psychotic symptoms such as: –
a. Delusion: A false belief
b. Hallucination: Seeing or hearing unreal things
c. Paranoia: False believes that other people are trying to harm the individual
3. Postpartum depression: Women with postpartum or Peripartum Depression experience MDD after their childbirth or pregnancy. They feel extreme sadness, anxiety, and exhaustion, making it difficult for new mothers to perform daily life activities and take care of their newborn babies.
4. Premenstrual Dysphoric Disorder (PMDD): Women with Premenstrual Dysphoric disorder have depression at the start and even during their period. These women may also experience:
a. Mood swings
b. Anxiety
c. Fatigue
d. Change is appetite and sleep pattern
e. Irritability
5. Seasonal affective disorder (SAD): SAD is characterized by the onset of major depression at the start of winter months when there is less sunlight. Effects of SAD include social withdrawal, weight gain, and increased sleep, mood swings.
6. Bipolar Disorder: Bipolar disorder falls in this category due to the episodes of mania and depression. During the manic episode of bipolar disorder, the individual is highly energetic, hyperactive. But in a depressive episode, the individual might feel sadness, irritability, no energy, social withdrawal.
What are the symptoms of Major Depressive Disorder?
Common signs and symptoms of MDD might include:
1. The feeling of sadness, hopelessness, and emptiness
2. Irritability and frustration on all most everything
3. Loss of interest and pleasure in all most all activities such as sports, sex, and hobbies
4. Anxiety
5. Headache
6. Sleep disturbance
7. Avoiding social interaction
8. Lack of energy or May feel tired all the time
9. Suicidal thoughts and suicide attempts
10. Reduced appetite and weight loss or increased appetite and weight gain
11. Feelings of worthlessness and low self-esteem
12. Concentration problem
13. Experience trouble in remembering things
14. Experience trouble in deciding
15. Negative thoughts
What are the causes and risk factors of Major Depressive Disorder?
The causes of depression are still unknown, but studies have shown that some factors can cause and can increase the risk of getting depression, such as:
1. Genetic Factor: Individuals with a family history of MDD are more likely to develop MDD. Researchers are still trying to find out the gene that causes depression
2. Biochemistry: Change in brain structure or neurotransmitters are directly connected to mood stability and depression
3. Environmental Factor: Environmental factors such as the divorce of parents, separation, or death of a loved one, abusive childhood can also lead to MDD
4. Personality: A negative personality type, low self-esteem, or low self-image, shyness could lead to MDD
5. Drug Abuse: Some drugs could trigger depression. Some drug addicts might feel depressed when they could not access these drugs and alcohol
6. Hormones: Disturbance in hormones of the body could cause MDD. Hormonal imbalance can be due to menopause, childbirth, thyroid problem
7. Trauma: A trauma such as the death of a loved one could lead to depression.
What are the effects of Major Depressive Disorder?
MDD has severe effects on the individual and their family members. MDD affects all possible ways, such as physically, emotionally, socially, and its effects include: –
1. Anxiety, panic disorder or social phobia
2. Social isolation
3. Low self-esteem
4. Suicidal thoughts and suicidal attempts
5. Obesity or underweight
6. Physical illness
7. Alcohol abuse
What are the treatment options available for Major Depressive Disorder?
Different treatment options are available for MDD that include:
1. Medications: Brain chemistry contributes to an individual’s depression and is factored into the treatment options. At the start of the medication treatments, the following antidepressants are prescribed to stabilize the mood and regulate neurotransmitters in the brain:
a. Selective serotonin reuptake inhibitors (SSRIs)
b. Tricyclic antidepressants
2. Psychotherapy: Psychotherapy or talk therapy can be used separately or injunction with antidepressant medications. Cognitive-behavioral therapy (CBT) is effective in treating MDD. Psychotherapy may involve only the individual, but at times to include family members or friends.
Group therapy is another form of psychotherapy that gathers people with similar MDD issues as a group lead by a psychotherapist or counselor. All group members get to understand and learn how others manage identical MDD situations.
3. Electroconvulsive Therapy (ECT): ECT has been reserved for people with MDD and cannot respond to any other treatments. ECT involves electrical stimulation of the brain while the patient is under anesthesia.
A patient receives ECT two to three times a week for a total of six to 12 treatments. ECT can be managed by a team of trained medical professionals, including a psychiatrist, an anesthesiologist, and a nurse.
4. Lifestyle changes: In addition to medication and therapies, a person with MDD can change their lifestyle to reduce or control the symptoms of MDD, such as:
a. Exercise regularly to develop a positive mindset and improve mood
b. Develop a healthy sleep routine
c. Consume healthy food that includes the required nutrients, such as omega-3 fatty acid, vitamin B, magnesium that are essential for good mental health
d. Avoid alcohol and drugs to improve mood
e. Set realistic and achievable goals
f. Socialize with others and confide in a trusted friend or relative
5. Mindfulness exercises: Mindfulness activities such as meditation, yoga, breathing exercises, and etc., have shown to have a positive effect against MDD.
What’s the Call To Action here for Major Depressive Disorders?
There is NO shame in seeking treatment for MDD, which is so prevalent in so many countries. Stop procrastinating now, and explore potential treatments for the sake of your family and loved ones.
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Co-Authored by Shereen Sakhawat (M.sc Applied Psychology)