Major depressive disorder (depression)

Overview of major depressive disorder (depression) – Depression is a persistent feeling of sadness and loss of interest.

Symptoms of major depressive disorder –

Symptoms may include –

  • Feeling sad, empty, or hopeless
  • Overeating or not eating at all
  • Loss of interest in favorite activities
  • Sleeping too much or not able to sleep
  • Aches, or pains, headaches, cramps, digestive problems
  • Feeling hopeless, irritable, anxious
  • Feeling very tired
  • Thoughts of suicide or death 

DSM 5 Diagnostic criteria for the major depressive disorder –

  • Five (or more) of the following symptoms have been present during the same two-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

NOTE: Do not include symptoms that are clearly attributable to another medical condition. 

  • 1) Depressed mood most of the day, nearly every day, as indicated by either subjective report (eg, feels sad, empty, hopeless) or observations made by others (eg, appears tearful). (NOTE: In children and adolescents, can be irritable mood.)
  • 2) Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation)
  • 3) Significant weight loss when not dieting or weight gain (eg, a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (NOTE: In children, consider failure to make expected weight gain.)
  • 4) Insomnia (not able to sleep) or hypersomnia (sleeping too much) nearly every day.
  • 5) Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down)
  • 6) Fatigue or loss of energy nearly every day
  • 7) Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick)
  • 8) Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by their subjective account or as observed by others)
  • 9) Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide 
  • The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
  • The episode is not attributable to the direct physiological effects of a substance or to another medical condition.

Causes and risk factors for the major depressive disorder –  The exact cause of depression is not known but a variety of factors may be involved –

  • The changes in the body’s balance of hormones may be associated with major depressive disorder.
  • A major depressive disorder is more common in people whose blood relatives also have this condition.
  • Neurotransmitters also play a role in major depression.

Risk factors for depression – Certain personality traits; traumatic or stressful events; blood relatives with major depression; being gay, lesbian, or transgender in an unsupportive situation; a history of other mental health disorder, abuse of alcohol or recreational drugs, serious or chronic illnesses and use of certain medications

Complications of major depressive disorder –

  • Overeating can lead to excess weight and puts you at risk for diabetes and heart disease
  • Suicide attempts or suicide
  • Relationship problems, work problems
  • Social isolation
  • Alcohol or drug misuse
  • Self-mutilation
  • Premature death

Management of major depressive disorder (depression) –

Psychotherapy – Psychotherapy, also known as talk therapy is talking about your condition and related issues with a mental health professional.

  1. Antidepressant medications – Citalopram, escitalopram, fluoxetine, paroxetine, bupropion, venlafaxine, desvenlafaxine, paroxetine, sertraline, amitriptyline, imipramine, desipramine, nortriptyline, maprotiline, phenelzine, tranylcypromine, selegiline.

Call 911 or seek immediate medical help, If you think you may hurt yourself or attempt suicide

Resources for depression –

Depression hotline numbers that you can call –

National Suicide Prevention Lifeline: 1-800-273-8255 (TALK). The Lifeline also offers hearing impaired services at 1-800-799-4889.

The Samaritans: (877) 870-4673 (HOPE)

  • You can also take a PHQ – 9 questionnaire online which is a tool to screen, monitor depression and share it with your doctor.

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