Major Depressive Disorder - Healthline

Major depressive disorder is a mood disorder that interferes with daily life. Learn about symptoms, causes, and treatment. HealthlineHealthConditionsDiscoverPlanConnectShopSubscribeMentalWell-BeingLifeYouthinFocusMind&BodySelf-CareConditionsTherapyMaternalWellnessParentingCrisisSupportDepression(MajorDepressiveDisorder)MedicallyreviewedbyJacquelynJohnson,PsyD.—WrittenbyMichaelKerr—UpdatedonOctober19,2021SymptomsCausesandriskfactorsTreatmentOutlookWhatismajordepressivedisorder?Sadnessisanaturalpartofthehumanexperience.Peoplemayfeelsadordepressedwhenalovedonepassesawayorwhenthey’regoingthroughalifechallenge,suchasadivorceorseriousillness.Thesefeelingsareusuallyshort-lived.Whensomeoneexperiencespersistentandintensefeelingsofsadnessforextendedperiods,thentheymayhaveamooddisordersuchasmajordepressivedisorder(MDD).MDD,alsoreferredtoasclinicaldepression,isasignificantmedicalconditionthatcanaffectmanyareasofyourlife.Itimpactsmoodandbehavioraswellasvariousphysicalfunctions,suchasappetiteandsleep.MDDisoneofthemostcommonmentalhealthconditionsintheUnitedStates.Datasuggeststhatmorethan7.8percentofU.S.adultsexperiencedamajordepressiveepisodein2019.SomepeoplewithMDDneverseektreatment.However,mostpeoplewiththedisordercanlearntocopeandfunctionwithtreatment.Medications,psychotherapy,andothermethodscaneffectivelytreatpeoplewithMDDandhelpthemmanagetheirsymptoms.Whatarethesymptomsofmajordepressivedisorder?Yourdoctororamentalhealthprofessionalcandiagnosemajordepressivedisorderbasedonyoursymptoms,feelings,andbehaviors.Typically,you’llbeaskedspecificquestionsorgivenaquestionnairesohealthprofessionalscanbetterdeterminewhetheryouhaveMDDoranothercondition.TobediagnosedwithMDD,youneedtomeetthesymptomcriterialistedinthe“DiagnosticandStatisticalManualofMentalDisorders,5thedition(DSM-5).”Thismanualhelpsmedicalprofessionalsdiagnosementalhealthconditions.Accordingtoitscriteria:youmustexperienceachangeinyourpreviousfunctioningsymptomsmustoccurforaperiodof2ormoreweeksatleastonesymptomiseitherdepressedmoodorlossofinterestorpleasureYoumustalsoexperience5ormoreofthefollowingsymptomsinthe2-weekperiod:Youfeelsadorirritablemostoftheday,nearlyeveryday.You’relessinterestedinmostactivitiesyouonceenjoyed.Yousuddenlyloseorgainweightorhaveachangeinappetite.Youhavetroublefallingasleeporwanttosleepmorethanusual.Youexperiencefeelingsofrestlessness.Youfeelunusuallytiredandhavealackofenergy.Youfeelworthlessorguilty,oftenaboutthingsthatwouldn’tusuallymakeyoufeelthatway.Youhavedifficultyconcentrating,thinking,ormakingdecisions.Youthinkaboutharmingyourselforsuicide.Symptomsparentsshouldbeawareofintheirteensincludethefollowing:onsetorincreaseduseofsubstances(i.e.,alcohol,smoking)pooreracademicperformanceproblemswithpeersincreasedsocialwithdrawal/isolationWhatcausesmajordepressivedisorder?TheexactcauseofMDDisn’tknown.However,severalfactorscanincreaseyourriskofdevelopingthecondition.Acombinationofgenesandstresscanaffectbrainchemistryandreducetheabilitytomaintainmoodstability.ChangesinthebalanceofhormonesmightalsocontributetothedevelopmentofMDD.MDDmayalsobetriggeredby:alcoholordrugusecertainmedicalconditions,suchascancerorhypothyroidismparticulartypesofmedications,includingsteroidsabuseduringchildhoodHowismajordepressivedisordertreated?MDDisoftentreatedwithmedicationandpsychotherapy.Somelifestyleadjustmentscanalsohelpeasecertainsymptoms.PeoplewhohavesevereMDDorhavethoughtsofharmingthemselvesmayneedtostayinahospitalduringtreatment.Somemightalsoneedtotakepartinanoutpatienttreatmentprogramuntilsymptomsimprove.MedicationsPrimarycareprovidersoftenstarttreatmentforMDDbyprescribingantidepressantmedications.Selectiveserotoninreuptakeinhibitors(SSRIs)SSRIsareafrequentlyprescribedtypeofantidepressant.SSRIsworkbyhelpinginhibitthebreakdownofserotonininthebrain,resultinginhigheramountsofthisneurotransmitter.Serotoninisabrainchemicalthat’sbelievedtoberesponsibleformood.Itmayhelpimprovemoodandproducehealthysleepingpatterns.PeoplewithMDDareoftenthoughttohavelowlevelsofserotonin.AnSSRIcanrelievesymptomsofMDDbyincreasingtheamountofserotoninavailableinthebrain.SSRIsincludewell-knowndrugssuchasfluoxetine(Prozac)andcitalopram(Celexa).Theyhavearelativelylowincidenceofsideeffectsthatmostpeopletoleratewell.SimilartoSSRIs,serotonin-norepinephrinereuptakeinhibitors(SNRIs)areanothertypeofantidepressantoftenprescribed.Theseaffectserotoninandnorepinephrine.OthermedicationsTricyclicantidepressantsandmedicationsknownasatypicalantidepressants,suchasbupropion(Wellbutrin),maybeusedwhenotherdrugshaven’thelped.Thesedrugscancauseseveralsideeffects,includingweightgainandsleepiness.Aswithanymedication,benefitsandsideeffectsneedtobeweighedcarefullywithyourdoctor.SomemedicationsusedtotreatMDDaren’tsafewhileyou’repregnantorbreastfeeding.Makesureyouspeakwithahealthcareprofessionalifyoubecomepregnant,you’replanningtobecomepregnant,oryou’rebreastfeeding.PsychotherapyPsychotherapy,alsoknownaspsychologicaltherapyortalktherapy,caneffectivelytreatpeoplewithMDD.Itinvolvesmeetingwithatherapistregularlytotalkaboutyourconditionandrelatedissues.Psychotherapycanhelpyou:adjusttoacrisisorotherstressfuleventworkingtowardachievingabalancedperspectiveofagivensituationandactinginaccordancewithvaluesinsteadofbaseduponmoodimproveyourcommunicationskillsfindbetterwaystocopewithchallengesandsolveproblemsincreaseyourself-esteemregainasenseofsatisfactionandcontrolinyourlifeYourhealthcareprofessionalmayalsorecommendothertypesoftherapy,suchascognitivebehavioraltherapyorinterpersonaltherapy.Ifyoudon’talreadyhaveahealthcareprofessional,theHealthlineFindCaretoolcanhelpyoufindaphysicianinyourarea.Anotherpossibletreatmentisgrouptherapy,whichallowsyoutoshareyourfeelingswithpeoplewhocanrelatetowhatyou’regoingthrough.OnlinetherapyoptionsReadourreviewofthebestonlinetherapyoptionstofindtherightfitforyou.LifestylechangesInadditiontotakingmedicationsandparticipatingintherapy,youcanhelpimproveMDDsymptomsbymakingsomechangestoyourdailyhabits.DietarychangesNutritiousfoodsbenefityourmindandbody,andwhilenofoodscancuredepression,certainhealthyfoodchoicescanbenefityourmentalwell-being.Considereatingfoods:containingomega-3fattyacids,suchassalmonrichinBvitamins,suchasbeansandwholegrainswithmagnesium,whichisfoundinnuts,seeds,andyogurtAvoidalcoholandcertainprocessedfoodsIt’sbeneficialtoavoidalcoholbecauseit’sanervoussystemdepressantthatworsensyoursymptoms.GetplentyofexerciseAlthoughMDDcanmakeyoufeelverytired,it’sessentialtobephysicallyactive.Exercising,especiallyoutdoorsandinmoderatesunlight,canboostyourmoodandmakeyoufeelbetter.SleepwellIt’svitaltogetenoughsleepeachnight,whichcanvaryfrompersontopersonbuttypicallyrangesbetween7to9hours.Peoplewithdepressionoftenhavetroublesleeping.Speakwithadoctorifyou’rehavingtroublesleepingoroversleeping.SAMHSA’sNationalHelplineTheSubstanceAbuseandMentalHealthServicesAdministrationhasafree,confidentialhelplineforpeopleandfamilymembersofthosefacingsubstanceabuseormentalhealthconditions.Theyareavailable24hoursadayat1-800-662-HELP(4357).Whatistheoutlookforsomeonewithmajordepressivedisorder?WhilesomeonewithMDDcanfeelhopelessattimes,it’simportanttorememberthatthedisordercanbetreatedsuccessfully.Thereishope.Toimproveyouroutlook,it’scriticaltostickwithyourtreatmentplan.Don’tmisstherapysessionsorfollow-upappointmentswithyourhealthcareprofessional.Neverstoptakingyourmedicationsunlessyourtherapistorhealthcareprofessionaladvisesyouto.Ondayswhenyoufeelparticularlydepresseddespitetreatment,itcanbehelpfultocallalocalcrisisormentalhealthserviceortheNationalSuicidePreventionLifeline.Resourcesareavailable.Afriendly,supportivevoicecouldbejustwhatyouneedtogetyouthroughadifficulttime.ReadthisarticleinSpanish.SuicidalthoughtsIfyoustarttakingantidepressantsandhavesuicidalthoughts,callyourdoctoror911rightaway.Althoughit’sarareoccurrence,someMDDmedicationscancausesuicidalthoughtsinpeoplewhohavejuststartedtreatment.Talkwithyourdoctoraboutconcernsyoumayhaveabouttakingmedicationsthatposethisrisk.LastmedicallyreviewedonOctober18,20218sourcescollapsedHealthlinehasstrictsourcingguidelinesandreliesonpeer-reviewedstudies,academicresearchinstitutions,andmedicalassociations.Weavoidusingtertiaryreferences.Youcanlearnmoreabouthowweensureourcontentisaccurateandcurrentbyreadingoureditorialpolicy.AssiesJ,etal.(2010).Plasmaanderythrocytefattyacidpatternsinpatientswithrecurrentdepression:Amatchedcase-controlstudy.ncbi.nlm.nih.gov/pmc/articles/PMC2871041/HeimC,etal.(2012).Currentresearchtrendsinearlylifestressanddepression:Reviewofhumanstudiesonsensitiveperiods,gene-environmentinteractions,andepigenetics.sciencedirect.com/science/article/abs/pii/S0014488611004043?via%3DihubHollonSD,etal.(2014).Effectofcognitivetherapywithantidepressantmedicationsvsantidepressantsaloneontherateofrecoveryinmajordepressivedisorder.jamanetwork.com/journals/jamapsychiatry/fullarticle/1897300Majordepression.(2019).nimh.nih.gov/health/statistics/major-depression.shtmlPenckoferS,etal.(2010).VitaminDanddepression:Whereisallthesunshine?onlinelibrary.wiley.com/doi/epdf/10.1111/j.1365-277X.2012.01283.xSanhuezaC,etal.(2012).Dietandtheriskofunipolardepressioninadults:Systematicreviewofcohortstudies.onlinelibrary.wiley.com/doi/epdf/10.1111/j.1365-277X.2012.01283.xSkarupskiKA,etal.(2010).LongitudinalassociationofvitaminB-6,folate,andvitaminB-12withdepressivesymptomsamongolderadultsovertime.ncbi.nlm.nih.gov/pmc/articles/PMC2904034/TrebatickaJ,etal.(2014).Psychiatricdisordersandomega-3fattyacids.sciencedirect.com/science/article/abs/pii/S0891584914013252?via%3DihubFEEDBACK:MedicallyreviewedbyJacquelynJohnson,PsyD.—WrittenbyMichaelKerr—UpdatedonOctober19,2021ReadthisnextDiagnosingDepressionMedicallyreviewedbyTimothyJ.Legg,PhD,PsyDDoctorslookforspecificsymptomstodiagnosesomeonewithdepression.Expecttoanswerin-depthquestionsaboutyourmood,behavior,anddaily…READMOREDepressionatNight:HowtoCopewithNighttimeDepressionMedicallyreviewedbyTimothyJ.Legg,PhD,PsyDYoumayexperiencedepressionsymptomsatnightmorethanduringtheday.Here'swhatyouneedtoknowaboutnighttimedepressionandhowtocope.READMOREDifferencesBetweenDysthymiaandDepressionDysthymia(persistentdepressivedisorder)anddepression(majordepressivedisorder)areverysimilar.Learnthedifferencesbetweentheconditions…READMOREWhatYouNeedtoKnowIfYourDepressionFeelsDebilitatingMedicallyreviewedbyTimothyJ.Legg,PhD,PsyDIfyouhaveoverwhelmingdepression,there'shope.Evenmajordepressioncanbesuccessfullytreated,andyoucanfeelbetter.Ifyouhavethoughtsof…READMOREThisIsWhatLivingwithMajorDepressiveDisorderLooksLikeMedicallyreviewedbyTimothyJ.Legg,PhD,PsyDADayinTheLifeofMajorDepressiveDisorder(MDD)READMORETipsforCopingwithUnexpectedEpisodesofMDDMedicallyreviewedbyTimothyJ.Legg,PhD,PsyDOneofthemostfrustratingaspectsofMDDisitsunpredictability.Herearesomeinsightfultipsondealingwithyournextunexpectedepisode.READMOREHerbs,Vitamins,andSupplementsforDepressionMedicallyreviewedbyDebraRoseWilson,Ph.D.,MSN,R.N.,IBCLC,AHN-BC,CHTResearchershavestudiednumerousherbs,supplements,andvitaminstodetermineiftheycanbenefitpeoplewithdepression.Learnwhatthey'vefound.READMOREHowtoGetOutofBedWhenDepressionIsKeepingYouDownMedicallyreviewedbyTimothyJ.Legg,PhD,PsyDDepressioncanmakeithardtogetoutofbedinthemorning,especiallywhenit’skeptyouupallnightorgivenyourestlesssleep.Here’seight…READMOREUnpackingtheComplexLinkBetweenDepressionandSubstanceUseDisordersMedicallyreviewedbyAlyssaPeckham,PharmD,BCPPDepressionmayraiseyourriskforsubstanceusedisorders—butsubstanceusecanalsoplayapartindepression.Weexplainthelinkhere.READMORE