What Is Major Depressive Disorder (MDD)?
Major depressive disorder is a serious mental disorder that affects more than 20 million Americans. It’s the leading cause of disability in the US, and the cost of treating it is high.
Major depressive disorder can lead to a host of negative outcomes, including loss of jobs, relationships, and health care. There is no known cure for major depressive disorder, but treatment options are available that can help improve patient symptoms [1].
1- Major Depressive Disorder Causes
The causes of MDD are still unknown, but there are a few suspected factors. Some research suggests that genes may play a role in developing MDD, while other studies suggest that environmental factors may also be involved. However, the exact cause of MDD remains unknown.
- Genetic Factors
Studies have found that MDD is linked to a variety of genetic factors, including variants in the serotonin transporter gene (SERT), which may lead to increased levels of serotonin in the brain.
Other genetic factors that have been linked to MDD include variations in the monoamine oxidase A (MAOA) gene, which can influence how well the body processes serotonin; and variations in chromosome 7q21, which has been associated with an increased risk for developing bipolar disorder.
- Environmental Factors
Although the precise cause of MDD is unknown, there are several environmental factors that may play a role. These include life stressors such as financial problems, family conflict, bereavement, or personal disasters; traumas such as abuse or neglect; and lifestyle factors such as smoking cigarettes or consuming excessive amounts of caffeine.
- Hormones
The cause of MDD is unknown, but there are several factors that may play a role. One potential cause is hormones. Pregnancy and post-partum can both increase levels of estrogen and progesterone, two hormones that have been linked to an increased risk for MDD.
Other possible causes include genetic predisposition, stress, and exposure to environmental toxins.
2- Major Depressive Disorder Risk Factors
Major depressive disorder (MDD) is a serious mental illness that affects millions of people across the world. Despite its prevalence, there is still much to learn about the risk factors for MDD.
However, researchers have identified several factors that are likely to increase your chances of developing MDD. Here are some of the most common risk factors:
1. History of depression or anxiety disorders.
2. Personal history of suicide attempts or thoughts.
3. Family history of major depression or bipolar disorder.
4. Environmental stressors such as financial difficulty, relationship problems, and traumatic events.
5. Genetics – some people are more likely to develop MDD based on their genes and cannot avoid it no matter what they do.
6. Poor physical health – being in poor physical condition can make you more prone to experiencing emotional problems, including depression.
3- Major Depressive Disorder Symptoms
MDD is characterized by a persistent feeling of sadness and loss of interest or pleasure in activities that were once enjoyed, along with other symptoms such as poor sleep, weight gain, difficulty concentrating, and feelings of worthlessness.
While there is no one-size-fits-all approach to treating MDD, effective treatment typically includes medication and therapy.
4- Major Depressive Disorder Types
Major depressive disorder (MDD) is a severe mood disorder that affects more than 20% of the population at some point in their lives.
There are three main types of MDD: unipolar, bipolar, and cyclothymic. Unipolar MDD is just one type of MDD, and it’s the most common. Bipolar disorder is when a person has two or more episodes of mania or depression within a 12-month period. Cyclothymic disorder is when a person has mild to moderate episodes of depression but doesn’t have full-blown manic episodes.
Other classifications include:
- Major Depressive Disorder with Anxious Distress
About 50% of people with MDD experience significant symptoms of anxious distress, which can significantly impact their quality of life. Anxiety is a normal response to stress, but when anxiety becomes excessive or chronic, it can interfere with daily functioning.
- Major Depressive Disorder with Mixed Features
Mixed features are a common feature of MDD. Mixed features occur when symptoms of both mania and depression are present at the same time. They can make it difficult to tell whether someone has had an episode of bipolar MDD or unipolar MDD, and they can make it hard to get treatment for either type of MDD.
- Major Depressive Disorder with Melancholic Features
Some people with MDD experience features that are classified as melancholic, such as loss of interest in activities, decreased energy, increased appetite, weight gain, sleep problems, and feelings of hopelessness. People with melancholic MDD may also have difficulty concentrating and making decisions.
- Major Depressive Disorder with Atypical Features
About 5% to 10% of people with MDD have atypical features that may suggest a different diagnosis. Atypical features may include:
1. Difficulty focusing attention or concentrating.
2. Irritability or excessive anger.
3. Sleep difficulties (such as poor sleep quality or insomnia).
4. Decreased appetite or weight loss.
5. Rumination (thinking about and dwelling on negative thoughts).
6. Excessive thoughts about death or suicide.
- Major Depressive Disorder with Psychotic Features
In some cases, individuals also experience psychotic features such as hallucinations and delusions. While the prevalence of MDD is estimated to be around 10%, the incidence of psychotic features is much higher, accounting for around 30% of all cases of MDD.
There are several reasons why psychotic features might occur in patients with MDD. One theory suggests that the symptoms of MDD might lead to a disturbing cognitive process that results in the development of psychosis.
Other possible explanations include changes in brain chemistry or abnormalities in neurotransmission. Regardless of the cause, it is important that clinicians consider any signs or symptoms of psychosis when diagnosing and treating patients with MDD.
- Major Depressive Disorder with Catatonia
Some people with major depressive disorder develop a condition called Catatonia. Catatonia is a condition that causes people to become paralyzed or extremely shy. Catatonia is a rare condition, but it’s one that’s often associated with major depression.
- Major Depressive Disorder with Peripartum Onset
Peripartum onset is a particularly serious form of the condition. Peripartum onset MDD occurs when major depression first becomes evident during or shortly after childbirth. This is a rare condition, accounting for only about 1% of all cases of MDD. Unfortunately, peripartum onset MDD frequently leads to severe depression and even suicide.
- Major Depressive Disorder with Seasonal Pattern
There is a significant minority of people who experience MDD with a seasonal pattern, meaning that their symptoms tend to worsen during certain periods of the year. Such MDD includes Seasonal Affective Disorder (SAD).
5- Major Depressive Disorder in Children and Teens
In children and teens, MDD can be especially challenging to treat. Many factors make MDD more difficult to manage in children and teens, including their younger age, greater sensitivity to stressors, and smaller body size.
Nevertheless, there are many effective treatments for MDD in both children and teens. If you think your child or teen may be suffering from MDD, it’s important to talk to your doctor about your concerns. There are many resources available online as well as through your local mental health center.
6- Major Depressive Disorder in Older Adults
Major depressive disorder (MDD) is a serious mental illness that affects older adults more than any other age group. The prevalence of MDD in older adults is about twice that of younger adults, and it is the most common psychiatric disorder in this population.
The causes of MDD are unknown, but several factors may be involved. Older adults are more likely to have comorbid physical illnesses and functional limitations, which can make MDD harder to manage. They also may experience social isolation and loss of independence, which can lead to feelings of hopelessness and despair.
There is no single effective treatment for MDD in older adults, but various interventions are available. Treatment usually begins with medication but can also include talk therapy or group therapy. Many older adults improve with treatment, but about one-third require ongoing care.
7- Major Depressive Disorder Prevention
Prevention of MDD starts with early detection and treatment. Screening for depression should begin in early adulthood, before the onset of symptoms, to identify people who may be at high risk for developing the disorder. People who screen positive for depression should be referred for evaluation and treatment.
There are many effective treatments for MDD, including medication and therapy. Medications can be highly effective in preventing relapse and improving symptoms, but they must be taken consistently and correctly to be effective. Therapy can help people learn how to manage their emotions, cope with stress, and establish healthy relationships. Both therapies and medications have side effects, but most are manageable with appropriate care.
8- Major Depressive Disorder Complications
Major depressive disorder (MDD) is a serious mental disorder characterized by persistent sadness and loss of interest or pleasure in activities that were once enjoyed. MDD can cause significant physical and emotional complications. Some of the most common complications are:
1. Poor sleep quality, which can lead to increased levels of stress and anxiety, increased levels of cortisol, and an increased risk for developing cardiovascular disease.
2. Weight gain or weight loss, either due to an increase in appetite or decreased activity levels due to depression.
3. Increased rates of suicide attempts, even in people who have never attempted suicide before.
4. Changes in sexual behavior, including an increase in risky sexual behaviors such as unprotected sex and engaging in high-risk recreational activities.
9- Major Depressive Disorder Test
One way to diagnose MDD is through a psychiatric test called the Hamilton Depression Rating Scale (HAM-D). The HAM-D is a 20-item questionnaire that measures five aspects of depression: depressed mood, anhedonia (a lack of interest in normally pleasurable activities), psychomotor retardation (slowness in movements), fatigue, and feelings of guilt or shame.
The score on the HAM-D ranges from 0 to 60, with higher scores indicating greater severity of depression.
10- Major Depressive Disorder Diagnosis
MDD can be diagnosed with a combination of symptoms and signs assessed by a doctor during a physical exam and comprehensive lab tests.
Psychiatric evaluation is also often necessary to rule out other possible causes for the person’s symptoms, such as substance abuse or an underlying medical condition.
The DSM-5, the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, includes a specific diagnosis for MDD called major depressive disorder with dysthymia (MDD-dysthymia).
11- Major Depressive Disorder Treatment
Major depressive disorder is a mental illness that causes significant distress in the individual. The most common form of treatment for major depressive disorder is medication. There are many different types of medication that can be used to treat major depressive disorder.
Some of the most common medications used to treat major depressive disorder include antidepressants, antipsychotics, and mood stabilizers.
Antidepressants are the most used type of medication to treat major depressive disorder. Antidepressants work by reducing the symptoms of major depression. They may also help improve mood and sleep patterns.
Antipsychotics are medications that are often used to treat schizophrenia. They can also be used to treat mild to moderate cases of major depression, although their use in this population is controversial.
Mood stabilizers are medications that help control mood fluctuations and improve overall mood stability.
Additionally, there are several types of psychotherapy that have been shown to be effective. One type of psychotherapy known as cognitive-behavioral therapy (CBT) is a structured approach that helps people learn how to change their thoughts and behaviors related to their depression.
CBT typically includes weekly sessions in which patients are taught about the role that thoughts and feelings play in their depression, ways to identify and challenge negative thinking patterns, and strategies for managing stress.
Conclusion
In conclusion, major depressive disorder is a serious mental illness that should not be taken lightly. It can cause a person to feel hopeless and helpless and can lead to suicide.
If you or someone you know is suffering from major depressive disorder, please seek help from a doctor or mental health professional. There is no shame in seeking help, and there is no one who is too far gone to recover.
