Is Major Depressive Disorder A Serious Mental Health Condition?

Feeling down, tired all the time, losing interest in stuff you used to love, and just feeling hopeless? Those are signs of depression, a real mental health problem. There are different kinds, but major depressive disorder (MDD) is what most people mean when they talk about depression. If you or someone you care about might have it, knowing about MDD, its signs, and what can help is super important.

What exactly is major depressive disorder?

Major depressive disorder is a serious mood problem, often called clinical depression. To get diagnosed, you need to feel symptoms most days for at least two weeks. These symptoms also have to mess with your work, sleep, school, and eating. MDD is different from bipolar disorder; with MDD, you don’t get those high-energy periods, just a constant low mood. The good news is, MDD can be treated, usually with a mix of therapy and medicine.

The World Health Organization (WHO) says about 280 million people around the world deal with depression. It’s a top reason for disability and seems to affect more women than men. But that might be because it’s harder for men to ask for help.

What are the signs of major depressive disorder?

Depression often shows up in your teens, 20s, or 30s, but kids and older adults can get it too. Sometimes, someone might only have one period of depression in their whole life.

The signs of major depression don’t just pop up every now and then. Instead, they’re there all day, almost every day, for a long time. When someone has a major depressive episode, they might feel tired, pull away from others, feel worthless, and just generally hopeless.

Common mental signs of depression:

According to the National Alliance On Mental Illness (NAMI), other common signs of depression include:

Trouble thinking clearly
Physical slowness
Sleeping too much or not enough (insomnia)
Feeling anxious and restless
Moving, speaking, or thinking slowly
Finding it hard to remember things
Struggling to focus, concentrate, or make decisions
Mood swings, sadness, or crying a lot
Feeling guilty
Feeling worthless
Being irritable and getting angry fast
Not enjoying things you used to
Changes in appetite, leading to weight loss or gain
Thoughts of suicide, trying to commit suicide, or urges to do so. If you or someone you know is having thoughts like this, please reach out to the 988 Suicide & Crisis Lifeline or chat at 988lifeline.org.

Depressive symptoms can be mild or severe. If they’re mild, you might still be able to do daily tasks, just not at your best. But with severe symptoms, it can be hard to do anything, like work, chores, social stuff, or even taking care of yourself.

What causes major depressive disorder?

Major depressive disorder is a tricky mental illness with lots of possible causes. The National Centers for Disease Control and Prevention say clinical depression can come from one or a mix of these:

Brain Chemistry: When brain chemicals like dopamine and serotonin are out of whack.
Genetics: If depression or other mental illnesses run in your family, or if you’ve had another mental health diagnosis.
Biology: Small physical differences in the brain.
Hormones: Hormone shifts during pregnancy or from things like birth control.
Personality: Certain traits, like being prone to worry, might make you more likely to get depression or other mental illnesses.

Some other things that aren’t about biology can also raise your risk of MDD:

Drug or alcohol problems
Low self-esteem
Stressful or upsetting life events, like abuse or neglect
Certain medications
Being judged or treated unfairly because of who you are, like being LGBTQ+
Living with a medical condition
Ongoing stress
Grief after losing someone

The Centers for Disease Control and Prevention say about one in six adults will deal with depression at some point. In the U.S., 16 million adults get diagnosed each year.

How do doctors diagnose major depressive disorder?

To get an MDD diagnosis, talk to your doctor or a healthcare professional. Your doctor might do a physical checkup first to make sure your symptoms aren’t caused by another medical problem.

Psychological evaluation

Once physical causes are ruled out, your doctor might send you to a mental health professional for a psychological evaluation. This usually involves talking about your symptoms and behaviors, and you might fill out a questionnaire. If mental illness runs in your family, your therapist or psychiatrist might ask about those diagnoses.

Diagnosis based on the DSM-5

After gathering all the details, the mental healthcare professional might give you a diagnosis based on the rules in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). You need to have five or more depressive symptoms for at least two weeks to be diagnosed with MDD.

What is MDD with psychotic features?

Depending on your situation and symptoms, you might get diagnosed with a specific type of depression called MDD with psychotic features, also known as psychotic depression. This can make someone lose touch with reality, sometimes leading to things like seeing or hearing things that aren’t there, having strange beliefs, or mixed-up thoughts.

It’s really important to get emergency medical help if someone has psychotic depression because it’s a condition that needs close monitoring by a professional.

With psychotic depression, severe depressive symptoms can happen alongside psychotic ones, like losing touch with reality. Besides seeing or hearing things, someone might also experience:

Obsessing over being sick (hypochondria)
Not being able to sleep
Being unable to move physically
Feeling anxious or agitated
Wanting to harm themselves or others

Two types of major depressive disorder with psychotic features

MDD with psychotic features comes in two forms:

Mood-congruent psychotic features: Here, the strange visions or thoughts someone has are tied to depressing themes. For example, they might involve guilt, feeling worthless, or thinking a lot about death.
Mood-incongruent psychotic features: In this case, the unusual thoughts or visions aren’t related to the person’s mood and might even go against their depressive feelings. The symptoms here can overlap with schizophrenia, and it can be much harder to recover from.

When someone has delusions, they might truly believe what they’re seeing or hearing and could try to hurt themselves or do something dangerous or impossible. That’s why getting help right away and sticking to a treatment plan is so important.

We don’t really know why some people get psychosis, but genetics and a family history of mental illness might play a role. Stress can also cause chemical imbalances in the brain. Things like exercise, meditation, and therapy can help manage stress and prevent these imbalances.

How to treat major depression

There are several proven ways to treat MDD, including therapy, medicine, and electroconvulsive therapy (ECT).

Therapy

Many types of therapy are used for MDD, like cognitive behavioral therapy (CBT), interpersonal therapy (IPT), and mindfulness-based cognitive therapy (MBCT). CBT, for instance, looks at how your thoughts, feelings, and actions are connected. Through CBT, you can learn how negative thinking patterns feed your depressive symptoms.

Antidepressant Medication

Many different medicines can help with a low mood. Common ones include selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs). MDD is thought to happen partly because of changes in the brain’s structure and how it works. Antidepressants can help fix these by changing the levels of certain brain chemicals (like serotonin, dopamine) that help control mood and motivation. Always talk to a healthcare professional before starting or stopping any medication. They can tell you how well it works, what side effects to expect, and how long you might need to take it.

Brain stimulation therapies

If other methods aren’t helping your depression, a healthcare professional might suggest brain stimulation therapies, which are used for depression that doesn’t respond to typical treatments. Transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT) are two such options. These therapies ease depressive symptoms by using electrical currents to activate certain parts of the brain. Studies show that TMS and ECT can really help reduce symptoms of hard-to-treat depression.

Depression treatment often works really well, though it might take six weeks or more to see changes. Still, some people find it hard to get help because they feel ashamed, or because there aren’t enough resources, trained doctors, or care available.

If left untreated, depression can lead to other serious problems, like physical health issues and trouble keeping up with family and friends, which can make you feel even more alone.

Mental health counseling options

If you’ve been diagnosed with depression, or think you might have it, it’s not your fault. Depression can affect anyone at any point in life, and you can always ask for help. For many, depression is one of the most manageable mental illnesses, and a mix of treatments often helps people feel much better.

The main point

MDD is a serious mental health problem where you feel intense sadness, tired, and lose interest in things for a long time, making it hard to live your daily life. But MDD is treatable, and a combined approach to care often works best. If you’re ready to see how depression treatment can help you, think about talking to a licensed therapist.

Is Major Depressive Disorder (MDD) A Serious Mental Health Condition?