Identifying Major Depression Symptoms

If you experience periods of intense sadness or loss of interest in activities you once enjoyed, and these feelings interfere with life and go on for more than two weeks, you might be experiencing symptoms of a mental illness called major depressive disorder (MDD). This mental illness is also called major depression, unipolar depression, and clinical depression.

Approximately 17.3 million Americans over 18 are diagnosed with MDD each year. In addition, 1.9 million children under age 17 are diagnosed with depression. MDD is strongly linked to other health issues. For example, people diagnosed with MDD have a 64% higher chance of coronary artery disease. Women are at twice the risk for MDD as men, but this mental illness affects people of all genders, ages, races, and demographics. 

For a doctor to diagnose someone with MDD, the symptoms must persist for at least two weeks and lead to impairments in their ability to carry out everyday life activities, such as social, educational, and occupational functioning. Understanding how major depression can impact you can help you receive treatment and reduce the impacts of the symptoms. 

• Ongoing feelings of sadness or hopelessness
• Loss of interest in activities that used to bring pleasure
• Sleep disturbances such as insomnia or excessive sleeping 
• Excessive tiredness and fatigue
• Anger and irritability without an understandable cause
• Changes in appetite causing weight gain or weight loss
• Ongoing anxiety, worry, and rumination
• Difficulty concentrating and recalling information 
• Physical complaints of chronic pain and physical aches such as headaches, muscle aches, or digestive issues
• Slowing of movement, thoughts, and speech 
• Feelings of guilt, self-blame, low self-esteem, or worthlessness
• Suicidal thoughts or urges or suicide attempts*

If you are experiencing suicidal thoughts or urges, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text 988 to talk to someone over SMS. They are available 24/7 to offer support. People with major depressive disorder are at high risk for suicide, so finding professional support can be essential. 

Major Depressive Disorder Specifiers

The most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, the DSM-5, includes two additional specifiers to aid in diagnosing MDD. These include the following: 

• Mixed Features: A MDD diagnosis with this specifier includes manic symptoms that do not meet the description of a full manic episode under bipolar disorder. Manic symptoms include talking rapidly, increased physical or mental energy, or non-standard high levels of self-esteem. 
• Anxious Distress: A MDD diagnosis with a specifier of anxious distress indicates that the person has significant problems with anxiety that need special treatment along with depression.  

For a clinician to diagnose depression, symptoms must cause significant impairment in social, occupational, or other areas of life. In addition, a medical professional must rule out substance use disorders or other medical conditions as a cause of the symptoms.

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources.

Risk Factors For Major Depression

Psychologists believe there are several contributing psychological factors in the development of MDD. These include unresolved grief or anger, chronic health conditions, a family history of depression, alcohol or substance use, and a diagnosis of another mental illness.

Unresolved Grief Or Anger

Although many people experience grief and move through the stages of bereavement without long-term difficulty, some people experience complicated grief.  Complicated grief means the emotions associated with grief are prolonged, and emotional hardships often seem significantly magnified. Unresolved anger can interfere with personal and professional relationships and result in the losing relationships or employment.  These types of losses may increase the risk of depression. 

Chronic Health Conditions

Physical health conditions can contribute to MDD, including cancer, heart disease, and other chronic diseases. Research from the Centers for Disease Control also shows a link between obesity and depression risk, which could cause further physical illness. Therefore, it may be beneficial for anyone experiencing depression symptoms to see their primary care provider to identify or rule out underlying physical or medical condition that could be contributing to depression symptoms.

Family History

Depression is 40% to 50% hereditary. A family history of depression may predispose someone to this mental illness. In families where depression is present, the risk of developing depression or having poorly controlled depression symptoms can increase.

Alcohol Or Substance Use

Alcohol and substance use directly affects the brain regions responsible for a person's reactions to stress. The inability to effectively manage stress or anxiety may increase the risk of depression. Because alcohol abuse and substance use symptoms can imitate symptoms of depression, it can be difficult to diagnose someone engaging in their use. Among individuals with a mood disorder, an estimated 32% have a co-occurring substance use disorder.

Other Mental Health Conditions

Those living with social anxiety disorder, obsessive-compulsive disorder (OCD), and panic disorder are at a higher risk for major depression. In addition, a co-diagnosis with one or more other mental illnesses increases the risk of suicide. If you or a loved one are experiencing suicidal thoughts, reach out for help immediately at the crisis line above. 

Even the most severe cases of depression respond to treatment, and depression is highly treatable. Seeking help as soon as possible can be vital to managing symptoms and promoting physical and emotional well-being. Many people with major depression can benefit from medications, psychotherapy, or a combination of the two. 

Medications

Medications, like selective serotonin reuptake inhibitors, may help an individual to manage depression when symptoms occur. Which medications may be helpful depends on the symptoms you experience and how those symptoms impact daily life. For this reason, discuss medication options with your primary care provider, a psychiatrist, or another qualified mental health care professional. They will be able to provide you with information about medication options, possible side effects, and expected outcomes.

Psychotherapy

Psychotherapy is also called talk therapy. It involves talking with a psychiatrist, psychologist, clinical social worker, counselor, or licensed mental healthcare provider. 

In psychotherapy, during the initial treatment session individuals may learn about the mental health condition affecting them and explore their feelings, thoughts, and behaviors. The therapist then assists them in developing healthy and practical coping skills to manage symptoms and prevent depression. Research indicates that talk therapy for depression is highly effective and as effective as medication but without the potential side effects. 

Does Major Depression Require Hospitalization?

For many people who seek treatment, outpatient treatment methods for depression are effective. However, in some cases, a hospital stay may help get symptoms under control. Hospitalization for MDD often results from an individual's need to recover in a safe and stable environment. In addition, a hospitalization period provides time to experience relief from daily stress or other issues that contribute to depression. If a health care provider prescribes medications that require close monitoring, they may recommend a hospital stay until the person reaches therapeutic levels of the medication. 

Further, preventing suicide is a common reason for hospitalization for major depression. Hospitalization allows time to recover in a safe environment while establishing and implementing a follow-up care plan with a mental health provider.  

Counseling Options 

Although in-person psychotherapy can be highly effective in treating depression, many clients face barriers to receiving care, like cost, location, or availability. Research shows that online talk therapy through platforms like BetterHelp is particularly helpful and cost-effective for people with depression. In addition, it can be much less stressful to talk to an online therapist via video chat sessions, phone calls, emails, or text messaging than traveling to an office for an appointment.