What Is Major Depression Disorder?
Depression can mean a lot of things. When most of us talk about depression, we’re talking about a feeling – an emotion that everyone gets from time to time. While it isn’t comfortable to experience feelings of depression, it’s also not dangerous for most people.
Here, we’ll talk about some of the most common and severe depressive disorders, including symptoms and how to get help, as well as depression NOS. However, “depression” is also a class of mental health disorders. People experiencing these disorders experience feelings and even physical symptoms of depression for inordinate periods that prevent them from living healthy lives.
Common Symptoms
Major Depressive Disorder is its own disorder. However, other major depressive disorders have their own differences in terms of causes, symptoms, and treatments. However, all of these disorders have symptoms that are common to them.
In most of the articles about depression on this site, we’ll point out that these symptoms have to stick around for a while for a diagnosis. While that’s still true in the case of major depressive disorders, specifics like when the symptoms manifest and how long they stick around for can be criteria of specific disorders, so we’ll talk about times when we talk about specific conditions.
Further, few people experience symptoms of depression for the entire time that they have depression. For the most part, symptoms come as “depressive episodes” that can last for as little as a few days at a time or may last for months or years.
Before we get into how these conditions are different, let’s look at the symptoms that are common to all forms of major depressive disorders.
Low Mood, Low Energy
The best-known and most recognizable symptom of depression is the inability to do things. This can be split into low mood and low energy.
Low mood includes feelings of sadness or hopelessness, as well as lack of interest. People with depression may not see the point in meeting obligations like going to work. They may also lose interest in things that they used to enjoy, like socializing and doing hobbies.
However, some people who have depression may want to do things or understand the importance of doing things but not have the physical energy. As we’ll see in a moment, depression comes with physical symptoms too. These can include a lack of energy as well as physical aches and pains that make it difficult to accomplish tasks.
Physical Symptoms
As mentioned above, some people with major depressive disorders experience physical symptoms, including low energy but also including aches and pains. These can include headaches, stomach pains, and even muscle soreness.
Physical symptoms can also include weight loss or weight gain that isn’t explained by other factors.
While we usually associate depression with people staying in bed all day, it’s not always the case. While some people with depression do sleep a lot more, some people with depression have trouble falling asleep or staying asleep, which may contribute to feelings of low energy. This is particularly common in children and adolescents with depression, but it can happen to anyone.
Thoughts Of Suicide and Death
Thoughts of suicide are another well-known symptom of depression, though they are – thankfully – less common.
Older adults experiencing depression may be less likely to experience thoughts of suicide but may instead experience obsessive thoughts of death. While not dangerous on their own like thoughts of suicide can be, thoughts of death should be taken seriously as a symptom of depression.
Major Depressive Disorder
Now that we have a general understanding of general depression let’s get into some of the specific major depressive disorders.
A major depressive disorder is a mental health condition manifesting at least five of the major symptoms of depression for at least two weeks.As mentioned above, “major depressive disorder” is both a classification of depressive disorders and their own specific condition. However, as specific conditions go, it’s not very specific.
Major depressive disorder can be treated with medication, talk therapy, or a combination of the two. While some people choose one or the other depending on their personal preferences, ability to pay through insurance, schedule, and other factors, people who use a combination of both therapies typically see the best response in the shortest time.
Persistent Depressive Disorder
A persistent depressive disorder is similar to major depressive disorder. Still, it involves fewer symptoms with larger gaps in between – but no gap for more than two months – experienced for at least two years. Sometimes, persistent depressive disorder follows major depressive disorder as the individual improves through treatment without seeing complete remission of symptoms.
A persistent depressive disorder is typically treated through the same treatments or combinations of treatments.
Medical Conditions
Some people experience depression as the result of another medical condition, such as those that lead to imbalances of brain chemicals, as some hormonal disorders do.
The treatment of disorder in these cases may depend on the underlying medical condition. The condition or medication for that condition may prevent safe medication of the depressive symptoms. However, talk therapy is always an option.
Mental Health Conditions
Just like mental disorders can be caused or aggravated by physical conditions, major depressive episodes are often caused by more complex mental disorders that also include other symptoms. The most common and familiar examples are seasonal affective disorder and bipolar disorder.
The seasonal affective disorder occurs when a lack of sunlight prevents their body from making enough of a vital messenger molecule. This leads to depressive disorders or an increase in depressive episodes during the winter months. In some people, it also leads to manic episodes in the spring when sunlight is prevalent again, and their bodies must adjust. The seasonal affective disorder can be treated through exposure to an artificial light that replicates sunlight.Once called “manic depression,” bipolar disorder is a mental condition that leads to alternating cycles of depressive episodes and “manic episodes” characterized by high energy, but also sometimes anxiety, lack of focus, and impulsive behavior. Bipolar disorders are typically treated with medication specific to that condition.
Co-Occurring Disorders
Depending on who you talk to, co-occurring disorders, also called comorbid disorders, can mean several things.
The National Alliance on Mental Illness defines co-occurring disorders as a mental disorder experienced at the same time as a substance abuse disorder. This is tragically common as people attempt to relieve the symptoms of their mental health condition by using substances like alcohol and illicit drugs – which in turn worsen their mental health condition.
The Anxiety and Depression Association of America defines co-occurring disorders as two or more mental disorders happening at the same time. In the case of depression, this may include substance abuse but may also include anxiety, eating disorders and body dysmorphic disorders, physical conditions as discussed above, and other conditions.
No matter how you define co-occurring disorders, the complication of treating them is the same: medication used to treat depression cannot aggravate any of the other conditions. It cannot interact with any other drug – prescribed or otherwise – present in the body.
In the case of substance abuse, this means that the individual often undergoes substance abuse counseling and talk therapy until they no longer use the substance and can begin to receive medication for their depression. Of course, talk therapy for their depression is always an option as well.
Finding Help
No matter what you think may be causing your depressive symptoms, the steps for getting help are the same.
Keep A Journal
Keeping a journal can help you to establish a timeline for your symptoms, as well as a more complete list of your symptoms. These can help you narrow down or eliminate potential mental disorders.
If you decide to go to your care provider for a diagnosis, your journal can help you to get a more accurate diagnosis in a shorter amount of time—the more detailed the journal, the better.
Maintain Social Connections
Maintaining social relationships is important in depressive disorders for several reasons. For one thing, it can make depressive disorders less likely in the first place. It also helps when others can point out when you may be approaching a depressive episode.
Relationships With Your Care Provider
Maintaining a relationship with your care provider might be less fun, but it’s just as important.
Maintaining a relationship with your care provider can help you to get an accurate diagnosis in as little time as possible. It’s particularly important if you have a physical health condition or are taking medication that may cause or aggravate depressive disorders.
Know Your Options
A theme in this article has been that how you receive treatment for your depressive disorder depends on the depressive disorder that you have. That’s particularly true when it comes to medication.
However, the other end of the treatment spectrum – talk therapy – is helpful for all kinds of major depression. It’s also helpful for people that don’t have depression – and diagnosis isn’t required to talk therapy.
For most people, seeing a therapist or counselor in person does require a diagnosis in that a diagnosis will help them get their insurance to cover talk therapy.
The Takeaway
Telehealth talk therapy solutions are a time-effective and cost-effective alternative. For more information about how a telehealth talk therapy solution could be right for you or someone you care about, visit BetterHelp.
The sheer number of depressive disorders out there can make having symptoms of depression seem even more hopeless. While we hope that this article gave you some background, the concern over what kind of depressive disorder is causing your symptoms should be more your doctor’s concern than yours. All you need to do is make your symptoms to an expert and follow their advice.
Frequently Asked Questions
What are the 4 types of depression?
These four types of depression are among the most common in the United States.
- Major depressive disorder
- Persistent depressive disorder
- Seasonal affective disorder
- Bipolar disorder
The nation’s institute of mental health also includes postpartum depression and psychotic depression as significant types. Harvard Health adds to these types another – premenstrual dysphoric disorder. Also, instead of postpartum depression, it uses the term perinatal depression to indicate that depressive episodes can happen during pregnancy or during the first year after the baby is born.
What are 4 major causes of depression?
No one knows exactly what causes major depression and most other types included. However, our institute of mental health outlines the four main risk factors that make depression more likely.
- Genetic factors, which show up as a family history of depression or mental illness
- Biological factors, which can be affected by diet, exercise, sleep, medical conditions like heart disease or diabetes, and medications
- Environmental factors, which can include factors from the physical environment, such as chemicals, air, and water pollution, ‘sick building syndrome,’ and natural disasters. Environmental causes can also refer to the social environment of the home or community.
- Psychological factors, such as other mental health problems, a tendency to think negatively, major life changes, stress, or trauma.
What is the biggest cause of depression?
Depression may have many causes, and one single cause doesn’t stand out more than others. The NHS, which is the institute of mental health and health care for the U.K., lists several causes of depression.
- Upsetting life events
- Personality issues, such as being self-critical or having low self-esteem
- Family history of depression
- Childbirth
- Feeling lonely
- Alcohol and substance abuse
- Physical illnesses and injuries
Which symptom is associated with major depression?
No matter what other depression symptoms you have, you have to have one of the two following symptoms to receive a diagnosis of major depressive disorder, according to the Diagnostic and Statistical Manual published by the American Psychiatric Association:
- Depressed mood with sadness, anxiety, or a feeling of emptiness
- Little or no pleasure or interest in hobbies or activities once enjoyed
The institute of mental health adds for following symptoms to the list for clinical depression:
- Pessimism or hopelessness
- Irritability
- Feelings of worthlessness, helplessness, or guilt
- Fatigue or low energy
- Slowed-down movements
- Restlessness
- Trouble remembering, concentrating, or with decisions
- Trouble sleeping, waking early or sleeping too much
- Weight gain or weight loss
- Increased or decreased appetite
- Aches, pains, or digestive issues without a discernible physical cause
- Thoughts of suicide or death, or suicide attempts
What happens in the brain during depression?
In an article on depression, major from the Institute of Mental Health, the authors describe what happens in the brain when you’re depressed. This national institute presents several possibilities but finally says that depression, while in the brain somewhere, may be in many different areas or no area in particular. First, the institute of mental health article says depression may happen in several parts of the brain all at once. In this case, it would be a combination of:
- Abnormality in the brain’s neurons
- Abnormalities in the receptors for neurotransmitters
- Abnormalities in the way signals are sent
Their second suggestion from that national institute is that a separate mechanism creates all these abnormalities in areas of the brain where mood is regulated. This may happen in the monoamine system, which could be an abnormality in the brain stem.
Depression, major, could also be explained by the idea that cognitive abnormalities happen because of abnormalities in the frontal cortex. Or it might be because of inadequate connectivity between the brain’s structures.
Another article from the institute of mental health refutes the theory that changes in the level of the neurotransmitter serotonin are solely responsible for depression. In fact, the entire idea that mental illness happens because of a chemical imbalance in the brain is called into question. One thing is certain, though. When you are depressed, your serotonin and other neurochemicals change.
While the idea of depression, major, being a chemical imbalance is as yet unproven, a former director of the institute of mental health says that researchers at the institute of mental health and elsewhere are still far from fully understanding what happens in the brain during depression. Current research suggests that depression has more to do with faulty circuits in the brain, and the changes in neurotransmitters are simply responding to those faults.
Since researchers at the institute of mental health still aren’t sure exactly what happens in the brain during depression, they study the effects of treatments to try to find out why they work. They explore how antidepressants work and try to see why side effects happen. They attempt to find out why some people have treatment-resistant depression. Treatments like transcranial magnetic stimulation and electroconvulsive therapy (ECT) may help because they affect the circuits in the brain. The current generated in ECT and transcranial magnetic equipment affects the brain because the circuits in the brain carry a type of electricity.
What is critical depression?
Although critical depression is not a formal scientific term, it could be used to describe severe depression with a clear and immediate danger of suicide. In this case, someone with critical depression is someone who needs help and needs it now.
Many researchers do refer to self-critical depression, though. If you tend to be overly critical or disapproving of yourself, you are more likely to have psychiatric disorders, including depression. Major depression, however, seems to happen even more to people who tend to be dependent on others, according to an article from the institute of mental health.
Who is at greatest risk for depression?
In a study published by the institute of mental health, researchers determined that people were at greatest risk for depression if they fit the following descriptions:
- A young adult
- Female
- Widowed, separated, or divorced
- Caucasian
- Poor
- Occasional drinker (vs. nondrinker)
- Family history of mental issues
- Less education
- Living in an area of high unemployment
- Living in an area with no medical clinics
How does depression affect synapse?
Depression is associated with atrophy of neuronal synapses, according to an article from the institute of mental health.
A synapse is a tiny space between two nerve cells. It’s in this space that messages are sent from one neuron to another. These messages are sent via neurotransmitters, such as serotonin, norepinephrine, and dopamine. In depression, the cortical and limbic areas of the brain, including the hippocampus and the prefrontal cortex, decrease in volume. At the same time, the neurons, or nerve cells in the brain, begin to atrophy. In this institute of mental health study, postmortem studies showed that the neurons decreased in size but not in number. The synapses become less dense.
Also, the institute of mental health review showed that stress and depression disrupted the signaling within the synapses. However, the study also showed that antidepressants, such as SSRIs, increased the plasticity of the synapses, allowing them to function better.
What is Anxiety Syndrome?
There are many types of anxiety disorders, and they can occur alongside depression. In the past, some experts have suggested that the next version of the diagnostic and statistical manual should include an entry for organic anxiety syndrome. An institute of mental health article from 1983 suggests that anxiety that originates from a medical condition like hyperthyroidism needs to be included among the disorders DSM manual of mental disorders outlines. Including it will allow researchers to study it and help doctors treat it more easily. The book of disorders, DSM-5, the current version of the American Psychiatric Association manual of mental disorders, does include the same idea, but it’s termed as Anxiety Disorder Due to Another Medical Condition in this statistical manual of mental problems.
Can depression change your personality?
A study reported by the institute of mental health concluded that personality does not change after a major depressive episode. However, more research might reveal personality changes after a severe episode, chronic depression, major recurrent depressive episodes. Currently, personality disorder symptoms are not included in the statistical manual of mental issues from the American Psychiatric Association. However, at some time in the future, the symptoms for mental disorders DSM lists may change as research adds new insights.
What are psychological factors of depression?
An article published by the institute of health listed four psychosocial factors in depression.
- Family history of psychiatric illness
- Loss of a close, nurturing relationship early in life
- Stressful events that happen in life
- Poor social support
Stressful events can include both events that seem positive and events that seem negative. For example, the death of a loved one, being in a car wreck or getting a divorce usually have negative consequences. So, it makes sense that they would make you feel depressed. But some things that may seem positive also increase your stress. Examples include getting a promotion, planning a wedding, or moving to a new city.
What is the result of depression?
The results of depression include everything from the mental to the social to the physical. In other words, depression can affect every aspect of your life. Aside from making you feel miserable, depression, major or otherwise, can disrupt your career, ruin your relationships, and keep you from following the most basic daily routines. Because of the loss of interest, you may abandon all your past hobbies, activities, and goals. It can even end your life – not only by suicide but possibly because you won’t take care of conditions like heart disease.
On the other hand, if you have depression and get treatment, you might have different outcomes. Many treatments are available, but therapy and medications are among the most common. Finding the right medication may take some time. Side effects can be a problem, and many people with depression stop taking medications because the side effects are so severe. But there is an answer. Just talk to your health professional about what’s happening and request a med change. They might change your dose or put you on a different medication altogether. The reference on mental disorders, DSM, gives your doctor information about the side effects of psychiatric medications, and your doctor has also learned about them in school and on their own. They can help you, even in the case of resistant depression that’s hard to treat. Communication is the key!
If you get therapy, ECT, medications, or other treatments, you may learn how to manage your depression like a pro. You can discover and practice new ways of thinking to approach life from a realistic and positive point of view. It’s also important to get good medical health care to keep your body well and healthy. In fact, with the right combination of treatments, you may have better mental wellness than you ever had before.
Is major depression disorder a disability?
It can be. Depression can have such severe and lasting effects that it can impair your ability to work. If so, it can be considered a disability.
How do I know if I’m bipolar?
If you have depression, you might wonder if you have bipolar. After all, bipolar is a mood disorder that includes depressive episodes. The institute of mental health describes the symptoms of bipolar depression, major, and other forms of clinical depression similarly. Symptoms of an episode of depression include:
- Depressed mood
- Lack of interest or pleasure
- Changes in appetite and weight
- Talking or moving slowly
- Trouble with making decisions, concentration, and memory
- Trouble doing simple things
- Feelings of worthless, hopelessness, and helplessness
- Trouble falling asleep, staying asleep, or sleeping too much
- Feeling tired or restless
However, if you have bipolar disorder, you also have hypomanic or manic episodes. According to the institute of mental health, these episodes include symptoms like:
- Elated or irritable mood
- Feeling jumpy or tense
- Needing less sleep
- Loss of appetite
- Talking about many different things
- Racing thoughts
- Thinking you can do many things at once
- Risky behavior
- Feeling important, extremely talented, or all-powerful
What is anhedonia mean?
Anhedonia means loss of interest and pleasure. When you have anhedonia, you don’t enjoy any of the things that usually make you feel happy or engaged. Anhedonia is a symptom of depression – major and other types of mood disorder that include depressive symptoms.
The institute of mental health has started an initiative to create behavioral tasks that can be used to study the loss of interest in anhedonia. As subjects do these tasks, researchers can use neuroimaging. The readouts from these procedures will give them data about what is happening in the brain when you have a loss of interest. Researchers will use the Snaith-Hamilton Pleasure Scale and other tests to measure the anhedonia or loss of interest. This is just one case in which the institute of mental health supports research into mental disorders.