Severe depression, also called major depressive disorder, is a debilitating mental illness that profoundly affects a person's life. It may cause a person to lose interest in activities they previously enjoyed and leave them experiencing symptoms of depression, such as prolonged sadness or exhaustion. They may withdraw from loved ones and feel there is nothing they can do to rid themselves of feelings of irritation, worthlessness, and guilt.
The American Psychiatric Association emphasizes the importance of seeking treatment to ensure an accurate diagnosis, as depression can share signs and symptoms with other conditions like bipolar disorder and may be linked to medical conditions, such as heart disease and chronic pain. Addressing the brain chemicals involved and understanding risk factors can help prevent depression and manage its emotional and physical problems, including sleep problems, low self-esteem, weight gain or weight loss, and suicidal thoughts or suicide attempts.
What Is Major Depressive Disorder?
According to the Diagnostic and Statistical Manual for Mental Disorders - 5th Edition (DSM-5), major depressive disorder involves symptoms that persist for at least two consecutive weeks. The main symptoms include irritability or depressed mood, which exist alongside others, such as reduced interest in everyday activities and sleep disturbances.
Major depressive disorder symptoms can cause difficulty functioning in areas like professional and social life. For a person to be diagnosed with this form of depression, their symptoms cannot be related to substance abuse or another medical condition or be better explained by another psychological disorder.
The symptoms of major depressive disorder include:
- A persistent low mood
- Loss of interest or pleasure in daily activities
- Significant weight changes
- Insomnia or hypersomnia (too little or too much sleep)
- Slow speech and impaired movement
- Persistent fatigue or loss of energy
- Feeling worthless or guilty without apparent reason
- Reduced ability to think clearly, focus, and make decisions
- Thoughts of death or suicidal ideation, plans, or attempts*
*If you are experiencing thoughts or urges of suicide or self harm, 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.
Causes Of Depression
It’s believed that environmental and biological forces can combine to cause depression. However, depressive symptoms and treatment for depression can vary from person to person.
What Is Regular Depression?
Those who aren’t experiencing major depressive episode or clinical depression could be experiencing a milder form of depression, referred to as dysthymia or persistent depressive disorder. The symptoms of dysthymia may be similar to those of major depression, but they are often less severe. The symptoms must last for two years or more on most days of the week to be diagnosed. Like major depression, dysthymia is highly treatable.
Getting Treatment For Depression
As depression is a treatable mental health condition, several treatment options exist, and a well-thought-out treatment plan for depression can significantly increase the chances of recovery. It's crucial to seek treatment and take steps to prevent depression when symptoms occur, as addressing emotional and physical problems related to the condition can improve overall well-being.
Many medications can be used in the treatment of depression. The type of medication a doctor prescribes may vary based on the patient’s symptoms, family history, diagnosis of other health conditions, such as bipolar disorder, interactions with other medications, and possible side effects.
Some common pharmacological treatments include:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin and norepinephrine reuptake inhibitors (SNRIs)
- Tricyclic antidepressants (TCIs)
- Norepinephrine and dopamine reuptake inhibitors (NDRIs)
- Monoamine oxidase inhibitors (MAOIs)
Studies have been conducted to measure the effectiveness of pharmacological treatments on major depressive disorder, with many finding that these medications can help reduce symptoms. One review of fourteen studies found that TCIs and SSRIs effectively treat depression in patients under 65.
Other studies suggest that medications are effective in treating this type of depression but that combinations of more than one prescription might double the likelihood of remission.
Psychotherapy is a method of treating mental conditions that could involve speaking with a licensed psychologist, psychiatrist, or another licensed health provider. These professionals often support individuals experiencing major depressive disorder and other mental health conditions using scientifically proven methods, as recommended by the National Institute of Mental Health (NIMH) and the Centers for Disease Control and Prevention (CDC). By engaging in psychotherapy, patients can learn to manage their emotions and develop coping strategies for various life challenges.
The perks of psychotherapy, as opposed to medication, are reduced risk of side effects. Some side effects of medications used to treat depression are nausea, loss of sexual desire, dry mouth, and constipation. These symptoms may cause patients to stop taking their medications, which can be dangerous. Speak to a doctor before starting or stopping any medication.
Additionally, the tools and insights that they gain from therapy can help them learn to cope with daily life. There are several different types of psychotherapy, including the following.
Cognitive Behavioral Therapy
Cognitive-behavioral therapy (CBT) aims to help patients identify and disrupt faulty thinking or patterns of thought that do not serve them. It may also target behaviors that harm the client or those in their life.
While cognitive behavioral therapy may be effective in treating this depression, it may not fit every case. Some studies question its effectiveness in the long term. Other studies have shown that CBT may work better as a tool for recurring patients who have recovered from three or more major depressive episodes but might not be as effective for two or fewer episodes.
Interpersonal therapy is a short-term therapy that focuses on improving the symptoms of mental health conditions by looking at the relationships in a person’s life and helping to resolve interpersonal problems. This therapy was created to treat depression in adults, but it has been proven more effective and is often used to treat depression in teenagers and children.
According to a study by Myrna M. Weissman, Ph.D., and Gerald L. Klerman, MD (2015), interpersonal therapy starts by teaching the patient about depression and informing them that the chances of remission are high.
Patients are advised that therapy can be used alongside medication to help treat depression. The study found that patients who used both medication and therapy had lower drop-out rates in the study.
Nutrition And Exercise
While medication and therapy can play an integral role in treating depression, one way to improve symptoms is through proper diet and exercise. However, diet and exercise are not full treatments for depression. Once a patient with depression is in remission, healthy habits could help manage symptoms alongside treatment.
You might consider a list of the types of foods that may boost mood and improve physical health, including the following:
- Antioxidants to prevent the brain from cell damage (blueberries, carrots, broccoli, nuts and seeds, oranges, strawberries, and tomatoes)
- Healthy carbohydrates, which can help release the calming hormone serotonin (whole grains, fruits, and vegetables)
- Foods that are high in protein to help boost awareness (tuna, chicken, beans, and soy products)
- Foods with vitamin D (tuna or salmon)
- Foods high in mood-boosting selenium (beans and lean meat)
- Omega-3 fatty acids that may target depressive symptoms (walnuts, flaxseed, and green vegetables)
One study found that exercise is almost as effective as pharmacotherapy for treating major depression. In the study, researchers found that 45% of patients assigned to a supervised exercise group, 40% of patients assigned to unsupervised home exercise, and 47% of patients assigned medication went into remission compared to 30% for the placebo group.
Modern Counseling Options
To someone experiencing major depressive disorder, symptoms can make life feel challenging. If you or someone you know is battling depression, know that depression is treatable. In the 21st century, there are many modern treatments available. One such treatment is online counseling.
Studies have found that online mindfulness-based CBT is as effective as traditional in-person therapy for treating symptoms of depressive disorders and anxiety. Additionally, online therapy allows individuals to attend therapy from home on days when they struggle to get out of the house.
If you’re interested in online counseling, services like BetterHelp can be beneficial. Online platforms often offer a database of licensed and trained psychology professionals who offer therapy at more affordable rates than in-person services.
Frequently Asked Questions
What makes a depression severe?
What is the most serious form of depression?
What does severe level of depression mean?
What are the 5 levels of depression?
What happens if depression is not treated?
Is major depression a serious problem?
How does depression affect the brain?
What percent of depression is severe?
Is major depression worse than bipolar?
What is the last level of depression?
Is depression a permanent condition?
What is a severe mental breakdown?
Can depression cause sudden death?
Can depression make you lose memory?
Can long-term depression cause brain damage?
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