Medical Definition Of Major Depression
- Medical Editor: Charles Patrick Davis, MD, PhD
Reviewed on 3/29/2021
Major depression: A disease with certain characteristic signs and symptoms that interferes with the ability to work, sleep, eat, and enjoy once pleasurable activities.
The characteristic signs and symptoms of major depression include loss of interest in activities that were once interesting or enjoyable, including sex loss of appetite with weight loss or overeating with weight gain loss of emotional expression a persistently sad, anxious or empty mood feelings of hopelessness, pessimism, guilt, worthlessness, or helplessness social withdrawal unusual fatigue, low energy level, a feeling of being slowed down sleep disturbance with insomnia, early-morning awakening, or oversleeping trouble concentrating, remembering, or making decisions unusual restlessness or irritability persistent physical problems such as headaches, digestive disorders, or chronic pain that do not respond to treatment thoughts of death or suicide or suicide attempts. Alcohol or drug abuse may be signs of depression.
Disabling episodes of major depression can occur once or a number of times in a lifetime.
For more information, see Depression.
Treating Major Depressive Disorder
While depression is a serious condition, it can be treated. In fact, between 80% to 90% of people with depression respond well to treatment, and almost all patients get some relief from their symptoms.
Its important to seek treatment for depression as soon as possible, because the earlier it is treated, the more effective the treatment can be. Ignoring the symptoms of depression and leaving it untreated can lead to self-harm or death.
Treatment for depression may involve medication, therapy, or brain stimulation. The treatment modalities chosen can depend on the severity of the depression and your individual needs.
New Tools For Assessing Suicide Risk
The DSM-5 does include new scales for assessing suicide risk: one for adults and one for adolescents. These scales are intended to help clinicians identify suicide risk in patients as they are developing treatment plans.
If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
For more mental health resources, see our National Helpline Database.
The tools are included in the new Section III of the DSM-5 and are intended to better support clinicians in identifying risk factors for suicide as well as scales for assessing suicidal behaviors .
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How Is Major Depression Treated
Major or clinical depression is a serious but treatable illness. Depending on the severity of symptoms, your primary care doctor or a psychiatrist may recommend treatment with an antidepressant medication. They may also suggest psychotherapy, or talk therapy, in which you address your emotional state.
Sometimes, other medications are added to the antidepressant to boost its effectiveness. Certain medicines work better for some people. It may be necessary for your doctor to try different drugs at different doses to determine which medicine works best for you.
There are other treatment options for clinical depression — such as electroconvulsive therapy, also called ECT or shock therapy — that can be used if drugs prove ineffective or symptoms are severe.Ã Other treatments for depression that is difficult to treat include intranasal ketamine or transcranial magnetic stimulation
Treatments For Recurrent Depressive Disorder
As with most other types of depression, the most common and effective treatment includes a combination of medication and psychotherapy while the individual is experiencing an active depressive episode. This treatment may last for months or at least until the symptoms become more manageable. Once the episode of recurrent depression is considered to be in remission, psychotherapy may be stopped, and the affected individual may remain on medication to prevent another occurrence.
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What Is Major Depression
Major depression, also known as unipolar or major depressive disorder , is characterized by a persistent feeling of sadness or a lack of interest in outside stimuli. The unipolar connotes a difference between major depression and , which refers to an oscillating state between depression and mania. Instead, unipolar depression is solely focused on the lows, or the negative emotions and symptoms that you may have experienced.
Fortunately, major depression is well understood in the medical community and is often easily treatable through a combination of medication and talk therapy. Below is a guide to everything from the symptoms and causes of major depression, to statistics and treatment that you can seek from a medical professional if you feel that you need assistance.
What Are The Signs Of Major Depression In Men
Depression in men is significantly underreported. Men who suffer from clinical depression are less likely to seek help or even talk about their experience.
Signs of depression in men may include irritability, anger, or drug and alcohol abuse . Suppressing negative feelings can result in violent behavior directed both inwardly and outwardly. It can also result in an increase in illness, suicide, and homicide.
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Who Is At Risk For Major Depression
Major depression affects about 6.7% of the U.S. population over age 18, according to the National Institute of Mental Health. Overall, between 20% and 25% of adults may suffer an episode of major depression at some point during their lifetime.
Major depression also affects older adults, teens, and children, but frequently goes undiagnosed and untreated in these populations.
Do I Need Health Insurance To Receive This Service
The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.
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What Can I Do If I Have Depression
If you have symptoms of depression, see your healthcare provider. They can give you an accurate diagnosis, refer you to a specialist or suggest treatment options.
If you or someone you know is thinking of hurting themselves or taking their own life:
- Go to the emergency department of your hospital.
- Contact a healthcare provider.
- Speak to a trusted friend, family member or spiritual leader.
A note from Cleveland Clinic
Depression is a common condition that affects millions of Americans every year. Anyone can experience depression even if there doesnt seem to be a reason for it. Causes of depression include difficulties in life, brain chemistry abnormalities, some medications and physical conditions. The good news is that depression is treatable. If you have symptoms of depression, talk to your healthcare provider. The sooner you get help, the sooner you can feel better
Last reviewed by a Cleveland Clinic medical professional on 12/31/2020.
References
How Is Depression Syndrome Diagnosed
Everyone may feel sad or down from time to time. However, clinical depression has more intense symptoms that last two weeks or longer.
To determine whether you have clinical depression, your healthcare provider will ask questions. You may complete a questionnaire and provide a family history. Your healthcare provider may also perform an exam or order lab tests to see if you have another medical condition.
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Deterrence And Patient Education
Patient education has a profound impact on the overall outcome of major depressive disorder. Since MDD is one of the most common psychiatric disorders causing disability worldwide and people in different parts of the world are hesitant to discuss and seek treatment for depression due to the stigma associated with mental illness, educating patients is very crucial for their better understanding of the mental illness and better compliance with the mental health treatment. Family education also plays an important role in the successful treatment of MDD.
Enhancing Healthcare Team Outcomes
An interdisciplinary approach is essential for the effective and successful treatment of MDD. Primary care physicians and psychiatrists, along with nurses, therapists, social workers, and case managers, form an integral part of these collaborated services. In the majority of cases, PCPs are the first providers to whom individuals with MDD present mostly with somatic complaints. Depression screening in primary care settings is very imperative. The regular screening of the patients using depression rating scales such as PHQ-9 can be very helpful in the early diagnosis and intervention, thus improving the overall outcome of MDD. Psychoeducation plays a significant role in improving patient compliance and medication adherence. Recent evidence also supports that lifestyle modification, including moderate exercises, can help to improve mild-to-moderate depression. Suicide screening at each psychiatric visit can be helpful to lower suicide incidence. Since patients with MDD are at increased risk of suicide, close monitoring, and follow up by mental health workers becomes necessary to ensure safety and compliance with mental health treatment. The involvement of families can further add to a better outcome of the overall mental health treatment. Meta-analyses of randomized trials have shown that depression outcomes are superior when using collaborative care as compared with usual care.
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Diagnosis Of Mood Disorders
- In depression: Types of depression
Major depressive disorder is characterized by severe symptoms that disrupt the individuals daily life, typically with effects on appetite, sleep, work, or the ability to enjoy life. Episodes of major depression can occur at any age and may occur once or multiple times in an
- In mental disorder: Major mood disorders
Symptoms of major depressive disorder include a sad or hopeless mood, pessimistic thinking, a loss of enjoyment and interest in ones usual activities and pastimes, reduced energy and vitality, increased fatigue, slowness of thought and action, change of appetite, and disturbed sleep. Depression must be distinguished from
Diagnosis Of Dsm 5 Depression
Diagnosis can only be given by the professionals in the mental health field on the basis of criteria given in DSM-5 for depression.
Following this criteria following summary has been extracted for :
A. The condition of a person needs to be monitored or reported by themselves considering the last 2 weeks, and five or more symptoms are required to be diagnosed with Major Depressive Disorder.
a. Depressed or low mood either reported by the person or observed by others around.
b. Lack of interest in doing any activity at all, or we can call this anhedonia
c. Increase or decrease in body weight
d. Sleep disturbance, either getting overly sleep or not getting sleepy at all
e. Decreased physical or motor activity, restricted oneself to bed or slowed down
f. Overly exhausted, or tired
g. Excessive feelings of remorse or guilt
h. Extremely low self-esteem and self-worth
i. Inability to concentrate or focus on the tasks at hand, as well as unable to make decisions
j. Continuously or excessively experiencing thoughts of death
B. These symptoms are disabling the person to work efficiently in their environment
C. The condition is not because of any medication or substance use
On the basis of the above criteria, mental health practitioners diagnose the client with depression.
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Treatment For Major Depressive Disorder
There are several treatment methods for major depression disorder. These approaches include psychotherapy, antidepressant medications, electroconvulsive treatment , and other somatic therapies. However, ECT is generally avoided, except in extreme circumstances, in favor of both psychotherapy and antidepressants. A medical psychiatrist can provide both psychotherapy services and prescribe antidepressants, which differ for each person based on individual needs.
If you find yourself experiencing any of the symptoms or relating in any way to major depression disorder, you should seek assistance from a medical professional. Thankfully, major depressive disorder has become much less stigmatized in recent years. There is plenty of in-depth information available about depression, and your chosen medical professional is often likely to go through it with you so you can choose the best treatment for your lifestyle.
You should feel as though you have options. You most likely will not have to be burdened by this disease and the negativity that often comes with symptoms of depression. Talking to a counselor and a medical professional is the first step to living a happier, more fulfilling life.
Prevalence Of Major Depressive Episode Among Adults
- Figure 1 shows the past year prevalence of major depressive episode among U.S. adults aged 18 or older in 2019.
- An estimated 19.4 million adults in the United States had at least one major depressive episode. This number represented 7.8% of all U.S. adults.
- The prevalence of major depressive episode was higher among adult females compared to males .
- The prevalence of adults with a major depressive episode was highest among individuals aged 18-25 .
- The prevalence of major depressive episode was highest among those who report having multiple races .
Figure 1
*Persons of Hispanic origin may be of any race all other racial/ethnic groups are non-Hispanic |NH/OPI = Native Hawaiian / Other Pacific Islander | AI/AN = American Indian / Alaskan Native
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How Is Major Depression Diagnosed
A health professional — such as your primary care doctor or a psychiatrist — will perform a thorough medical evaluation. You might receive a screening for depression at a regular doctorââ¬â¢s visit. The professional will ask about your personal and family psychiatric history and ask you questions that screen for the symptoms of major depression.
There is no blood test, X-ray, or other laboratory test that can be used to diagnose major depression. However, your doctor may run blood tests to help detect any other medical problems that have symptoms similar to those of depression. For example, hypothyroidism can cause some of the same symptoms as depression, as can alcohol or drug use and abuse, some medications, and stroke.
What Is Recurrent Depressive Disorder
Recurrent depressive disorder is a type of clinical depression. Rather than having one episode of depression, whether short or long, a person with recurrent depressive disorder will experience additional episodes of depression after periods of time without symptoms.1 These episodes can be considered as mild, moderate, or severe and with or without psychosis, depending on the number of symptoms and how much these symptoms impact an individuals life.
Although not included in the American Psychiatric Associations Diagnostic and Statistical Manual of Mental Disorders , recurrent depressive disorder is listed in the World Health Organizations International Classification of Diseases . This is not a type of bipolar depression. In fact, according to the ICD-11, to be diagnosed with recurrent depressive disorder, the affected individual cannot have a period of increased energy, hypomania, or mania during the time in between depressive episodes.2 The period in between episodes is simply without symptoms of depression.
Those who have had an episode of depression are 50% more likely to have a recurrence.3 Additionally, individuals with recurrent depressive disorder who have had two episodes are 80% more likely to have a third.
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What Does Remission Mean In Depression
Remission is a phase on the path of depression treatment that comes after a major depressive episode.
Whether youre in traditional talk therapy, taking medication, or exploring other avenues of depression treatment, remission of depression is the goal.
Youll typically enter the remission phase when depression symptoms have been reduced, either partially or fully.
This often means the oppressive fog that kept you lethargic, unmotivated, and feeling hopeless has lifted, at least somewhat.
Its a good sign that your treatment plan is working for you and a reminder that major depressive disorder is not a permanent life sentence.
What Does Severe Depression Feel Like
Severe depression is classified as having the symptoms of mild to moderate depression, but the symptoms are severe and noticeable, even to your loved ones.
Episodes of major depression last an average of six months or longer. Sometimes severe depression can go away after a while, but it can also be recurrent for some people.
Diagnosis is especially crucial in severe depression, and it may even be time-sensitive.
Major forms of depression may also cause:
- delusions
- hallucinations
- suicidal thoughts or behaviors
Severe depression requires medical treatment as soon as possible. Your doctor will likely recommend an SSRI and some form of talk therapy.
If youre experiencing suicidal thoughts or behaviors, you should seek immediate medical attention. Call your local emergency services or the National Suicide Prevention Lifeline at 800-273-8255 right away.
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Freud Mourning And Melancholia
Sigmund Freud, the father of psychoanalysis, wrote about depression in his 1917 essay, Mourning and Melancholia. In it, he defined melancholy as built around a sense of loss where the lost object itself is unknown, following the mental process of repression.
Freud stated that depression interferes with the normal mourning process, thereby causing the individual experiencing it to feel a general sense of sadness, believing the anguish and hopelessness they are feeling to be inescapable.
What Causes Mood Disorders
Mood disorders have no single cause, but several risk factors interact to produce the clinical symptoms of the various mood disorders. Individuals with depression and bipolar disorder often find a history of these disorders among immediate family members.Footnote 3 ,Footnote 4 Many different genes may act together and in combination with other factors to cause a mood disorder. Research is getting closer to identifying the specific genes that contribute to depression.
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Also Known As Major Depressive Disorder
Steven Gans, MD, is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
Clinical depression, also called major depression or major depressive disorder , is often confused with having a sad or low mood. Although feeling sad is one symptom of clinical depression, there must be several other signs and symptomsin addition to sadnessfor someone to be formally diagnosed with clinical depression.
Clinical depression is considered a potentially chronic and severe disorder with medical comorbidities and high mortality. Understanding the signs and symptoms of clinical depression are important to ensure someone can receive an accurate diagnosis and treatment.