Major Depressive Disorder
Depression is a medical condition that affects your mood and ability to function. Most people go through periods of feeling down, but when you’re depressed you feel persistently sad for weeks or months, rather than just a few days.
According to the World Health Organization, it is a common illness worldwide, with an estimated 3.8% of the population affected, including 5.0% among adults and 5.7% among adults older than 60 years. Approximately 280 million people in the world suffer from this disorder
Without treatment, depression can get worse and last longer. Fortunately, treatments can be very effective in improving the symptoms.
Common types of depression
Major depressive disorder (MDD):
The classic type, it is a state where a sad mood is all-consuming that last longer than two weeks and interferes with everyday life.
Persistent depressive disorder (PDD):
this type refers to low mood that has lasted for at least two years but may not reach the intensity of major depression. Many people with this type are able to function day to day, but feel low or joyless much of the time.
Bipolar depression:
People with bipolar disorder have alternating periods of low mood and extremely high-energy (manic) periods. During the low period, they may have depression symptoms such as feeling sad or hopeless or lacking energy.
Psychotic depression:
People with this type have severe depressive symptoms and delusions or hallucinations. Delusions are beliefs in things that are not based in reality, while hallucinations involve seeing, hearing, or feeling touched by things that aren’t actually there.
Depression types unique to women
Although women are at higher risk for general depression, they are also at risk for two different depression types that are influenced by reproductive hormones—perinatal depression and premenstrual dysphoric disorder (PMDD).
Perinatal depression
This type includes major and minor depressive episodes that occur during pregnancy or in the first 12 months after delivery (also known as postpartum depression). Perinatal depression affects up to one in seven women who give birth and can have devastating effects on the women, their infants, and their families.
Premenstrual depression PMDD.
This type is a severe form of premenstrual syndrome, or PMS. Symptoms of premenstrual depression usually begin shortly after ovulation and end once menstruation starts.
Symptoms of depression
- Low mood most of the day, nearly every day.
- Insomnia, early-morning wakefulness, or sleeping too much.
- Loss of interest in things once pleasurable, including sex
- Change of appetite with significant weight loss when not dieting or weight gain.
- A slowing down of thought and a reduction of physical movement.
- Fatigue or loss of energy nearly every day.
- Feelings of guilt, worthlessness, and helplessness.
- Diminished ability to think or concentrate, or indecisiveness, nearly every day.
- Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
Treatment of depression
Although this disorder can be a devastating illness, it often responds to treatment. The key is to get a specific evaluation and treatment plan. After an assessment rules out medical and other possible causes, a patient-centered treatment plans can include any or a combination of the following:
Psychotherapy:
Including cognitive behavioral therapy, family-focused therapy and interpersonal therapy.
Medications:
Including antidepressants, mood stabilizers and antipsychotic medications. Antidepressants can take a few weeks to have an effect. Some antidepressants have side effects, which often improve with time.
Brain stimulation therapies:
Can be tried if psychotherapy and/or medication are not effective. These include electroconvulsive therapy (ECT) for depressive disorder with psychosis or repetitive transcranial magnetic stimulation (rTMS) for severe depression.
Self-help:
Regular exercise, getting enough sleep, and spending time with people you care about can improve the symptoms.
Alternative approaches
Iincluding acupuncture, meditation, faith and nutrition can be part of a comprehensive treatment plan.
This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.