What is major depressive disorder?
Major depressive disorder or MDD, is diagnosed when a person suffers from a persistently low or depressed mood, the inability to feel pleasure, decreased interest in pleasurable activities, feelings of guilt or worthlessness, lack of energy, poor concentration, appetite changes, psychomotor retardation (slow thinking or body movements), agitation, sleep disturbances or suicidal thoughts.
A diagnosis will be made when a person suffers from at least five of the above symptoms.
WHO has projected MDD to rank first as the cause of the burden of disease worldwide by 2030.
Major depressive disorder is believed to be caused by multiple factors including biological, genetic, environmental and psychosocial. Initially MDD was believed to be mainly due to chemical imbalances in the brain, especially serotonin, norepinephrine, and dopamine, which is why antidepressants which worked on these receptor inhibitors had some measure of success. However, recent theories indicate that it is associated primarily with more complex neuro systems and circuits which cause the disturbances in the neuro transmitter systems.
What are the categories of depressive disorders?
· Persistent depressive disorder, formerly dysthymia
· Disruptive mood dysregulation disorder
· Premenstrual dysphoric disorder
· Substance/medication induced depressive disorder
· Depressive disorder due to another medical condition
· Unspecified depressive disorder
How does major depressive disorder impact life?
Since depression can affect every aspect of your life, including the way you sleep, eat, mood, memory, concentration, your education, career, relationships and overall health it can lead to losing your job, friends and every family if left untreated.
Anger, irritability, restlessness, aggressiveness, feeling sad, empty and hopeless, reduced sexual desire and impaired sexual performance and all impact your romantic and platonic relationships. You may find people withdraw from you the more you withdraw from them.
Excessive drinking, engaging in high-risk activities, inability to concentrate, decreased levels of productivity, delayed responses during conversations, needing to take many days off work can put your job or career in jeopardy.
Your overall health can be affected by disordered eating, insomnia, excessive sleepiness and inability to sleep through the night, fatigue, headaches, random pains and digestive problems.
All of the above-mentioned symptoms can severely effect your social life and lead you to withdraw further which, in turn, makes the symptoms of depression feel unbearable.
What treatments are available?
Major depressive disorder is most effectively treated with a mixture of medications, psychotherapy, counselling, lifestyle changes, dietary changes and support from friends, family, professionals and the wider community.
It requires patience to find the right medication, therapist and treatment team. Medications include selective serotonin reuptake inhibitors (SSRI’s), serotonin-norepinephrine reuptake inhibitors (SNRIs), atypical antidepressants, tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs).
It can take weeks for the full effect to take hold and sometimes you will need to try several different medications before you find the one that works for you.
Psychotherapy helps you to adjust to a crisis or other current difficulties, identify negative beliefs and behaviours, and replace them with healthy, positive ones, find better coping and problem-solving solutions, identify issues that contribute to your depression, regain a sense of control and satisfaction in life, learn to set realistic goals, and develop the ability to tolerate and accept distress using healthier behaviours.
Hospital or residential treatment can be necessary if your depression is so severe that you are no longer able to properly care for yourself or you’re in immediate danger of harming yourself or someone else.
Other treatment options include electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS).
Our support team can help you in your everyday life to experience a greater quality of life by ensuring you’re eating healthy, nutritious meals, attending appointments, keeping yourself and home clean and hygienic, as well as accessing the community and rebuilding interpersonal skills.
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