What is major or clinical depression?
Major depressive disorder (MDD) is a condition characterized by signs and symptoms that interfere with the ability to work, sleep, eat, and enjoy once pleasurable activities. Depression is common and often goes undiagnosed, because, the onset of the first episode of major depression may not be obvious if it is gradual or mild.
According to the DSM-IV – a manual used to diagnose mental health conditions.For a major depressive episode a person must have experienced at least five of the nine symptoms below for the same two weeks or more, for most of the time almost every day, and this is a change from his / her prior level of functioning. One of the symptoms must be either (a) depressed mood, or (b) loss of interest.
a. Depressed mood. For children and adolescents, this may be irritable mood.
b. A significantly reduced level of interest or pleasure in most or all activities.
c. A significant loss or gain of weight (eg, 5% or more change of weight in a month when not dieting). This may also be an increase or decrease in appetite. For children, they may not gain an expected amount of weight.
d. Difficulty falling or staying asleep (insomnia) or sleeping more than usual (hypersomnia).
e. Behavior that is agitated or slowed down. Others should be able to observe this.
f. Feeling fatigued, or diminished energy.
g. Thoughts of worthlessness or extreme guilt (not about being ill).
h. Ability to think, concentrate, or make decisions is reduced.
i. Frequent thoughts of death or suicide (with or without a specific plan), or attempt of suicide.
To be considered major depression:
Your symptoms aren't due to a mixed episode – simultaneous mania and depression that can occur in bipolar disorder
Symptoms must be severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others
Symptoms are not due to the direct effects of something else, such as drug abuse, taking a medication or having a medical condition such as hypothyroidism
Symptoms are not caused by grieving, such as temporary sadness after the loss of a loved one
Treatment
Although major depression is a serious mental disorder that profoundly affects an individual's quality of life. It is highly treatable. Many types of treatment are available. Medications and psychotherapy are very effective for most people. Some studies have shown that antidepressant drug therapy combined with psychotherapy has better results than either therapy alone.
Medications
Medications include:
Selective serotonin re-uptake inhibitors (SSRIs)
Serotonin and norepinephrine reuptake inhibitors (SNRIs)
Norepinephrine and dopamine reuptake inhibitors (NDRIs)
Atypical antidepressants
Tricyclic antidepressants
Monoamine oxidase inhibitors
Psychotherapy
There are several types of psychotherapy that have been shown to be effective for depression including cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT).
Cognitive-behavioral therapy (CBT) helps to identify negative beliefs and behaviors and replace them with healthy, positive ones.
Interpersonal therapy (IPT) focuses on the interpersonal context and on building interpersonal skills.
