Major Depressive Disorder


What is Major Depressive Disorder?

Major depressive disorder, also referred to as clinical depression, is one of the most common mental health disorders worldwide. Every year, over 5% of the worldwide population suffers from an episode of major depression, and close to 7% of the United States population in a given year will suffer from the disorder.

This prevalent and serious health condition also costs the United States economy billions of dollars per year in lost productivity. People suffering from depression will often miss work, and depression is cited as one of the biggest causes of temporary work disability in the United States.

While the disease is prevalent and serious, major depressive disorder is also highly treatable. Most who seek treatment do not experience a relapse. But if left untreated, major depressive episodes can become more frequent and longer lasting.


For those prone to major depressive disorder, most will experience their first episode sometime in their teenage or young adult years. Parents and school officials are usually the first to notice any depressive changes in their children.


Although there is no known, singular cause of depression, the medical and scientific communities have determined that depression is a conglomerate of different causes. The genetic component is one of the largest determining factors in developing the disorder. Heritability for the disorder is between 40 and 50 percent.

But, environmental influences and inherent personality traits account for the remaining half. Life stressors, traumatic events, and having a negative or perfectionistic personality can all raise the risk of developing depression.

Hormonal factors can also contribute to the development of major depressive disorder. In fact, women are twice as likely to develop major depression than men. Postpartum or post-natal depression is major depressive disorder that develops right before or right after giving birth. It affects up to 15% of mothers and is a highly treatable condition. But if left untreated, it can turn into a very serious condition called postpartum psychosis.

In postpartum psychosis, women experience hallucinations and delusions that can sometimes prove fatal to themselves and others. There are many famous and tragic cases of untreated postpartum psychosis where the mother murdered her children, such as the cases of Andrea Yates and Carol Coronado.

What are the signs and symptoms of major depressive disorder?

Depression affects the individual’s entire well-being. There are physical, emotional, and behavioral symptoms of the disorder. For a diagnosis of major clinical depression, a combination of the following symptoms must be present for up to two weeks.

Physical Symptoms

  • Changes in eating habits—eating too much or too little. Some people will experience a significant increase or decrease in weight without active dieting or increasing their physical activity.
  • Changes in sleep patterns. Some will sleep too much, and others will have trouble falling asleep or staying asleep and may develop insomnia.
  • Fatigue, despite how much the individual sleeps. People who have depression and oversleep with the disorder still feel tired despite how many hours of sleep they get.
  • Slowed movement or speech patterns. Individuals with depression will talk slower, or move slower. Sometimes, they will experience a ‘brain fog’ that makes their thoughts not as coherent and their thoughts may be slowed.
  • Decreased energy, despite how much or how little they rest.
  • Random, unexplainable aches and pains, such as muscle tenderness and joint pain. Depression is considered a ‘whole-body’ disease and will cause random aches and pains with no discernible cause. These are called psychosomatic symptoms in the medical community.
  • Increased risk of infection

Emotional Symptoms

  • Pervasive feelings of sadness, worry, guilt, or shame
  • Irritability
  • Feeling restless
  • Lack of motivation
  • Anhedonia—anhedonia is a lack of pleasure or joy from usually enjoyable activities.
  • Feeling empty or having a blunted emotional affect—some sufferers of depression will feel intense, negative emotions, such as anger or pervasive sadness. But others will experience the opposite effect. They will feel no emotions or extremely dulled emotions. This is called a blunted affect.
  • Rumination. Some sufferers of depression will experience rumination, which is persistent, intractable thoughts. Oftentimes, the thoughts center around feelings of worthlessness, guilt, and hopelessness. Rumination will sometimes lead to suicidal thoughts, ideation, self-harm, and suicide attempts.

Behavioral Symptoms

  • Lashing out at others
  • Crying for no reason or for reasons the person wouldn’t normally find sad or tragic.
  • Missing important events
  • Poor performance at work or in school
  • Forgetting or refusing to participate in self-care and normal hygiene routines
  • Self-harm
  • Self-medicating with drugs and alcohol. For those with depression, sometimes the symptoms can be overwhelming, and they will choose escape with drugs and alcohol.

Dependencies can develop, and up to 25% of people who attend drug rehabilitation programs
also suffer from comorbid clinical depression. Furthermore, an additional 25% of individuals in drug rehab actively experience other mental health conditions, like anxiety and PTSD.

Since depression is a whole-body disease, the symptoms of major depressive disorder are extremely disruptive. For involved family members, work colleagues, and friends, they are also hard to miss. By encouraging the individual to get help and they are not their symptoms, a qualified doctor can make the proper diagnosis and get the individual the help they need.

Without it, untreated depression sufferers can experience the negative repercussions of a major depressive years after the event passes; like when students are preparing for college, or college students need to take and pass mid-term exams. The negative effects of depression can be long-lasting and its effects far-reaching.

What are the treatment options?

Since major depression has a variety of signs and symptoms and is disruptive in many facets of a person’s life, and there is no ‘one cause’ of the disorder, treatment requires different and simultaneous forms. Talk or behavioral therapy in addition to medication is the most effective treatment method for depression sufferers.

The FDA has issued warnings for antidepressant prescriptions given to teenagers and children. Some can increase thoughts of suicide for this age group, but antidepressants are still the best treatment method for all sufferers regardless of age. With careful monitoring from family, doctors, and therapists, teenagers can safely take antidepressants and recover from depression.

Despite the warnings, there are numerous, effective antidepressants on the market that are safe for this high-risk age group.

Talk and behavioral therapy help sufferers to monitor their emotions, develop awareness of their symptoms and triggers, and handle them more effectively.

With antidepressant medications, it typically takes two weeks for sufferers to notice any lessening of symptoms. This is because of the fundamental nature of how brain chemistry and antidepressants interact.

Antidepressants work by increasing certain neurotransmitters in the brain that affect mood, motivation, and energy, and it takes a while for these chemical neurotransmitters to reach therapeutic levels.

Although major depressive disorder is painful and disruptive, with the right treatment, support and help from family, doctors, and therapists, sufferers can go on to make a full and life-long recovery from the disease.