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Major Depressive Disorder and Related Conditions

Depression Resources

Everyone has days where they feel blah, down, or sad. Typically, these feelings disappear after a day or two, particularly if circumstances change for the better. People experiencing the temporary "blues" don't feel a sense of crushing hopelessness or helplessness, and are able, for the most part, to continue to engage in regular activities. For people dealing with depressive disorders, negative feelings linger, intensify, and often become crippling. With normal sadness, people are still able to experience pleasure when positive events happen. With depressive disorders, the hopelessness and failure stay even when good things are happening. Other, more intense sorts of symptoms, such as suicidal thoughts and hallucinations (e.g., hearing voices), are also often present. These symptoms suggest that serious varieties of depression may be present, including the subject of this center: Major Depressive Disorder (MDD) or (more informally), Major Depression. Major Depression.

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Fast Facts: Learn! Fast!

What is depression?

  • Major Depressive Disorder is a common yet serious medical condition that affects both the mind and body.
  • It creates physical (body), psychological (mind), and social symptoms.
  • Informally, we often use the term "depression" to describe general sadness. The term Major Depressive Disorder is defined by a formal set of medical criteria which describe symptoms that must be present before the label may be appropriately used.
  • According to the World Health Organization, depression is a common illness worldwide, with an estimated 15% of people affected.
  • Depressive disorders are a leading cause of absenteeism and lost productivity.
  • We also know that people who are depressed cannot simply will themselves to snap out of it. Getting better often requires appropriate treatment.

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What are the symptoms of depression?

  • Symptoms can vary a great deal from one person to the next. Typical symptoms include:
    • Trouble sleeping or sleeping too much
    • Being tired and have no energy
    • A dramatic change in appetite resulting in weight loss or gain
    • Feelings of worthlessness, self-hate, and guilt
    • Inability to concentrate, think clearly, or make decisions
    • Agitation, restlessness, and irritability
    • Inactivity and withdrawal from typical pleasurable activities
    • Feelings of hopelessness and helplessness
    • Thoughts of suicide or death
  • Symptoms can also change over time, such as with someone who is initially withdrawn and sad becoming very frustrated and irritable as a result of decreased sleep and the inability to accomplish simple tasks or make decisions.
  • When depression is severe, people may even experience symptoms, such as hallucinations and delusions.

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What are the causes of depression?

  • The biopsychosocial model says that biological, psychological and social factors are all interlinked causes of depression.
  • Depression has been linked to problems or imbalances in the brain with regard to the neurotransmitters serotonin, norepinephrine, and dopamine.
  • A person who has a parent or sibling with depression is almost three times more likely to develop Major Depression than someone with no history of depression in their parents or siblings, which suggests that genetics play a role in the causes of depression.
  • Long-term stress that lasts for a year or more can affect the body's immune system and lead to an increased risk of developing physical illnesses and an increased likelihood of becoming depressed.
  • Psychological factors influencing depression include negative patterns of thinking, low coping skills, judgment problems, and difficulty in understanding and expressing emotions.
  • Personality factors, history and early experiences; and relationships with others are seen as important factors in causing depression.
  • People can also become depressed as a result of social factors such as: experiencing traumatic situations (a family death, divorce, job loss, abusive relationship, etc.), lack of social support/relationships, or harassment (bullying).

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When should I seek help for depression?

  • If your depressed mood lasts for more than two weeks, or is seriously interfering with your ability to function at work, with your family, and in your social life, you should consult with a mental health professional as soon as possible.
  • If you find yourself thinking seriously about suicide, you should make an appointment with a mental health doctor (a psychiatrist, or psychologist) as soon as you can.
  • If you are feeling like you will commit suicide within hours or days unless you receive some relief, then skip making an appointment with a doctor and go immediately to your local hospital emergency room and tell them there that you are feeling suicidal.

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How is depression diagnosed?

  • The diagnosis process often starts with a visit to a primary care doctor who may ask simple questions about your feelings and experiences.
  • A physical examination, medical history and lab tests will be done to determine if your depression is related to a physical condition.
  • If a physical condition is ruled out, then you should see a mental health professional, such as a psychologist or psychiatrist, who will talk with you to learn more about your current problems and symptoms, as well as to obtain a complete history of previous symptoms, a family history, a history of significant stressful life events, and information concerning your lifestyle, social support, alcohol or drug use, and any suicidal thoughts or tendencies you may be experiencing.
  • In order to compare your symptoms to those of other people in order to determine the severity of your symptoms, you may be asked to complete one or more standardized questionnaire forms.

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How is depression treated?

  • It is important to know that depression is a HIGHLY treatable condition.
  • There is no single therapy that works equally well for every depressed person.
  • Depression is most often treated with a combination of medication and psychotherapy.
  • Antidepressants help with some of the brain chemistry causes of depression. Typically this will include either a SSRI (selective serotonin reuptake inhibitor), such as Prozac, Zoloft, or Paxil, or a SNRI (serotonin norepinephrine reuptake inhibitor), such as Wellbutrin or Effexor.
  • Psychotherapy helps people understand and then change the behavioral, cognitive and social patterns that cause or contribute to the depressed mood.
  • More severe cases of depression may require different and more frequent therapy than milder cases.
  • People with severe depression who may be engaging in self-destructive behavior, such as attempting suicide, refusing to eat, refusing to get out of bed, or may be showing signs of psychotic behavior, such as hallucinations and delusions, may require inpatient hospitalization.
  • People sometimes turn to Complementary and Alternative Medicine (CAM) techniques such as traditional Chinese Medicine, Acupuncture, Homeopathy, and Herbal Therapy for relief from their symptoms. Very few of these approaches have been tested in clinical trials for depression, so there is often little scientific evidence to support these practices.
  • One of the best studied and most famous CAM remedies for depression is St. John's Wort, which is an herbal preparation of a plant extract. Research does support this as a stand-alone alternative treatment for depression and in parts of Europe this herb is often the preferred remedy for treating depression.
  • If you are interested in CAM approaches, the best plan is to consult with a qualified CAM practitioner who can help determine which combination of treatments, and in what dosages, would be most beneficial for you.

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Are there self-help methods for depression?

  • Self-help approaches to treating depression are best thought of as additions to professional treatments.
  • People should not delay treating depression professionally, or attempt to treat it solely on their own.
  • The more that you take an active role in helping yourself recover, the better your chances of recovery are likely to be.
  • It is important to accept your diagnosis and to take the medications and other therapies that have been prescribed for you regularly.
  • Accept invitations to social events and maintain your typical social schedule as best you can even if you are not enjoying it as much as you used to.
  • One way to reduce the amount of stress you experience is to prioritize the demands you are facing and then to do only the most pressing tasks.
  • Talk about what is bothering you with a therapist or with friends or family members. If you don't feel comfortable talking, then keep a journal and vent through writing.
  • Regular physical exercise is thought to have an antidepressant effect.
  • One way to regain a sense of control is to educate yourself about your illness.
  • Choosing to make positive improvements in your sleep, eating, drug and alcohol use, exercise, social and spiritual habits can end up helping you improve your mood.

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News Articles

  • Grip Strength Indicative of Cognition in Major Depression

    For individuals with major depression and bipolar disorder, grip strength is positively associated with cognition, according to a study published online April 18 in JAMA Psychiatry. More...

  • Ketamine Nasal Spray Shows Promise Against Depression, Suicide

    In a small, early study, a nasal spray containing the club drug ketamine appears to quickly help ease depression and even curb thoughts of suicide. More...

  • Telltale Clues That Your Child Is Depressed

    Know what to look for if you suspect your child or teen may be depressed. More...

  • Prenatal Exposure to SSRI Tied to Fetal Brain Development

    Prenatal exposure to a selective serotonin reuptake inhibitor is associated with fetal brain development, according to a study published online April 9 in JAMA Pediatrics. More...

  • Depressive Symptoms Tied to Diabetes Self-Management

    The presence of depressive symptoms can predict improvement in self-efficacy and adherence to diabetes management, according to a study published online March 27 in Diabetes Care. More...

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    • Many Grad Students Struggle With Anxiety, Depression

      Depression and anxiety is nearly seven times more common among graduate students than in the general population, a new study finds. More...

    • IL-6 Levels Predict Response to ECT in Depressive Disorder

      For patients with major depressive disorder, interleukin-6 may predict benefit from electroconvulsive therapy, according to a study published recently in the Journal of Clinical Psychiatry. More...

    • 1 in 20 Younger Women Suffers Major Depression

      Depression is a big problem in women during and after pregnancy, but it's also a concern throughout the reproductive years. More...

    • Heart-Healthy 'DASH' Diet May Also Help Lower Depression Risk

      Eating plenty of vegetables, fruits and whole grains may lower your risk of depression, new research suggests. More...

    • Guidelines Updated for Managing and ID'ing Adolescent Depression

      Clinical practice guidelines have been updated to assist primary care physicians in the screening, treatment, and management of adolescent depression in youth aged 10 to 21 years. The details of the updates are presented in two reports published online Feb. 26 in Pediatrics. More...

    • Antidepressants Do Work, Some Better Than Others: Study

      Antidepressant drugs actually do help ease depression, countering debate over whether the medications do what they're supposed to, a large research review has found. More...

    • Treatment Initiation for Depression Low in Primary Care

      Treatment initiation for depression remains suboptimal in the primary care setting, despite wide availability of effective treatments and increased detection efforts, according to a study published online Feb. 8 in the Journal of General Internal Medicine. More...

    • During 2013 to 2016, 8.1 Percent of U.S. Adults Had Depression

      During 2013 to 2016, 8.1 percent of American adults aged 20 years and older had depression in a given two-week period, according to a February data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics. More...

    • Depression Common in U.S., Women Hit Hardest

      Nearly one in 10 U.S. adults has depression, and the rate is almost twice as high for women as men, health officials say. More...

    • No Proof At-Home 'Cranial Stimulation' Eases Depression

      Devices that send electrical pulses to the brain -- in the comfort of your own home -- are a treatment option for depression and certain other conditions. But a new research review finds little evidence they work. More...

    • Acne Linked to Increased Risk of Major Depressive Disorder

      Acne is associated with increased probability of developing major depressive disorder, with risk highest within one year of diagnosis, according to a research letter published online Feb. 7 in the British Journal of Dermatology. More...

    • Many With Depression Delay, Avoid Treatment

      Only one-third of people newly diagnosed with depression start treatment quickly, and seniors and minorities are the least likely to get help in a timely fashion, a new study finds. More...

    • Talk Therapy May Be Worth It for Teen Depression

      Talk therapy can be a cost-effective way to treat teens with depression who don't take or stop using antidepressants, a new study finds. More...

    • Cognitive Behavioral Therapy Cost-Effective in Depressed Teens

      For adolescents with depression who declined or quickly stopped using antidepressants, a brief cognitive behavioral therapy program is cost-effective, according to a study published online Jan. 19 in Pediatrics. More...

    • Transdermal Estradiol May Help Prevent Depressive Symptoms

      Transdermal estradiol plus intermittent micronized progesterone can prevent clinically significant depressive symptoms among euthymic perimenopausal and early postmenopausal women, according to a study published online Jan. 10 in JAMA Psychiatry. More...

    • Hormone Therapy May Ease Depression Linked to Menopause

      A year of hormone therapy cut the risk of depression symptoms in women going through menopause and early postmenopause, new research shows. More...

    • Esketamine Safe, Effective for Treatment-Resistant Depression

      Esketamine seems to be efficacious and safe for patients with treatment-resistant depression, according to a study published online Dec. 27 in JAMA Psychiatry. More...

    • Feeling Sad? Here's How to Beat the Holiday Blues

      The holiday blues might be a common phenomenon, but there's plenty you can do to protect your mental health this time of year. More...

    • Health Tip: Fight Seasonal Affective Disorder

      Seasonal Affective Disorder (SAD), common in the winter months, is a type of depression triggered by decreased exposure to daylight. More...

    • Simple ECG May Help Distinguish MDD From Bipolar Depression

      Heart rate variability and specific inflammatory biomarkers can differentiate major depressive disorder from depression in bipolar disorder, according to a study published online Oct. 5 in The World Journal of Biological Psychiatry. More...

    • Treatment Trajectories Vary for Children With Depression

      For youths with depression, there are distinct treatment trajectories, which have varying health outcomes, according to a study published online Nov. 20 in JAMA Pediatrics. More...

    • Help for Seasonal Depression

      As many as 20 percent of Americans get the winter blues when days grow shorter. More...

    • Online CBT Program Beneficial for Depression, Anxiety

      For patients with depression and anxiety, online computerized cognitive behavioral therapy (CCBT) provided via a collaborative care program is beneficial, but combining an internet support group with CCBT offers no additional benefit, according to a study published online Nov. 8 in JAMA Psychiatry. More...

    • Locus ID'd That Links Comorbid Alcohol Dependence, Depression

      A newly identified genetic risk variant is associated with comorbid alcohol dependence and major depression in African Americans, according to a study published online Oct. 25 in JAMA Psychiatry. More...

    • Summer Baby, Higher Odds for Postpartum Depression?

      Season of delivery and other factors may influence the risk, study finds. More...

    • More Evidence That Depression Shortens Lives

      And women have been hit even harder than men over past decades, study finds. More...

    • Health Tip: Do You Need Psychological Therapy?

      Behaviors that may be concerning More...

    • Psychosocial Intervention Ups Adherence to Antidepressants

      A psychosocial intervention can improve early adherence to antidepressants among middle-aged and older adults, according to a study published online Sept. 27 in JAMA Psychiatry. More...

    • Cancer Patients May Have Undiagnosed Depression

      Mental health screening at start of and during cancer treatment is vital, study author says. More...

    • Too Many New Mothers Silent on Postpartum Depression

      One in five new mothers who develops postpartum depression or another mood disorder after childbirth suffer in silence, according to a study published online Aug. 1 in the Maternal and Child Health Journal. More...

    • 1 in 5 Moms Mum About Post-Pregnancy Blues

      Strong support networks increase chances a woman will reveal her symptoms, study says. More...

    • Google Search for 'Depression' Now to Provide Screening Test

      Web search giant Google is partnering with the National Alliance on Mental Illness to make depression screening a part of a search for 'depression' on the site. More...

    • Antidepressants Used by 12.7 Percent of Those Age ≥12 in U.S.

      Antidepressant use is common among U.S. individuals aged 12 years and older, with non-Hispanic whites more likely to take antidepressants than other racial/ethnic groups, according to an August data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics. More...

    • U.S. Antidepressant Use Jumps 65 Percent in 15 Years

      Women nearly twice as likely to use the drugs as men, CDC report finds. More...

    • Smoking During Pregnancy Up Among Women With Depression

      Over the past decade, smoking during pregnancy has increased significantly among women experiencing a major depressive episode, according to a study published in the Oct. 1 issue of Drug and Alcohol Dependence. More...

    • Depression After Coronary Artery Disease Diagnosis Ups Death Risk

      For patients with coronary artery disease, a depression diagnosis is associated with increased risk of mortality, according to a study published online July 26 in the European Heart Journal: Quality of Care & Clinical Outcomes. More...

    • Yoga May Help Ease Depression

      It's not a cure-all but has great potential, leader of an American Psychological Association panel says. More...

    • Longer Estrogen Exposure May Protect Against Depression

      Women exposed to estrogen for longer periods of time during the reproductive years may have a lower risk of depression, according to a study published online July 17 in Menopause. More...

    • Estrogen May Influence Women's Depression Risk

      Early menstruation, more frequent periods seem to make sad times less likely, researchers suggest. More...

    • Losing Medicaid Tough on People Battling Depression: Study

      Breaks in coverage result in more ER visits and longer hospital stays, research finds. More...

    • Addition of Aripiprazole Ups Major Depressive Disorder Remission

      For patients with major depressive disorder, augmentation with aripiprazole is associated with an increased likelihood of remission, according to a study published in the July 11 issue of the Journal of the American Medical Association. More...

    • No Sign That Antidepressants in Pregnancy Harm Kids' Brains: Study

      Large Swedish study found no link between mom's use of the drugs and kid's intellectual disability. More...

    • Med Switch Not Always Best Choice With Tough Depression

      Adding an antipsychotic or a second antidepressant may produce better results, researchers say. More...

    • Depression Contributes to Health Decline Seen in Cancer Caregivers

      Depression is known to be linked to worsening physical health, and this may be especially true for cancer caregivers, according to a study published online June 29 in Cancer. More...

    • Depression May Worsen Health for Cancer Caregivers

      Identifying signs early on might help protect these loved ones, study suggests. More...

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