July 13, 2024

Major Depression

Major depression, known clinically as “major depressive disorder,” or just “clinical depression,” is a medical condition causing continuing psychological feelings of disinterest and profound sadness.  If left untreated, major depression will often manifest itself by presenting with physiological symptoms as well.

In the United States alone it is estimated that major depression affects over 10 percent of the population, with a greater number of women being affected than men.  Major depressive disorder is one of the leading causes of disability for individuals between the ages of 15 and 44 years of age.  In order for someone to be diagnosed with major depressive disorder at least five clinical symptoms must be present for two weeks or longer.

What is Major Depressive Disorder?

Major depressive disorder not only affects the way people feel, but also the way they think and behave.  Major depression is not simply a case of the blues from experiencing a minor episode of disappointment, but a lasting feeling of hopelessness that often causes people to feel their life is no longer worth living.  Major depression is a chronic physiological condition that requires medical treatment.

Clinical depression is not a psychological weakness and is not a transient condition that a person can just “snap out” of.  Those who suffer from major depression often have trouble functioning in their normally daily activities, develop problems at work, frequently have their sleep patterns disrupted and have trouble interacting with family and friends.

Symptoms of Major Depressive Disorder

Common symptoms for major depression include:

Negative Feelings

Feelings of despair, sadness, unexplained crying or irritability

Loss of Interest

Lack of interest in normal activities and relationships

Change in Sleep Patterns

Suddenly sleeping much more than normal or bouts of insomnia, with maintenance insomnia, waking up in the middle of the night, being most common.

Changes in Eating Behavior

Suddenly eating more or less than normal, accompanied by weight loss or gain, or a loss of interest in favorite foods.

Reduced Libido

Sudden and unexplained reduction of sex drive or a complete loss of interest in sex.

Decreased Energy Levels

Lethargy and/or frequent episodes of tiredness usually accompanied by a need for frequent naps.

Unexplained Physical Symptoms

Suddenly developing headaches, backaches or heaviness in the chest or abdomen, among others.

Thoughts of Death or Suicide

A sudden preoccupation with death or thoughts of suicide

If you have thoughts of suicide please get help immediately.   The Suicide Hotline is available 24/7 in the United States at 1-800-273-8255.  If you are not in the U.S. please contact your doctor or local suicide hotline for assistance.   Treatment is available and can help.

Causes of Major Depressive Disorder

Although each person has different reasons for his or her major depression some of the common causes include:

Traumatic Life Events

Life losses such as the death of a loved one, family member, friend or even a pet can often trigger clinical depression.  In addition, setbacks such as financial difficulties, work or job stress, or relationship issues can also be a major cause of depression.  Events from childhood are also thought to be common triggers for depression in adulthood.

Biological Factors

While there is not a definitive explanation as yet, patients suffering from major depression appear to have lower levels of certain mood enhancing neurotransmitters, such as serotonin, in the brain.

Hormonal Imbalances

Changes in the body’s chemistry from hormone imbalances, such as major changes in thyroid gland function or when women go through menopause can lead to major depression.


Depression does seem to be more common in people with family history of the illness.  However, as yet there is no definitive clinical evidence to support heredity as a major contributing factor for clinical depression and correlative studies have proven inconclusive.

Depressed WomanTreatments for Major Depressive Disorder


Psychological counseling or psychotherapy is the most common form a treatment for major depression.  Counseling provides a support system for patients to talk about their condition and the related concerns in an effort to discover what issues may be responsible for triggering the depression.

Psychological counseling for depression is always done in a one-on-one setting or support group setting with a trained and licensed counselor, psychologist or psychiatrist with at least a master degree in a related field.

Even though counseling is the most effective form of treatment over the long term, psychotherapy can take several months to produce a lasting effect.


Because counseling takes time, prescription drug therapy may be indicated in the short term, to help a patient to return to a normal routine as soon as possible.  Antidepressant medications work through either increasing low levels of mood enhancing neurotransmitters, or by preventing the body from reabsorbing the neurotransmitters already present.  Other medications, such as sleep aids and anti-anxiety medications may also be indicated.


Physical activity is an often overlooked aid in treating major depression.  Moderate exercise naturally increases serotonin levels and release natural endorphins, the body’s natural opiates, both of which elevate mood.

Other Treatments

Shock therapy, known as electroconvulsive therapy (ECT), may be indicated for very severe cases of major depressive disorder — if the patient is not responding to either counseling or medication.  With ECT, paddles are placed on the sides of the head and a very low-voltage electrical current is passed through the brain in an attempt to stimulate neurotransmitters production.  ECT is highly effective, usually providing immediate relief that can last for several weeks.  Similar to ECT, transcranial magnetic stimulation (TMS) uses magnets to produce and electromagnetic field to alter brain chemistry.


There is neither a quick and dirty explanation nor treatment for major depressive disorder; however, depression can be effectively treated.  A combination of factors usually brings on a bout of depression, and it usually requires a combination of treatment and behavior modification to deal with the condition.

The single biggest issue many people face with depression is in accepting that they need help in dealing with the disorder, and not just try to “tough it out” on their own.  Very rarely will severe depression remedy itself; without treatment depression can last for years and take a toll on every aspect of a patient’s life.  Besides seeking treatment, a combination of smaller efforts can lead to larger long-term gains when dealing with depression.

When faced with major depression people should simplify their lives by reducing workload and obligations when they are feeling down and should never try to make important decisions when feeling depressed.  However, depressed people should try to engaging in mood enhancing activities as much as possible, such as working out and visiting or going out with friends.  Writing in a journal can have a positive effect, similarly to therapy, by allowing the patient to express their thought and feelings.

One of the biggest roadblocks many people face when trying to overcome depression is a feeling of isolation.  Depression is a serious illness and having people around to show concern and compassion is a curial step in the recovery process.  A support system of friends and family, working in conjunction with a qualified therapist, is crucial for anyone attempting to overcome depression.


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