Major Depressive Disorder

The word “depressed” and its multiple variations are thrown around casually in every day conversation. Often, one will say something like “that movie was so depressing.” Sometimes, a person who is feeling blue will describe his mood as depressed, but he does not actually have Clinical Depression. Clinical Depression, also called Major Depressive Disorder, is a serious, severe psychological disorder that affects the everyday lives of many individuals. It is actually quite common as “at least 10% of people in the U.S. will experience Major Depressive Disorder at some point in their lives. Two times as many women as men experience Major Depression.” (Levinson & Nichols, 2013) Major Depressive Disorder has many different causes; it is different for every person. But two of the most common causes are genetics and previous experiences. The disorder is often overlooked as just long-term sadness that will pass eventually. However, there are many more symptoms to the disorder than just plain sadness.

The symptoms associated with Major Depressive Disorder can be very painful, both emotionally and physically. Luckily for those who suffer from MDD, there are many different forms of treatment available. There is a wide variety of psychotherapies available, such as cognitive, behavioral, and interpersonal therapy, as well as many different kinds of antidepressants suited to fit a range of cases. Major Depressive Disorder is a serious mental illness that should be taken seriously –never brushed aside or ignored. The first step to overcoming Major Depressive Disorder is finding the root of the problem, understanding the symptoms, and providing the best possible treatment. If all is done properly and effectively, a person can break free from this detrimental disorder before it breaks him. Often, it is very unclear why an individual develops Major Depressive Disorder.

Through scientific and therapeutic studies, the root of the problem that causes abnormality can be found. Scientific studies have shown that, among the population, one of the most common causes of MDD is genetics. Surprisingly enough, an individual who is affected by depression most likely has another family member who is also affected by it. “If someone has a parent or sibling with major depression, that person probably has a 2 or 3 times greater risk of developing depression compared with the average person.” (Levinson & Nichols, 2013) Often, the development of depression is similar to cancer – a person who does not smoke and takes care of his health develops cancer simply because of his genetics. The other main cause in MDD cases is unrelated psychological factors, or previous life experiences. Most times, but not always, childhood trauma can trigger depression later in life. Scarring experiences such as sexual or physical abuse, parental relationship problems, death of a love one can all causes depression. Discovering what life experience brings a patient to depression is often found during psychotherapy sessions. “Understanding one’s past often puts the depressive problem into a much clearer perspective.” (Robbins, 2009, p. 75) Once the cause is somewhat pinpointed, a therapist can determine an approach that would the patient some peace of mind. However, sometimes the causes of each case of depression are truly hard todetermine. Sometimes it is simply genetics, sometimes it is simply life experiences and sometimes it is both. But once a therapist has some idea of what is going on inside of his patient’s head, the steps towards overcoming MDD can begin. Before treatment can be administered, it is important to consider which symptoms a patient may have.

Despite common belief, sadness is not the only symptom of Major Depression. A person who suffers from MDD will have an extended episode that will last about two weeks, where he will experience sadness as well as a loss of interest in most aspects of life. “The diagnosis of major depressive disorder requires a distinct change of mood, characterized by sadness or irritability and accompanied by at least several psychophysiological changes, such as disturbances in sleep, appetite, or sexual desire; constipation; loss of the ability to experience pleasure in work or with friends; crying; suicidal thoughts; and slowing of speech and action.”(Belmaker & Agam, 2008, p. 57) Symptoms of Major Depressive Disorder affect both the body and the mind. The body slows down, as positivity in the mind drops down. This is an interactive relationship. Depression will change how a patient thinks, which will change how his body acts. Thoughts of suicide are a cognitive issue. Cognitions that lead up to ultimate thoughts of suicide are lack of self-esteem or confidence, thinking poorly about the future, and feeling regret or guilt. These thoughts are the most severe, most characterized and most detrimental symptoms that occur in Major Depressive Disorder. But there is hope for those who suffer from the multiple symptoms MDD brings, thanks to many different treatments available.

There are two effective forms of treatment for Major Depressive Disorder that are most commonly used: medication and psycho-therapy. Antidepressants are often prescribed for those suffering from depression. “The treatment of major depression with antidepressants is a milestone in psychiatry because of their high rate of success.” (Nathan, Gorman & Salkind, 1999, p. 103) There are many different kinds of antidepressants to choose from, with different dosages, chemicals, and purposes. The most common types are tricyclic antidepressants, monoamine oxidase inhibitors, and selective serotonin reuptake inhibitors. (Robbins, 2009, p. 139) The earliest of the three types is tricyclic antidepressants. Popular tricyclic antidepressant brands are Elavil, Tofranil, and many others. Tricyclic antidepressants are just as effective as some of the inhibitors, but its high number of overdoses has made it less prescribed since new forms of antidepressants have become available. (Nathan, Gorman & Salkind, 1999, p. 104) Monoamine oxidase inhibitors are newer to the antidepressant field. An earlier form of this drug was used to regulate and improve the mood levels of patients suffering from Tuberculosis. (Nathan, Gorman & Salkind, 1999, p. 104) After some minor adjustments to the base drug, monoamine oxidase inhibitors such as Nardil and Parnate are used to treat major depression. However, the eating restrictions and severe side effects, such as insomnia and palpitations, have caused it to be an unpopular choice. (Robbins, 2009, p. 141) Selective serotonin reuptake inhibitors are the most preferred choice out of the antidepressant options. Most patients will be prescribed this kind of inhibitor.

The most popular brand names are Prozac, Zoloft, and Celexa. Selective serotonin reuptake inhibitors come with little to no side effects, and have a low overdose death rate. (Nathan, Gorman & Salkind, 1999, p. 104) Antidepressants can cause huge improvements in cases of MDD. However, medication paired with some form of psychotherapy creates the best results. (Robbins, 2009, p. 139) Therapy is used all around the world to treat all different types of mental disorders. Studies have shown that talking and expressing one’s true thoughts has no negative repercussions. In a structured, welcoming environment, it can actually be extremely beneficial. Three commonly used forms of therapy to treat MDD are cognitive, behavior, and interpersonal therapy. Cognitive therapy focuses “on changing the depressed patient’s negative view of the self, the world, and the future.” (Nathan, Gorman & Salkind, 1999, p. 103) This helps quell the detrimental cognitions that affect a patient. In cognitive therapy, a patient is forced to look at his thought process and the abnormal behavior that is caused by it.

Through sessions led by a therapist, a patient will grow to realize his own cognitive errors, and eventually train his mind to think properly and positively. Behavior therapy “focuses largely on improving social and communication skills and on decreasing unpleasant or negative life experiences.” (Nathan, Gorman & Salkin, 1993, p. 106) Unlike cognitive therapy, this form of therapy forces a patient to look at his behavior and decisions, and what impact it has on his life. Sometimes, a therapist will put a patient in some sort of situation or activity, and help him assess the problem and make a reasonable decision. Practice and step by step walkthroughs help a patient through his depressive episodes and can prevent future episodes. Interpersonal therapy “provides an alternative focus to the treatment of depression, moving away from the patient’s psyche and belief systems to his or her interpersonal relationships.” (Robbins, 2009, p. 158) IPT is usually a short-term therapy process that goes on for about three or four months. Interpersonal therapy focuses on social conflicts and interactions that a patient faces, which may lead to stress or negative emotions. Often, an interpersonal dispute can cause a major depressive episode, so evaluating these issues is crucial to the treatment process.

All three of these psychotherapeutic methods have proven successful in cases on Major Depressive Disorder. Once a therapist determines an underlying cause to a patient’s onset, the therapist can determine which therapy will suit the patient best. Major Depressive Disorder cannot be simply defined as “sadness”. Everyone feels sad or gets the blues once in a while, but not everyone has Major Depressive Disorder. However, it is not an uncommon disorder as many people do suffer from it. Major Depressive Disorder is a serious illness that requires a lot of time, attention, and patience to treat. MDD consumes the everyday lives of many different people. Major Depression is not limited to age, race, or geographical location. Anyone with the hereditary depressive gene or a terrible past can develop this mental disorder.

The symptoms that come with Major Depressive Disorder are hard to cope with, as they take over a person’s mind and body. Luckily, scientific and psychological studies have made it easier to treat Major Depressive Disorder and suppress its severe symptoms. Multiple forms of antidepressants are available to treat different cases of MDD. Along with medication, there are three different types of psychotherapy – cognitive, behavior, and interpersonal – that have been proven successful in treating the disorder. Major Depressive Disorder, if untreated, can be fatal. There have been countless reported cases of suicide associated with Major Depression. But there is hope those who suffer from Major Depressive Disorder. Where there is a will, there is a way. The will rests upon the shoulders of the person who is suffering from the disorder; he must step up and ask for help. From there, the process can begin and he will no longer see an empty pit of darkness ahead of him, but see a light at the end of the tunnel.

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