Clinical depression (major depressive disorder) (original) (raw)

“Major depressive disorder” is another name for clinical depression. This condition can cause a persistent low mood, sleep disturbances, difficulty focusing, a loss of motivation, and other symptoms.

A person with major depressive disorder (MDD) will experience a persistent low mood for 2 weeks or more and a loss of interest in activities they usually enjoy.

Individual symptoms may include sleep problems, fatigue or loss of energy, appetite changes, and difficulty concentrating.

There are multiple types of depression, including MDD with psychotic features.

There are several types of MDD, each with slightly different symptoms that may occur at certain times in a person’s life.

• Major depression with seasonal pattern: A person may experience this form of depression in the winter months as a result of a lack of sunlight.
• MDD with peripartum onset: According to a 2024 study, up to 18% of women may experience an episode of depression during pregnancy or in the first year after giving birth.
• MDD with psychotic features: A person experiences delusions or hallucinations alongside other symptoms of depression.

To receive a diagnosis of MDD, a person must have had some of the following symptoms every day for at least 2 weeks:

• changes in sleep patterns
• persistent sad or low mood
• changes in appetite
• reduced motivation
• unexplained aches and pains
• suicidal thoughts or actions
• lack of interest in usual activities
• difficulty focusing

Depression symptoms in children and teens

Signs of MDD in children and teenagers are similar to those in adults, but there can be some key differences:

• Preschool-aged children: It is unusual for children this young to receive a diagnosis of depression. However, excessive crying, a lack of interest in playing, and anxiety are signs that a child may be experiencing depression.
• School-aged children: A loss of interest in hobbies, hostility toward others, a short temper, a tendency to get upset easily, and low self-esteem can be signs of depression in children of school age.
• Teenagers: A tendency to feel down all the time, weight changes, drug and alcohol misuse, extreme tiredness, and suicidal thoughts can all be signs of depression in teenagers.

Older adults

For this reason, doctors may find it challenging to diagnose depression in older adults.

A doctor may also use a questionnaire to evaluate a person’s symptoms as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. There are separate questionnaires for children and adults.

Depression may develop over time, or an event or a combination of factors may trigger it. The following sections outline some of the possible causes.

Genetics, biology, and environment

• Genetics: Genetic factors can contribute to clinical depression and other mood disorders. People are more likely to develop depression if members of their family have experienced it.
• Biology: According to a 2021 study, people with depression often have smaller or thinner areas in certain parts of the brain, such as the parts involved in emotions and decision making. These differences in brain structure may increase the risk of developing depression.
• Environment: Environmental factors, such as trauma or a significant loss, may trigger stress, anxiety, and depression in people who have genetic features that increase their risk.

Brain chemistry

Ultimately, more research on this topic is necessary.

Hormones

The risk may be higher:

• during pregnancy and after delivery
• around the menstrual cycle
• around menopause and perimenopause

Medical conditions

According to the American Heart Association, depression can develop after a person experiences a physical health condition such as a stroke or heart attack.

Treating depression may involve lifestyle changes, therapy, medication, or a combination of strategies.

Medication

Depending on the person’s symptoms, a doctor may prescribe:

• antidepressants
• mood stabilizers
• antipsychotics

There are different types of antidepressants. It usually takes 4 to 8 weeks before results start to show.

If a person’s symptoms have not reduced after they have tried at least two types of antidepressant medication, a doctor may prescribe the nasal spray esketamine.

People who use esketamine will usually continue taking an oral antidepressant to maintain the improvement in their symptoms.

Therapy

Psychotherapy is a key strategy for treating depression.

Many types of psychotherapy can help with depression. Examples include cognitive behavioral therapy, which helps people understand how their thinking can affect their behavior and mood, and interpersonal therapy, which aims to help people form strong attachments.

Some people find that depression resolves after a few months of attending psychotherapy, while others need treatment for several years.

Brain stimulation therapy

Options include:

• electroconvulsive therapy
• repetitive transcranial magnetic stimulation
• vagus nerve stimulation

These methods may be helpful for people whose symptoms have not responded to other treatments.

Lifestyle changes

A healthy, active lifestyle may help a person manage depression.

According to a 2024 research review, exercise — especially yoga, jogging, and strength training — is an effective treatment option for depression. The researchers concluded that more intense forms of exercise led to greater improvements.

Many factors increase the risk of depression, including:

• genetic factors
• major life changes
• trauma
• work-related stress and other types of stress
• physical health conditions and recovery
• the use of certain medications
• insulin resistance

A person should seek medical attention if they notice symptoms of depression, such as a low mood that lasts for 2 weeks or more.

For many people, seeking help can feel intimidating. However, depression is a widespread health problem, and a doctor will be able to suggest treatment strategies. Further complications may develop if a person does not receive treatment.

It is not always possible to prevent depression, but if a person knows their triggers and can recognize the start of an episode, they may find it easier to take action.

As soon as a person notices the symptoms of depression, they should seek medical help. Starting treatment early can help prevent depression from becoming severe.

How does major depressive disorder (MDD) affect daily life?

MDD can severely impair a person’s day-to-day life. It can lead to challenges in many areas, including:

• relationships
• work and education
• finances

People with this condition may also have difficulty sleeping and eating.

Can a person recover from major depressive disorder?

MDD affects people differently. With treatment, some people may recover within weeks or months. Others may need treatment for several years.

It can take time to find a treatment plan that works, but many people find that their symptoms respond well to a combination of therapy and medication.

Is major depressive disorder the worst form of depression?

Yes, MDD can be the most severe form of depression, although it can range from mild to severe. Any type of depression can escalate to a severe level if a person does not receive treatment.

Major depressive disorder is one of the most common mental health conditions in the United States. It can have a severe impact on daily life.

Treatment plans may include therapy, medication, and lifestyle strategies.

A doctor can help each person find a strategy that works best for them.