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Major Depressive Disorder

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Major Depressive Disorder

When someone says that they're depressed, what exactly does this mean? Do they have major depressive disorder, or are they just feeling sad at that moment because of a breakup or a bad test grade? In this explanation, we will take a look at the difference.

  • We'll go over the causes and other risk factors of depression.
  • We'll look at the DSM-5 criteria of symptoms in order for someone to be diagnosed with depression.
  • We'll review how SSRIs and Cognitive Behavioral Therapy work and why they are effective treatments.

Major Depressive Disorder: Definition

Major depressive disorder is one of the most common mental health disorders. When someone is experiencing symptoms of depression, they have a lower mood and overall negative thoughts about life and themselves. The length of major depressive disorder varies on the person, but it can last anywhere from a couple of months to a year (or longer).

If someone has been experiencing milder symptoms of depression for over two years, they will be diagnosed with persistent depressive disorder.

Major Depressive Disorder vs. Depression

So now that we know what major depressive disorder is, what's the difference between major depressive disorder and depression?

For the most part, nothing! The only real difference between these two terms is when and how they're used.

Major depressive disorder is used to describe people who have been clinically diagnosed (typically used more in a doctor's, therapist's, or psychiatrist's office).

Depression, on the other hand, is the colloquial way to talk about feeling sad. When someone's having a bad day and says they're feeling depressed, this would be an accurate way of using that term. It would probably be an exaggeration, but it would be the correct way to use the term.

Because of these differences, someone with major depressive disorder can say that they have depression, and they would be correct. However, someone cannot say that they have major depressive disorder if they have not been clinically diagnosed with it.

Major Depressive Disorder Causes

Depression is most often diagnosed in people in their 20s and 30s, but symptoms can develop at any age. Women are diagnosed with major depressive disorder more often than men; however, is that statistic due to higher rates of depression in women, or is it due to the stigma around men being emotional and not seeking help as a result?

While clinicians are not sure what the exact cause of major depressive disorder is, they are certain that genetics play a role. Experts think the cause of 40 to 50% of depression is genetics. They know there is a higher risk, but there is still insufficient testing to determine how big that risk is exactly.

Along with genetics, clinicians believe that a change in brain chemistry is also a cause of depression. Once again, the research does not have a sufficient number of studies to fully support this claim. However, some believe that those with depression lack certain neurotransmitters in their brains.

Another potential cause of depression is a hormone imbalance. Some researchers have put forth that estrogen and progesterone changes can be linked to depressive symptoms.

Other risk factors

There are also risk factors that will put someone at a higher risk of developing depression.

Personality

People who think less of themselves, are pessimistic, or struggle with being too hard on themselves tend to have a higher chance of developing major depressive disorder.

Being in the LGBTQ+ Community

Oftentimes, people who are in the LGBTQ+ community are at a higher risk of developing major depressive disorder. This is because they exist in a society where people can be unsupportive of their gender identity or sexual orientation. While some families are extremely supportive of LGBTQ+ family members, other families are not, leading to higher rates of depression.

Stressful Life Events

People who have experienced extremely traumatic life events, such as physical, emotional, or sexual abuse, are at a higher risk of developing major depressive disorder. Additionally, those who experienced the death of a loved one, the loss of a job, or any other jarring life events are also at a higher risk.

Substance Abuse

Those who struggle with addiction will be a higher likelihood of developing depression.

Major Depressive Disorder, Photograph of a woman sitting on a log with a bottle in her hand. behind her is someone hugging her, StudySmarterAlcoholism is a risk factor for depression - rebcenter-moscow, Pixabay.

Major Depressive Disorder Symptoms

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the tool that psychologists, psychiatrists, and doctors use to diagnose varying mental health problems. Since it was first published, there have been updates, with the most current version being the DSM-5 (fifth edition). The DSM-5 outlines the necessary symptoms required in order to be diagnosed with major depression.

Five or more of the following symptoms have to have been present over a two-week period, with at least one of the symptoms being depressed mood or loss of interest/pleasure:

  • Depressed mood for most of the day for nearly every day. This can be reported by the person or by observations made by others.
  • Less or lack of interest or pleasure in most or all activities. This has to last for most of the day for nearly every day. This can be reported by the person or by observations made by others.
  • Significant weight loss without intentionally dieting, or weight gain
  • Insomnia or hypersomnia most days
  • Psychomotor agitation or retardation most days. This has to be observable by others.
  • Feelings of worthlessness or guilt most days
  • Lack of ability to think or focus most days. This can be reported by the person or by observations made by others.
  • Thoughts of death, suicidal ideation, a suicide plan, or a suicide attempt

If you are feeling suicidal, this is the phone number for the National Suicide Prevention Lifeline (able to be called 24/7): 800-273-8255.

Additionally, these symptoms have to be reported as being the cause of impairment to daily aspects of someone's life, and they must be unattributable to another medical condition or the effects of a substance that has been ingested.

Major Depressive Disorder Treatments

As with most mental health disorders, it has been found that a combination of antidepressants and therapy lead to the most improvement in symptoms of depression.

Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective Serotonin Reuptake Inhibitors, also known as SSRIs, are antidepressants that help reduce symptoms of depression. They are one of the most common forms of antidepressants, but do you know they work?

We all have little chemicals in our brains called neurotransmitters. Neurotransmitters are messengers that carry information between two neurons. They make their journey through the synapse, which is the space between the two neurons. Once a neurotransmitter has been released by one neuron into the synapse, the process of reuptake absorbs that neurotransmitter into the other neuron. But what if we don't want the process of reuptake to happen? That is where SSRIs come into play. As you can tell by the name, Selective Serotonin Reuptake Inhibitors, these drugs hinder the process of reuptake, allowing for more of the neurotransmitter to exist in the synapse.

Major Depressive Disorder, An illustration of the reuptake process where the neurotransmitter crosses the synapse to the other neuron, StudySmarterThe neurotransmitters travel from one neuron, through the synapse, to the other neuron, Wikimedia Commons.

If you've heard of the word serotonin, you'll probably know that it is one of the things your brain releases to make you happy. People believe that when someone is depressed, they have lower levels of serotonin than people without depression, leading to the development of SSRIs.

Serotonin is a neurotransmitter. Applying serotonin to the explanation above, when someone takes a Selective Serotonin Reuptake Inhibitor, instead of the serotonin traveling from one neuron to the other, it stays in the synapse. The reuptake process doesn't happen, which causes a build-up of serotonin in the synapse between the two neurons. It is this build-up of serotonin that medical professionals say causes an increase in mood. With more serotonin in our synapses, we must be happier, right?

Yes, for the most part. While SSRIs have been proven to be effective in reducing symptoms of depression, there are still a couple of unanswered questions.

First, why do symptoms not improve until someone has been on SSRIs for a couple of weeks? Studies have shown that there is an immediate increase of serotonin in the synapse after taking an SSRI, but it takes weeks for you to feel an improvement. Does this mean that serotonin is only a component in affecting our mood, rather than the whole explanation?

Additionally, are SSRIs effective for all people diagnosed with major depressive disorder? Studies have shown that SSRIs are effective for people with severe symptoms of depression. However, placebo pills are just as effective as SSRIs in people with milder symptoms of depression.

While SSRIs are most often used for depression, they can also be used to treat generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, phobias, bulimia, and post-traumatic stress disorder.

Therapy

The main form of psychotherapy used to treat people with depression is cognitive behavioral therapy (CBT). CBT focuses on your behaviors and attitudes and tries to change your thought and behavioral processes. CBT teaches problem-solving skills, helps the person understand why they react to situations in certain ways, and then works on changing that.

This form of therapy is mainly focused on helping the patient to react differently to stimuli that, in this case, might make the symptoms of depression worse. By changing these patterns of negative thinking and responses, one can better handle the stressors that were causing their depression in the first place.

While CBT treatment is short-term psychotherapy, usually lasting from five to 20 sessions, it is also a type of therapy you can continue once the formal treatment is over. Since you learn how to restructure thoughts and problem-solving skills, you can still employ those tactics in your life even when treatment has concluded.

Major Depressive Disorder - Key takeaways

  • Major depressive disorder, also called depression, is a mental health disorder that negatively impacts someone's mood, thoughts, and life.
  • Causes of depression include genetics, change in brain chemistry, and hormone imbalance. Risk factors are being part of the LGBTQ+ community, traumatic life events, substance abuse, and personality.
  • According to the DSM-5, people need to experience five of their listed symptoms for at least two weeks in order to be diagnosed with depression. Symptoms include lower mood, suicidal ideation, weight loss/gain, and feelings of worthlessness.
  • A combination of medication (SSRIs) and therapy (CBT) is the best treatment for depression.
    • SSRIs stop serotonin from entering a neuron and therefore leave more in the brain.
    • CBT has the person reframe their thinking and reactions to stimuli.

Frequently Asked Questions about Major Depressive Disorder

Major depressive disorder is a mental health disorder when someone experiences continual negative thought and lower mood. 

People are not 100% sure of the causes of major depressive disorder but some possibilities are genetics, change in brain chemistry, and hormone imbalance. Risk factors are sexuality, gender, traumatic life events, substance abuse, and personality. 

Major depressive disorder can last from a couple of months to a year. 

Some of the symptoms of major depressive disorder are lower mood, suicidal ideation, weight loss/gain, and feelings of worthlessness. 

Major depressive disorder is a disability but is oftentimes not recognized as one. 

Final Major Depressive Disorder Quiz

Question

How long does someone have to be experiencing symptoms of depression for in order to be diagnosed?

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Answer

At least two weeks

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Question

What are the two symptoms of depression that the DSM-5 requires at least one to be present in order to be diagnosed?

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Answer

Depressed mood and lack of interest in activities

Show question

Question

What is the exact cause of depression?

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Answer

We don't know! Possible causes are genetics, hormone imbalance, and a change in brain chemistry. 

Show question

Question

Why is being LGBTQIA+ a risk factor for depression?

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Answer

They are not as accepted by their families and society as they should be which can lead to lowered mood and depression

Show question

Question

How long does depression last?

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Answer

Depends on the person but usually from two to three months to around a year

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Question

What is the difference between depression and major depressive disorder?

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Answer

There is none! We tend to use "depression" colloquially, but "major depressive disorder" is the clinical name. 

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Question

How much of a factor does genetics play in the cause of depression?

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Answer

Around 40-50%

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Question

If someone were experiencing depressive symptoms and psychosis, would they be diagnosed with major depressive disorder?

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Answer

Nope! Although there are depressive symptoms, a better explanation for that could be schizophrenia or bipolar I.  

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Question

How do SSRIs work?

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Answer

They force more serotonin to stay in the brain through inhibiting the reuptake process

Show question

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How does CBT work?

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Answer

It helps the person reframe their thinking and behavior when presented with various stimuli. It also teaches coping and problem-solving skills. 

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What is reuptake?

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Answer

The process by which a neurotransmitter enters a different neuron

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Can someone be cured of depression?

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Answer

Yes, eventually symptoms of depression can go away.

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How does major depressive disorder differ from persistent depressive disorder?

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Answer

Major depressive disorder can be diagnosed after two weeks of symptoms; persistent depressive disorder has to be diagnosed after two years of symptoms. Also, persistent depression symptoms are usually milder. 

Show question

Question

Why is serotonin important in the treatment of depression?

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Answer

Serotonin is a neurotransmitter that is partially responsible for good mood so when more serotonin in the brain can lead to a better mood

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Question

Are SSRIs an effective treatment for depression?

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Answer

Yes, if you have severe symptoms. However, it has been found that people with mild symptoms find a placebo just as effective. 

Show question

Question

What is the length of a major depressive disorder?

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Answer

Can vary, but lasts anywhere from 4 months to a year (or longer).

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T/F: Men are diagnosed with Major Depressive Disorder more often than women.

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Answer

False.

Show question

Question

Experts believe that 40/50% of depression is caused by _______.

Show answer

Answer

Genetics

Show question

Question

While there is a lack of evidence, some experts attribute depression to a lack of ____________ in the brain.

Show answer

Answer

Neurotransmitters.

Show question

Question

Changes in these two hormones can be linked to depression:

Show answer

Answer

Progesterone and estrogen

Show question

Question

T/F: People with low self-esteem are more likely to develop depression.

Show answer

Answer

True

Show question

Question

People who have suffered from ________ events such as emotional, physical, or sexual abuse are at a higher risk of developing depression.

Show answer

Answer

traumatic

Show question

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T/F: Someone with depression has more interest in daily activities than someone without.  


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Answer

False

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T/F: Someone suffering from depression may lose or gain weight over a short period of time.

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Answer

True

Show question

Question

What are neurotransmitters?

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Answer

Messengers that carry information between two neurons.

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What does SSRI stand for?

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Answer

Selective Serotonin Reuptake Inhibitors

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What is known as the happiness hormone?

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Answer

Serotonin

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What is the main form of therapy used to treat depression?

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Answer

Cognitive behavioral therapy

Show question

Question

T/F: CBT is a long-term therapy.

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Answer

False.

Show question

Question

CBT sessions are typically anywhere from 5-__ sessions.

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Answer

20

Show question

60%

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