Major depression, also called major depressive disorder (MDD), represents one of the most serious challenges faced by healthcare providers throughout the world.
It is the leading cause of disability in the U.S. for ages 15 to 44. MDD affects approximately 14.8 million – or about 6.7% – of American adults.
While MDD can develop at any age, the average age at onset is 32. It is more prevalent in women than in men, with women between the ages of 18 and 45 comprising the majority of cases.
According to the DSM-5, the American Psychiatric Association’s manual, major depression is characterized by one or more major depressive episodes, each of which lasts at least 2 weeks. The cardinal symptoms of major depressive disorder are depressed mood and loss of interest or pleasure.
Other symptoms can vary enormously. For example, some people with MDD experience insomnia and weight loss, while others gain weight and sleep excessively. Other symptoms of major depression include the following:
- Irritability or frustration, even over small matters
- Reduced sex drive
- Insomnia or excessive sleeping
- Agitation or restlessness – for example, pacing, hand-wringing or an inability to sit still
Slowed thinking, speaking or body movements
- Indecisiveness, distractibility and decreased concentration
- Fatigue, tiredness and loss of energy – even small tasks may seem to require a lot of effort
- Feelings of worthlessness or guilt, fixating on past failures or blaming yourself when things aren’t going right
- Trouble thinking, concentrating, making decisions and remembering things
- Frequent thoughts of death, dying or suicide
- Crying spells for no apparent reason
- Unexplained physical problems, such as back pain or headaches
Treatment for Severe Depressive Syndrome
Another severe depressive syndrome characterized by a constellation of classical signs and symptoms, called MDD-melancholia, is more common among older people. This is a severe form of depression that causes the sufferer to withdraw into isolation.
When someone has this form of depression, nothing seems to make them happy and even the most joyful events in life have little meaning. Some are so impaired that they are unable to dress, shower, or even feed themselves, and may spend entire days alone in bed. In the worst cases, this may cause severe dehydration and malnutrition.
Because of the severity of this type of depression, psychotherapy is generally ineffective. Conventional treatment generally includes immediate suicide assessment, followed by antidepressant medication and sometimes electro convulsive therapy.
About 10 to 15% of patients formerly hospitalized with MDD commit suicide. Of all suicides attributed to depressive disorders, MDD accounts for about 20 to 35%. Research has determined that suicide is more common among those with more severe and/or psychotic symptoms, with late onset, with co-existing mental and addictive disorders. Because the high suicide rate, it’s critical that people with any type of depression seek help immediately from a depression therapist.