Sadness. Lethargy. Loss of interest in things once previously enjoyed. Social withdrawal. While the majority of people are familiar with these widely-known symptoms of depression, many are not aware that depression has a more specific term: Major depressive disorder, or MDD. And it’s something that’s been diagnosed more and more since the start of the pandemic. Lindsay Henderson, PsyD, is a therapist and Director of Psychological Services at Amwell who says that the pandemic has been challenging for people of all ages, which means that depression can impact everyone between 7 and 97 and even beyond that. As one example, she shares that an April 2022 Mental Health America online screening found that 51% of 11- to 17-year-olds had frequent suicidal ideations nearly every day in a two-week period. “People should be reassured that it’s completely normal to experience these feelings and there are many options for getting help,” Henderson says. “A lot of people go through times where they feel depressed and are struggling. There’s no reason to be ashamed during low periods, and everyone should feel empowered to speak up for themselves and to receive the help they need.” If you’ve already been diagnosed with major depressive disorder and want to learn more, or suspect that you are suffering from depression, read on for helpful information and discover treatment options.
What is major depressive disorder and what are the symptoms?
Dr. Gail Saltz, clinical associate professor of psychiatry at New York Presbyterian Hospital and host of the How Can I Help? podcast says that major depressive disorder is a psychiatric diagnosis as described in the Diagnostic and Statistical Manual of Mental Disorders, or the DSM, the book that professionals use to arrive at diagnoses for their patients. Symptoms can include more than two weeks of daily feelings of sadness, hopelessness, helplessness, worthlessness, anhedonia (loss of ability to take pleasure in previously pleasurable things), loss of energy, lack of concentration, loss of libido, oftentimes what are called neuro vegetative symptoms (loss of appetite, difficulty sleeping, early morning awakening), and either passive suicidal ideation (life isn’t worth living with no actual plan) or active suicidal ideation with plan and intent, as Dr. Saltz describes. Additionally, some people can feel very irritable, numb, agitated, restless, and anxious. Others can have terrible guilt and ruminate on depressing thoughts. “While these symptoms are completely normal experiences from time to time, once they start interfering with daily functions, it might be time to reach out for help,” Henderson says.
Is MDD Different from “Regular” Depression?
While you may think that major depressive disorder sounds a lot more serious than the “regular” depression you’re familiar with, actually—there’s no such thing as “regular” depression. In fact, major depressive disorder is simply the clinical term for depression, or a condition that goes beyond occasional blues. “Regular depression is actually not a concept, diagnosis, or description used in the mental health field, at least by clinical professionals,” Henderson says. “It’s more an example of a clinical term that has evolved to be commonly used in day-to-day descriptions of our moods. In this sense, mental health professionals likely would not consider ‘regular depression’ to be a correct use of the term. Major depressive disorder (MDD), on the other hand, is the most commonly used formal diagnosis for depressive symptoms using the DSM-V, which is the manual clinicians use to assess and diagnose mental disorders.”
How to Get a Diagnosis
Henderson says that professionals can tailor a major depressive disorder diagnosis in multiple ways, using severity, duration, and accompanying symptoms as benchmarks. You can start by speaking with your primary doctor about your potential symptoms of depression, who may refer you to a therapist, psychologist, or psychiatrist to talk further and arrive at a formal diagnosis. You’ll be asked a series of questions that will help the professional as they work toward a diagnosis.
Treatment Options for MDD
If you’re experiencing symptoms of major depressive disorder, all hope isn’t lost, although it may feel that way. There are many treatment options you can explore with a professional. Dr. Saltz says that treatment for MDD can include various forms of psychotherapy, from cognitive behavioral therapy to psychodynamic psychotherapy to interpersonal psychotherapy—it can be helpful to speak with a therapist about which type of therapy will work best for you. “Some patients may even see better results when seeing a therapist virtually, as virtual appointments can be easier to access, fitting better into patients’ busy schedules so they stay on track with their treatment and can help eliminate the stigma associated with seeking treatment,” Henderson notes. Medication can be added to therapy and can be prescribed by your primary doctor or psychiatrist. Dr. Saltz says that thyroid function should also be checked, as a slow thyroid can cause depression and treatment is to replace thyroid hormone. “Medication choice is on a case-by-case basis, and sometimes, the first choice doesn’t work, and you must move to another,” Dr. Saltz says. If medication doesn’t cut it, there are other treatments to try, such as something called transcranial stimulation (TMS), a form of noninvasive brain stimulation that uses magnetic pulses to make depression-causing areas of the brain to function better. You can also make lifestyle changes to lessen symptoms of major depressive disorder. These can include regular physical activity, getting high-quality sleep when you can, eating well, practicing mindfulness and meditation, and reaching out for social connection when you feel able. “It’s important to remember that treatment depends on each individual patient, and what works well for one person may not work well for others,” Henderson says. While it may not feel like it in your darkest moments, major depressive disorder is a treatable illness. Stick with your therapy appointments, lean on friends and family whenever you need to, and give yourself grace as you navigate a tough time in your life. It’s not, and never has been, your fault that you’re going through this. Next up, learn how telehealth can help ease depression symptoms.
Sources
Lindsay Henderson, Psy.D., a therapist and Director of Psychological Services.Dr. Gail Saltz, clinical associate professor of psychiatry at New York Presbyterian Hospital and host of the How Can I Help? podcast.Mental Health America: “Mental Health and COVID-19”
