Major Depressive Disorder, Adult
Major depressive disorder (MDD) is a mental health condition. It may also be called clinical depression or unipolar depression. MDD causes symptoms of sadness, hopelessness, and loss of interest in things. These symptoms last most of the day, almost every day, for 2 weeks. MDD can also cause physical symptoms. It can interfere with relationships and with everyday activities, such as work, school, and activities that are usually pleasant.
MDD may be mild, moderate, or severe. It may be single-episode MDD, which happens once, or recurrent MDD, which may occur multiple times.
What are the causes?
The exact cause of this condition is not known. MDD is most likely caused by a combination of things, which may include:
Your personality traits.
Learned or conditioned behaviors or thoughts or feelings that reinforce negativity.
Any alcohol or substance misuse.
Long-term (chronic) physical or mental health illness.
Going through a traumatic experience or major life changes.
What increases the risk?
The following factors may make someone more likely to develop MDD:
A family history of depression.
Being a woman.
Troubled family relationships.
Abnormally low levels of certain brain chemicals.
Traumatic or painful events in childhood, especially abuse or loss of a parent.
A lot of stress from life experiences, such as poor living conditions or discrimination.
Chronic physical illness or other mental health disorders.
What are the signs or symptoms?
The main symptoms of MDD usually include:
Other symptoms include:
Sleeping or eating too much or too little.
Unexplained weight gain or weight loss.
Tiredness or low energy.
Being agitated, restless, or weak.
Feeling hopeless, worthless, or guilty.
Trouble thinking clearly or making decisions.
Thoughts of suicide or thoughts of harming others.
Isolating oneself or avoiding other people or activities.
Trouble completing tasks, work, or any normal obligations.
Severe symptoms of this condition may include:
Psychotic depression.This may include false beliefs, or delusions. It may also include seeing, hearing, tasting, smelling, or feeling things that are not real (hallucinations).
Chronic depression or persistent depressive disorder. This is low-level depression that lasts for at least 2 years.
Melancholic depression, or feeling extremely sad and hopeless.
Catatonic depression, which includes trouble speaking and trouble moving.
How is this diagnosed?
This condition may be diagnosed based on:
Your symptoms.
Your medical and mental health history. You may be asked questions about your lifestyle, including any drug and alcohol use.
A physical exam.
Blood tests to rule out other conditions.
MDD is confirmed if you have the following symptoms most of the day, nearly every day, in a 2-week period:
How is this treated?
This condition is usually treated by mental health professionals, such as psychologists, psychiatrists, and clinical social workers. You may need more than one type of treatment. Treatment may include:
- Psychotherapy, also called talk therapy or counseling. Types of psychotherapy include:
Cognitive behavioral therapy (CBT). This teaches you to recognize unhealthy feelings, thoughts, and behaviors, and replace them with positive thoughts and actions.
Interpersonal therapy (IPT). This helps you to improve the way you communicate with others or relate to them.
Family therapy. This treatment includes members of your family.
Medicines to treat anxiety and depression. These medicines help to balance the brain chemicals that affect your emotions.
- Lifestyle changes. You may be asked to:
Limit alcohol use and avoid drug use.
Get regular exercise.
Get plenty of sleep.
Make healthy eating choices.
Spend more time outdoors.
Brain stimulation. This may be done if symptoms are very severe and other treatments have not worked. Examples of this treatment are electroconvulsive therapy and transcranial magnetic stimulation.
Follow these instructions at home:
Activity
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Exercise regularly and spend time outdoors.
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Find activities that you enjoy doing, and make time to do them.
- Find healthy ways to manage stress, such as:
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Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
Alcohol and drug use
General instructions
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Take over-the-counter and prescription medicines only as told by your health care provider.
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Eat a healthy diet and get plenty of sleep.
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Consider joining a support group. Your health care provider may be able to recommend one.
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Keep all follow-up visits as told by your health care provider. This is important.
Contact a health care provider if:
If you ever feel like you may hurt yourself or others, or have thoughts about taking your own life, get help right away. Go to your nearest emergency department or:
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Call your local emergency services (911 in the U.S.).
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Call a suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255 or 988 in the U.S. This is open 24 hours a day in the U.S.
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Text the Crisis Text Line at 741741 (in the U.S.).
Summary
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Major depressive disorder (MDD) is a mental health condition. MDD causes symptoms of sadness, hopelessness, and loss of interest in things. These symptoms last most of the day, almost every day, for 2 weeks.
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The symptoms of MDD can interfere with relationships and with everyday activities.
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Treatments and support are available for people who develop MDD. You may need more than one type of treatment.
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Get help right away if you have serious thoughts about hurting yourself or others.
This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.