Major Depressive Disorder, Adult

• Relationships.
• Work and school.
• Things you usually like to do.

What are the causes?

The cause of MDD is not known.

What increases the risk?

• Having family members with depression.
• Being female.
• Family problems.
• Alcohol or drug misuse.
• A lot of stress in your life, such as from:
  • Living without basic needs such as food and housing.
  • Being treated poorly because of race, sex, or religion (discrimination).
  • Things that caused you pain as a child, especially if you lost a parent or were abused.
  • Health and mental problems that you have had for a long time.

What are the signs or symptoms?

• Being sad all the time.
• Being grouchy (irritable) all the time.
• Not enjoying the things you usually like.
• Sleeping too much or too little.
• Eating too much or too little.
• Feeling tired.

• Gaining or losing weight, without knowing why.
• Being restless and weak.
• Feeling hopeless, worthless, or guilty.
• Trouble thinking or making decisions.
• Thoughts of hurting yourself or others, or thoughts of ending your life.
• Spending a lot of time alone.
• Being unable to do daily tasks.

• Believe things that are not true.
• Hear, see, taste, or feel things that are not there.
• Have mild depression that lasts for at least 2 years.
• Feel very sad and hopeless.
• Have trouble speaking or moving.
• Feel very sad during some seasons.

How is this treated?

• Talk therapy. This teaches you about thoughts, feelings, and actions and how to change them.
  • This can also help you to talk with others.
  • This can be done with members of your family.
• Medicines.
• Lifestyle changes. You may need to:
  • Limit alcohol use.
  • Stop using drugs, if you use them.
  • Exercise.
  • Get plenty of sleep.
  • Eat healthy.
  • Spend more time outdoors.
• Brain stimulation. This may be done when symptoms are very bad or have not gotten better.

Follow these instructions at home:

Alcohol use

• Do not drink alcohol if:
  • Your health care provider tells you not to drink.
  • You are pregnant, may be pregnant, or are planning to become pregnant.
• If you drink alcohol:
  • Limit how much you use to:
    • 0–1 drink a day for women.
    • 0–2 drinks a day for men.
  • Know how much alcohol is in your drink. In the U.S., one drink equals one 12 oz bottle of beer (355 mL), one 5 oz glass of wine (148 mL), or one 1½ oz glass of hard liquor (44 mL).

Activity

• Exercise as told by your doctor.
• Spend time outdoors.
• Make time to do the things you enjoy.
• Find ways to deal with stress. Try to:
  • Meditate.
  • Do deep breathing.
  • Spend time in nature.
  • Keep a journal.
• Return to your normal activities when your doctor says that it is safe.

General instructions

• Take over-the-counter and prescription medicines only as told by your doctor.
• Talk to your doctor about:
  • Alcohol use. It can affect medicines.
  • Any drug use.
• Eat healthy foods.
• Get a lot of sleep.
• Think about joining a support group. Ask your doctor about that.
• Keep all follow-up visits. Your doctor will need to check on your mood, behavior, and medicines, and change your treatment as needed.

Where to find more information:

• National Alliance on Mental Illness: nami.org
• National Institute of Mental Health: nimh.nih.gov
• American Psychiatric Association: psychiatry.org

Contact a doctor if:

• You feel worse.
• You get new symptoms.

Get help right away if:

• You hurt yourself on purpose (self-harm).
• You have thoughts about hurting yourself or others.
• You see, hear, taste, smell, or feel things that are not there.

• Call 911.
• Call the National Suicide Prevention Lifeline at 1-800-273-8255 or 988. This is open 24 hours a day.
• Text the Crisis Text Line at 741741.