Occasional low moods are a natural part of life, but when those feelings linger and interfere with your daily activities, they could signal something more significant. Clinical depression, also called major depressive disorder (MDD), is a common but serious mental health condition. If you or someone you love is struggling, know that you’re not alone, and help is available.
Understanding Major Depressive Disorder
Major depressive disorder is more than feeling sad. It’s a medical condition affecting how you think, feel, and manage daily life. To be diagnosed with depression, symptoms must last at least two weeks and be severe enough to interfere with your ability to function at home, at work, or in social settings.
MDD vs. PDD & Other Forms of Depression
Major depressive disorder is marked by episodes of intense low mood, fatigue, and physical ailments, lasting at least two weeks at a time. Persistent depressive disorder (PDD) involves less severe symptoms, but they remain constant for at least two years.
Depression vs. Sadness
Sadness typically has a cause or a reason behind the feeling, then dissolves once the situation changes or with time. Depression may or may not have been triggered by an outside cause, but the symptoms of low mood and fatigue are also influenced by dysfunction in brain chemicals.
Recognizing Symptoms of MDD
Symptoms of major depressive disorder can include feelings of worthlessness or hopelessness, changing to sleep and appetite, loss of interest in previously enjoyed activities, and lower energy. For someone to get a diagnosis of clinical depression, they must have at least five symptoms on the list below.
Common symptoms of clinical depression include:1
- Feeling sad, hopeless, or empty most of the time
- Loss of interest in hobbies or activities
- Fatigue or low energy
- Trouble sleeping or sleeping too much
- Changes in appetite or weight
- Feeling worthless or guilty
- Difficulty concentrating or making decisions
- Thoughts of death or suicide
New Directions Mental Health is dedicated to supporting your mental health. If you are experiencing suicidal thoughts, we encourage you to reach out for immediate support through your local crisis services by dialing 988, contacting your local emergency services, or visiting your local emergency room.
Signs of Clinical Depression in Children
Symptoms of major depression are similar in children, with changes to mood, sleep, appetite, and motivation being common. However, some children may not have the vocabulary to explain how they’re feeling, and they may report physical ailments like an upset stomach or headache.
Signs of depression in children could include:
- Consistent low mood, sadness, or irritability
- Being more tired than usual, perhaps putting less effort into school or home activities
- Low self-esteem, saying things like, “I’m not good enough” or “No one likes me”
- Changes to sleeping habits, either sleeping too much or not sleeping through the night
- An increase in aches and pains, maybe reporting stomach aches, headaches, or other physical concerns
What Can Cause Clinical Depression?
There’s no single cause of clinical depression. Instead, it often results from a mix of factors:
- Genetics: Depression has a genetic component, meaning that if an immediate family member has depression, the chances of development are higher
- Biology: Changes in neurotransmitter production or hormone levels may play a role
- Life events: Stressful situations like job loss, divorce, or trauma can be triggers for people who already have other risk factors
- Medical conditions: Some health issues or medications can lead to depressive symptoms
Getting an MDD Diagnosis
A mental health professional like a therapist or psychiatric provider can assess your symptoms and offer a diagnosis of clinical depression when appropriate, as can a medical doctor. A clinician will talk with you about what you’re experiencing, as well as your medical and family history, to determine whether you have MDD or a different concern.
To receive a diagnosis of major depressive disorder, you must have at least five of the symptoms listed above for a minimum of two weeks.
Other Specifiers That Could Be Added to an MDD Diagnosis
A clinician may add other terms onto your diagnosis if they notice any specifics that may influence your care or describe certain symptoms. These qualifiers are not abnormal, they may just describe certain elements of your situation to provide more details.
Specifiers that may be added to a depression diagnosis could be:
- Seasonal pattern: Commonly called seasonal affective disorder or seasonal depression, symptoms worsen in one season, usually in the winter, then resolve once things shift
- Peripartum onset: Hormones can play a role in developing depression, which change drastically during pregnancy and postpartum
- Anxious distress: Added to a diagnosis when someone experiences heightened anxiety in addition to their depression symptoms
- Atypical depression: Higher reactivity, increased appetite, sleeping more, and being overly sensitive to criticism and rejection
- Psychotic features: Delusions or hallucinations in addition to typical depression symptoms
Treatment for Major Depressive Disorder
Treating major depressive disorder often involves a combination of therapy and medication. Specialized interventions like TMS or Spravato® may be added to a treatment plan for those who haven’t responded to traditional approaches.
Supportive treatments may include:
- Therapy: Working with a trained therapist to explore emotions, challenging situations, and develop coping strategies
- Psychiatric medication: A psychiatric provider can assess your history and symptoms to determine which medication (and dosage) could ease symptoms
- Spravato® treatment: A fast-acting nasal spray for adults with difficult-to-treat depression, administered in-clinic under provider supervision
- Transcranial magnetic stimulation (TMS): A non-invasive, low-side-effect option that uses magnetic pulses to stimulate parts of the brain involved in mood regulation
How Long Will It Take for Depression Treatment to Work?
How long it takes to start feeling better is extremely subjective, and will depend on your brain chemistry, symptoms, and situation. However, a general timeline is typically 4-6 weeks for medication to take effect. When starting depression therapy, people often start noticing positive changes after a couple of months, starting to integrate the coping techniques they’ve learned and speaking to themselves more kindly. While relief isn’t always immediate, many people find relief early on in therapy by simply having someone to talk to, and hope through the coping skills therapists often share early on.
Note that healing rarely happens in a “straight line.” There will be days when things still feel hard, and it’s likely that your symptoms won’t disappear overnight. However, depression treatment can help you manage your symptoms, regain energy, and get back on track with any goals or tasks that got abandoned during the worst of the depressive episode.
When TMS or Spravato® Might Be Added to Your Treatment Plan
For people who cannot tolerate the side effects of antidepressants or who don’t find relief after trying multiple medications, alternative treatments like TMS or Spravato® could be added to the care plan. You should feel comfortable talking to your providers about what symptoms are still lingering, and they can discuss with you whether an alternative depression treatment could be appropriate.
Call New Directions Mental Health & Find Depression Relief
If you feel overwhelmed, stuck, or hopeless, know that there is a path forward. With the right support, many people living with clinical depression can find relief and reclaim joy in their lives. Whether you’re new to mental health care or looking for new options after trying other treatments, New Directions Mental Health is here to help our neighbors in Pittsburgh, Wexford, and throughout Pennsylvania manage their mental health and live rich, fulfilling lives.
Give us a call today at 724.374.7414 to learn more, or schedule your first appointment today.
Source:
- Major Depression. (2023). National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/major-depression
