It is very common for many of us to have a blue day now and then. These minor sad feelings usually pass within a few days, and you are back to your happy self. However, when someone has what is called Major Depressive Disorder, they experience a depressed mood that lasts longer than 2 weeks. They experience symptoms that are severe enough to interfere with their job, family life, and this change in behavior is often noticed by their family and friends.
Symptoms of Major Depressive Disorder (or MDD) include five or more of the following:
1) Depressed mood most of the day, nearly every day. by either subjective report (individual reports that they are feeling empty, sad, or hopeless) or by observation made by people close to them ( family reporting that the patient is tearful, fatigued, or uninterested in usual activities). In adolescents or children often they may display more anger than usual.
2.A diminished interest in most of the activities that they used to enjoy.
3. A change in diet or weight. Either they experience significant weight loss (more than 5% if body weight in a month) when they aren’t trying to lose weight. They may also experience an increase or decrease in appetite.
4. Insomnia ( inability to sleep) or hypersomnia (sleeping a lot – especially during the day) nearly every day.
5. Restlessness or being slowed down.
6. Fatigue or loss of energy nearly every day
7. Feelings of worthlessness or inappropriate guilt, again nearly every day.
8. Problems concentrating, being indecisive.
9. Recurrent thoughts of death. Not just a fear of dying, but recurrent suicidal ideation with or without a specific plan.
I’ve listed out the basic 9 criteria that is outlined by the DSM-V( Diagnostic and Statistical Manual-V) but please remember, many individuals that struggle with MDD don’t experience all 9. According to the DSM-V( the diagnostic manual that is used by all mental health professionals in order to diagnose mental health disorders) only 5 are needed for a diagnosis. And there are several other types of depression that I will write about later.
MDD is believed to be one of the most common mental disorders in the United States. Statistically, women are 70% more likely to experience depression than men, although I have seen many men in my practice struggling with depression. It is the leading cause of disability for Americans aged 15 – 44. According to the CDC, 9% of adults experience feelings of guilt, hopelessness, and end up receiving a diagnosis of depression.
It is believed that depression rates have greatly risen over the past 50 years. Why? Perhaps people now have better access to physicians and mental health professionals to make the diagnosis. With the increase of television advertisements explaining the symptoms of depression and names of medications to treat depressive disorders many individuals realize that what they are feeling is not simply “the blues” but they may be experiencing something that is not “normal”But is treatable. Also, many movie stars and well known individuals are coming out discussing their struggles with mental disorders gives some people “permission” to seek treatment. However, there is still a lot of stigma surrounding mental illness. Many adults remember having family members struggling with depression and hearing someone saying to “pull yourself up by your bootstraps” and get over it.
With the advancement and advertisement of medications as part of the treatment plan for depression, many people feel that all they need to do is go to their GP and get a pill and that will fix everything .Unfortunately, much research suggests that medication alone is not as effective for depression as medication and therapy. In a recent study of 3000 individuals suggests that “A combination of talk therapy and drugs worked best for treatment of Depression and Anxiety. Many GP’s offer the name and number of a therapist when they give a patient a prescription for an antidepressant. But making that call, can be very difficult. And many doctors don’t have the time to follow-up and see if their patient is seeing a mental health therapist.
As a Therapist, I offer both talk therapy or a combination of talk therapy and Mindfulness exercises. If medication is something you are interested in, I can contact your physician or a physician that I have a good relationship with. Some of my patients flatly refuse medication, and as long as they are not threatening to hurt themselves or others, I am more than willing to work with them through different types of therapy to avoid medication.
When you call a therapist ask if they know about psychotropic medications (many mental health therapists did not take classes to learn about medications and prefer to refer you to a psychiatrist). I was lucky to have a Psychiatrist on my Doctoral Committee, which is rare, and I spent years during my 6 years of graduate school learning about medications, how they worked, and which worked better for what. Regardless, before I have a patient get an antidepressant I send them to a doctor to make sure there isn’t a physical reason for their depression such as hyperthyroidism, Fibromyalgia, Hypoglycemia, hormonal disorders and varying other issues that I like to make sure are ruled out.
If any of the symptoms I listed above seem familiar, please feel free to give me a call. Or contact your physician and ask for a physical to make sure you are healthy and there isn’t any other reason for feeling depressed.
But remember, if you are struggling with depression there is no shame in asking for help. You don’t have to tell all your friends or family members if you are afraid they won’t understand. Psychotherapy is confidential, so no one will know unless you share.