What is Clinical Depression or Major Depression: Exploring its Symptoms and Treatments

Clinical depression, also known as major depression and as the name suggest, is a severe form of depression. Most of us know depression as a state of feeling sad, miserable, irritated, and unhappy. However, it is normal for all of us to experience this state at some point of time in life for some hours or days, especially when a dear one dies or when a divorce gets finalized. If at all these feelings of sadness, frustration, or irritation tend to continuously last almost every day and disrupt one’s daily life for several weeks, it can be clinical depression. In this article, let’s find out what is clinical depression and how it can be treated.

Overview of Major Depressive Disorder (Clinical Depression)

A clinically depressed person often experiences a major depressive episode marked by a prolonged state of sadness, loss of interest in once-loved activities, and difficulty concentrating. It is just not a mental state, but a chronic ailment that disrupts the way people think, feel, and function. If such a major depressive episode tends to occur again and again, the condition of the clinically depressed person can worsen with the thoughts and attempts of suicide. This marks a grave form of the disorder.

Medically, clinical depression refers to a mood disorder that features a depressed mood almost throughout the day, especially in the morning, and lack of interest in social relationships as well as in normal activities, the signs that prevail daily for at least two weeks. In general, the mood of a clinically depressed must indicate a bizarre distraction from normality and that the educational, professional, social, or other important functioning must show a sudden negative impairment. Before we go into the detailed signs of clinical depression, let’s first understand the causes.

Causes of Major Depressive Disorder

Until now, the exact cause that can trigger the major depressive disorder symptoms is not known. In fact, the experts are of the opinion that many events together trigger a major depressive episode. However, there are cases in whom a single factor has led to the illness. Moreover, it has been found that people become depressed because of the lack of right knowledge for understanding the ups and downs of life. Listed below are the various causes of clinical depression.

• Biological: Usually, a clinically depressant tends to have either high levels or low levels of a few brain chemicals that are known as neurotransmitters. Such an imbalance is attributed to major depression.
• Hereditary: If there is a family history of major depression, chances of developing such a depression are high for the new and upcoming generations.
• Cognitive (Mental Behavior): All those who are inclined towards a negative thinking pattern and often have a feeling of low self-esteem are highly prone to develop major depression.
• Concurring Factors: Many a times, it has been observed that clinical depression hits those people who have been already suffering from certain chronic ailments such as cancer, heart disease, hormonal disorders like Thyroid, diabetes, Alzheimer’s disease, and Parkinson’s disease.
• Gender: More than men, women are twice at the risk of developing the major depressive disorder. Although there are no clear reasons, many experts have revealed that the possible reasons are hormonal changes during menstruation, menopause, pregnancy, and childbirth as well as stress due to multiple responsibilities at home and work.
• Medicines: Clinical depression can also hit in form of a side effect of a few medications or sudden withdrawal of them.
• Events: Many times, unexpected or tough events such as death, divorce, a change in living place, gloomy weather during rains and winter, social isolation, financial crisis, and emotional, physical, and mental abuse can unintentionally invite clinical depression.

Likely Victims of Major Depressive Disorder

According to the reports of National Institute of Mental Health (NIMH), in the U.S., the signs of clinical depression are seen in almost 6.7% of the population belonging to the age groups of above 18. However, even teens, kids, and elderly are affected by this type of depression that in most of them remains undiagnosed and untreated. Let’s now find out the symptoms of clinical depression in each of these different age groups.

Major Depressive Disorder Symptoms

Let’s first take a look at the common major depression symptoms that are noticeable during a major depressive episode.

• Feelings of worthlessness for most of the time in a day
• Feelings of unhappiness
• Loss of energy
• Loss of concentration
• Indecisiveness
• No sleeping or excessive sleeping daily
• Reduced interest in almost all activities daily (anhedonia)
• Increased or decreased appetite
• Loss or gain in weight (over 5% of variation in a month)
• Irritability on small to big matters
• Angry outbursts
• Restlessness in form of inability to stand still or fidgeting
• Decelerated body movements accompanied with slow thinking patterns and speech
• Unexplained issues such as headaches and back pain
• Crying spells for no clear reason
• Recurring thoughts of suicide or death

These symptoms of clinical depression vary from one person to another because of the difference in age, gender, family background, and inherited traits. One can conclude that a major depressive episode is marked by some or all of the above symptoms.

Clinical Depression Symptoms in Kids and Teens

In kids and teens, this chronic illness often co-exist with mental as well as behavioral health conditions, such as Attention-Deficit Hyperactivity Disorder (ADHD) or anxiety disorder. So, the symptoms of clinical depression can be different in those below 18. Let’s check them out!

• Sadness marked by constant worry and irritability in kids
• Anxiety, avoiding social interactions, and anger in adolescents and teens
• Variations in thinking and sleep patterns (more in kids)
• Reduced performance in schools

Major Depression Symptoms in Adults and Elderly

It is rare to see a depressed adult, as most adults are quite satisfied. However, this does not mean that major depression cannot occur in them. In fact, many a times, the illness is undiagnosed, as the affected adults are mostly unwilling to seek a major depression treatment. Listed below are the unique symptoms of clinical depression in the elderly, which can co-exist along with the aforementioned general ones.

• Less obvious symptoms such as a general feeling of dissatisfaction, boredom, preference of staying in home always, or being dependent on someone else for even simple chores
• Suicidal thoughts, especially in men

Diagnosis of Major Depressive Disorder

If anybody is depressed for a longer period, it is vital for her/him to see a doctor as soon as possible. It is essential to understand that the major depressive disorder symptoms might not leave on their own. Further, the mental, physical, and emotional wellbeing of a clinically depressed person tend to deteriorate further if major depression is left untreated. Above all, it can even make the affected person to commit suicide. So, it’s better to seek a major depression treatment rather than putting your life at risk.

In case a clinically depressed person is unwilling to seek a treatment for clinical depression, she/he should try talking to the best friend, a health care professional, or to someone in whom she/he can trust. It is better to start by talking to a friend and then consult a health professional like your family care doctor or a psychotherapist. These people are skilled enough to pull you out from depression. They will perform a clinical depression test for diagnosis and will also interrogate about your family as well as personal psychiatric history.

Now, this clinical depression test does not include lab tests such as X-ray and blood test although a blood test can be suggested to detect the presence of other medical conditions such as thyroidism and stroke that might have similar symptoms as that of major depression. In general, such a test will include a physical evaluation, blood test (optional), and psychological evaluation to know your thoughts, feelings, and behavior.

Chief Diagnostic Criteria for Major Depression

• One must meet the criteria mentioned in the DSM or Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association.
• Five or more symptoms must co-exist more than a two-week period, and one of them must be either loss of interest or a depressed mood.
• Symptoms must be grave in nature, must not be the result of drug abuse or a medical condition, and must not be caused by grieving.

Major Depressive Disorder Treatment

The most successful treatment for clinical depression is a combination of lifestyle changes, antidepressant medication, and therapy. The key point here is that the treatment must be taken as soon as possible, or else, it will be harder to treat this illness with the passage of time. As a statement of encouragement, although over 50% patients might not respond to antidepressants initially, 80% of them have high chances of substantial recovery.

Antidepressants

• Rectifying the Balance of the Serotonin and Norepinephrine Neurotransmitters:
  • SSRIs (Selective Serotonin Reuptake Inhibitors) such as Celexa and Prozac
  • SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) such as Pristiq and Cymbalta
• Targeting Other Neurotransmitters (Dopamine): Bupropion and Remeron
• Tricyclic Antidepressants (TCAs) and Monoamine Oxidase Inhibitors (MAOIs) [Least Preferred]:
  • Tofranil
  • Parnate
• Atypical Antipsychotics only in Special Cases:
  • Seroquel
  • Abilify

All these medications have side effects ranging from minor (dizziness) to major (suicidal thoughts). Therefore, kids, teens and women must be constantly monitored for their suicidal behavior during the initial few months after starting the major depressive disorder treatment.

Therapies

• Cognitive Behavioral Therapy: Helps in discarding negative thoughts and in learning problem-solving skills.
• Electroconvulsive therapy (ECT – Shock Therapy): Is the only effective as well as safe major depression treatment for boosting mood and removing suicidal thoughts.
• Light Therapy: Is suggested for dealing with the symptoms during winters only.
• Transcranial Magnetic Stimulation: Uses strong magnetic fields to change the activity in brain, which can be a solution to those who are unresponsive to antidepressants.

Lifestyle Changes

• Have sleep of 8 hours daily.
• Maintaining a stress-free schedule daily.
• Include nutritious vegetables and fruits in diet.
• Exercise daily for 15 minutes.
• Avoid alcohol, drugs, and caffeinated beverages.

We hope that this article on clinical depression (major depression) will be helpful to you.