Major depressive disorder (MDD) is a mental disorder characterized by severe and persistent bad mood, which is accompanied by low self-esteem, loss of interest or pleasure from previously enjoyable activities. The concept of “depression” is used in various cases. It is often used to define this syndrome, but may also be related to other mood disorders or simply to a bad mood. Major depressive disorder adversely affects family life, professional or school life, sleep, eating habits, and general health. In the United States, about 3.4% of people with major depressive disorder commit suicide, and up to 60% of people who committed suicide suffered from depression or another mood disorder.
Other names: clinical depression, major depression, unipolar depression or recurrent depression in case of repeated manifestations. The diagnosis of major depressive disorder is based on the patient’s own experiences, behavior reported by relatives or friends, as well as during the study of the mental state. There is no laboratory testing to determine clinical depression, although doctors usually conduct physical tests that may show similar symptoms.
The most common age of onset of the disorder is the age from 20 to 30 years, a slightly lower probability of its manifestation falls on the range between 30 and 40 years. As a rule, people who are treated with antidepressants, in many cases receive special counseling, in particular, undergo cognitive behavioral therapy (CPT). Medications seem to be effective, but the effect is significant only in cases of extremely severe depression. Hospitalization may be necessary in cases involving self-neglect or a significant risk of harm to yourself or others. A small proportion of patients are treated with electroconvulsive therapy (ECT). Of course, a disorder can vary widely in its manifestations, ranging from a one-time manifestation over a period of several weeks to a disorder that lasts a lifetime, on the basis of major depression. Persons with depression have a shorter lifespan compared to those who do not suffer from depression; this is partly due to greater susceptibility to illness and suicide. It is not clear whether drugs affect suicide risk. Current and former patients may be stigmatized (hanging social labels). The understanding of the nature and causes of depression has been recognized for centuries, although this understanding is incomplete and there are still many aspects of depression that are the subject of discussion and research. The alleged causes are psychological, socio-psychological, hereditary, evolutionary and biological factors. Long-term use of appropriate drugs can cause or worsen the symptoms of depression. Psychological treatments are based on theories of personality, interpersonal communication and learning. Most biological theories focus on monoamine chemicals, namely serotonin, norepinephrine and dopamine, which are naturally present in the brain and provide communication between nerve cells. This symptom complex (syndrome) was named, described and classified as a mood disorder in the 1980 Psychological Association’s Diagnostic Aids publication.
Symptoms and signs
Major depression significantly affects family life and personal relationships, professional or school life, sleep and eating habits, as well as general health. Its effect on good general well-being is comparable to the effects of chronic diseases such as diabetes. A person who has manifestations of major depression usually complains of a bad mood, which permeates all aspects of life, as well as the inability to experience pleasure from those activities that previously brought satisfaction. Depressed people can be preoccupied with their problems, reflect on them, have thoughts of their own inferiority, feel guilty, regret, helplessness, hopelessness and self-loathing.
In severe cases, people with depression may show symptoms of psychosis. These symptoms include delusions or, less commonly, hallucinations, usually of an unpleasant nature. Other symptoms of depression include poor concentration and memory (usually in persons with metabolic and or psychotic symptoms , non-participation in social activities, low sexual desire, and thoughts of death or suicide.
Insomnia is often manifested in people prone to depression. Usually, the person wakes up oche Hb early and can not fall asleep then s. Hypersomnia or excess sleep may also occur. Some antidepressants can cause insomnia due to their stimulating effect. A person in depression may report several physical symptoms, including fatigue, headaches, problems with digestion; somatic complaints are the most common problems in developing countries, according to the criteria of depression of the World Health Organization. Appetite is often reduced, leading to weight loss, although increased appetite and weight gain can also occur. Family members and friends may notice that the person is either very nervous or sluggish. In older people with depression, cognitive symptoms may appear, such as forgetfulness and more noticeable slowing of movements.
Depression in older people often coexists with physical disorders, such as stroke, other cardiovascular diseases, Parkinson’s disease, and chronic obstructive pulmonary disease. Children with depression may experience irritable (not depressed) moods; symptoms may vary depending on age and situation. Most lose interest in school, they show a decrease in performance. Diagnostics may be delayed or missed if symptoms are treated as a usual capriciousness. Depression can also coexist with attention deficit hyperactivity disorder (ADHD), which makes it difficult to diagnose and treat both disorders.
Major depression often occurs in conjunction with other mental disorders. A 1990-1992 national survey of comorbidities showed that 51% of people suffering from depression are also subject to persistent anxiety. Symptoms of anxiety can have a significant impact on the course of depressive diseases, reducing the likelihood of recovery, increasing the risk of relapse and contributing to disability and suicide attempts.
American neuroendocrinologist Robert Sapolski argues that the relationship between stress, anxiety and depression can be measured and demonstrated biologically. There are elevated rates of alcohol or drug abuse, in particular, there is a manifestation of dependence; at about one third of individuals diagnosed with ADHD develop concomitant depression. Post-traumatic stress and depression are often combined in their manifestation. Depression and pain also often occur together. One or more pain symptoms occur in 65% of patients with depression, and from 5 to 85% of patients with pain syndromes experience depression, depending on the underlying disease; There is a low prevalence in general practice and a higher prevalence in specialized clinics. Diagnosing depression is often delayed or skipped altogether, making the condition worse.
The result may also worsen if the depression was identified, but its causes were not understood. Depression is often associated with a 1.5–2 fold increase in the risk of cardiovascular diseases that are not dependent on other risk factors; they themselves are directly or indirectly associated with risk factors, such as smoking or obesity. People with major depression rarely follow the doctor’s recommendations regarding the treatment and prevention of cardiovascular diseases, which ultimately increases the risks of complications. In addition, cardiologists may not reveal depression, which complicates the course of cardiovascular diseases.