Everyone has days where they feel blah, down, or sad. Typically, these feelings disappear after a day or two, particularly if circumstances change for the better. People experiencing the temporary “blues” don’t feel a sense of crushing hopelessness or helplessness, and are able, for the most part, to continue to engage in regular activities. Prolonged anhedonia (the inability to experience pleasure), hopelessness, and failure to experience an increase in mood in response positive events rarely accompany “normal” sadness. The same may be said for other, more intense sorts of symptoms such as suicidal thoughts and hallucinations (e.g., hearing voices). Instead, such symptoms suggest that serious varieties of depression may be present, including the subject of this document: Major Depressive Disorder (MDD) or (more informally), Major Depression.
For people dealing with Major Depression, negative feelings linger, intensify, and often become debilitating.
Major Depression is a common yet serious medical condition that affects both the mind and body. It is a complex illness, creating physical, psychological, and social symptoms. Although informally, we often use the term “depression” to describe general sadness, the term Major Depression is defined by a formal set of criteria which describe which symptoms must be present before the label may be appropriately used.
Major Depression is a mood disorder. The term “mood” describes one’s emotions or emotional temperature. It is a set of feelings that express a sense of emotional comfort or discomfort. Sometimes, mood is described as a prolonged emotion that colors a person’s whole psychic life and state of well-being. For example, if someone is depressed, they may not feel like exercising. By not exercising for long periods of time, they will eventually experience the negative effects of a sedentary lifestyle such as fatigue, muscle aches and pains, and in some cases, heart disease.
Mood disorders rank among the top 10 causes of worldwide disability, and Major Depression appears first on the list. Disability and suffering is not limited to the individual diagnosed with MDD. Spouses, children, parents, siblings, and friends of people experiencing Major Depression often experience frustration, guilt, anger, and financial hardship in their attempts to cope with the suffering of their friend or loved one.
Major Depression has a negative impact on the economy as well as the family system. In the workplace, depression is a leading cause of absenteeism and diminished productivity. Although only a minority of people seek professional help to relieve a mood disorder, depressed people are significantly more likely than others to visit a physician. Some people express their sadness in physical ways, and these individuals may undergo extensive and expensive diagnostic procedures and treatments while their mood disorder goes undiagnosed and untreated. As a result, depression-related visits to physicians account for a large portion of health care expenditures.
Symptoms associated with Major Depression cause clinically significant distress and impairment in social, occupational, or other areas of functioning. A person is diagnosed with MDD when they experience five or more of the following symptoms nearly every day for the same two-week period, and at least one of the symptoms is depressed mood or loss of interest or pleasure:
- Difficulty sleeping or excessive sleeping
- Fatigue and lack of energy
- A dramatic change in appetite resulting in a 5% change in weight (gain or loss) in a month
- Feelings of worthlessness, self-hate, and guilt Inability to concentrate, think clearly, or make decisions
- Agitation, restlessness, and irritability
- Inactivity and withdrawal from typical pleasurable activities
- Feelings of hopelessness and helplessness
- Thoughts of death or suicide
Depressive symptoms can vary tremendously from one individual to the next. While one depressed person may experience feelings of sadness, hopelessness, and helplessness, another may feel angry, irritated, and discouraged. Depressive symptoms may also seem like a change in someone’s personality. For example, a typically patient person might begin to lose his or her temper about things that normally would not be troubling to him or her. Depressive symptoms can also change across the course of the illness; someone who is initially withdrawn and sad can become highly frustrated and irritable as a result of decreased sleep and the inability to accomplish simple tasks or make decisions.
Rashmi Nemade, Ph.D., Natalie Staats Reiss, Ph.D., and Mark Dombeck, Ph.D.
For a confidential referral to a mental health provider, please call the EAP at 352-265-5493 or 1-866-643-9375.