Major Depressive Disorder: What Is It and What Are the Signs?
Major Depressive Disorder, more commonly just called Depression, is one of the most common mental health diagnosis you can receive. It, along with anxiety, has led the pack for years and with the recent pandemic, rates have shot up even further with 40% of US adults experiencing some form of mental health or substance use issue in June of 2020. (1)
Major Depressive Disorder (MDD) causes pervasive feelings of sadness or a loss of pleasure or interest in activities that you used to enjoy. It can be very debilitating for those who are experiencing it and can cause problems at work, school, or with friends and family.
In order to qualify for a diagnosis of MDD you have to experience symptoms almost all day, most days and it has to have been going on for at leas two weeks. You must have a total of 5 symptoms from the qualifying list and one of them must be either pervasive sadness or anhedonia (loss of interest in or pleasure from things you used to find enjoyable.)
Here is the total list of diagnostic criteria from the DSM V (2), which is used by mental health professionals to diagnose mental health issues.
1. DEPRESSED MOOD :
Often described as sad, hopeless, discouraged or “down in the dumps.” In some cases, you might not be able to identify sadness but might experience a deadening or lack of emotion, irritability, fatigue, anxiety, or somatic complaints like body pain or headaches.
2. ANHEDONIA:
Loss of interest or pleasure is nearly always present to some degree. You might start not caring anymore about the things you were passionate about. Your loved ones might notice social withdrawal, a lack of engagement in loved hobbies, or even a reduction in sexual desire.
3. SIGNIFICANT WEIGHT LOSS OR WEIGHT GAIN:
Appetite changes with MDD can involve either an increase or decrease. Some people lose their appetite altogether while others can’t stop eating. In order to be considered significant the gain or loss must be more than 5% of your body weight in a given month.
4. INSOMNIA OR HYPERSOMNIA:
Sleep disturbances associated with MDD can involve difficulty sleeping or sleeping excessively but not feeling rested.
5. PSYCHOMOTOR AGITATION OR SLOWING:
This can include an inability to sit still, pacing, hand-wringing, pulling or rubbing skin or the other extreme like slowed speech, thinking, and body movements, increased pauses before answering, or speech that is quiet, slow, or even muteness.
6. FATIGUE OR LOSS OF ENERGY:
These are very common complaints and include sustained fatigue without physical exertion. Even the smallest things can feel overwhelming and many people struggle with the smallest tasks such as brushing their teeth or combing their hair. Some people even report feeling like their walking through water or stuck in Jello.
7. FEELINGS OF WORTHLESSNESS OR EXCESSIVE/INAPPROPRIATE GUILT:
This can include unrealistic, negative evaluations of one’s worth, rumination over past failings (even minor ones,) and interpreting trivial day-to-day events as evidence of their personal failings. These beliefs can rise the level of delusions (like believing you are personally responsible for homelessness,) although this is rare. Guilt over having depression itself, unless it raises to the level of a delusion, is not considered adequate to meet this criteria.
8. DIFFICULTIES THINKING, CONCENTRATING, OR MAKING DECISIONS:
People struggling with these symptoms may seem easily distracted, complain of memory difficulties, or become unable to engage in cognitively difficult activities. These symptoms can often be mistaken for the symptoms of ADD or even dementia but usually the symptoms resolve almost completely as the depression improves.
9. PREOCCUPATION WITH DEATH OR SUICIDE:
Evidence of this symptom might range from a passive desire to go to sleep and never wake up to suicide planning and attempts. You might experience suicidal ideations that are distressing for you or you might believe the people you love are better off if you’re dead.
If you find yourself preoccupied with death or planning your suicide, it’s time to get professional help. Depression tricks us into hopelessness. But there is hope. Life can get better. The world needs you and there are people out there who care about you.
If you need help with your thoughts or plans of suicide, you can find immediate support here.
MDD can also be accompanied by other symptoms like anxious distress, melancholy (a more severe form of sadness and anhedonia heavy depression), or even catatonia (a state of immobility.) Additionally, it might be triggered during pregnancy or by the season changing. We see A LOT of seasonal depression in Michigan from January to March.
The basic criteria for MDD is :
that you have 5 of the above symptoms
they occur almost all day, every day
they’ve lasted at least two weeks
they are causing you distress or difficulty functioning
EVEN IF YOU DON’T MEET THE EXACT CRITERIA BUT ARE EXPERIENCING ANY EMOTIONAL SYMPTOMS THAT ARE MAKING YOUR DAY-TO-DAY LIFE MORE DIFFICULT, I ENCOURAGE YOU TO SEEK PROFESSIONAL HELP. THERE IS NO REASON TO SUFFER UNNECESSARILY. WORKING WITH A PROFESSIONAL DOES NOT MEAN THERE IS ANYTHING WRONG WITH YOU, IT JUST MEANS YOU’LL MEET WHATEVER GOALS YOU HAVE FASTER AND EASIER THAN IF YOU DID IT ON YOUR OWN. IT’S THE SAME DIFFERENCE AS ROOFING YOUR OWN HOUSE OR FIXING YOUR OWN CAR, YOU COULD DO IT BUT UNLESS YOU HAVE THAT EXPERTISE IT’S PROBABLY GOING TO TAKE YOU LONGER AND COST YOU MORE MONEY TO DO IT ON YOUR OWN.
It can be difficult to distinguish normal sadness from the symptoms of MDD especially when it’s become normal for everyone to say they’re “depressed” and with the state of the world a lot of us are. However, normal sadness is often much more flexible than MDD and sadness can ebb and flow as time and circumstances change whereas MDD is much more rigid and entrenched regardless of outside circumstances. Additionally, normal sadness normally won’t cause you to lose your job or drop out of school, so functioning is a huge indicator that what you’re experiencing is something more serious and could use professional intervention.
Major Depressive Disorder is a pervasive mental health issue but the good news is, there are lots of treatments for it. Your options range from exercise to talk therapy to medication to ECT. Most people will be able to enter remission from their symptoms and go on to lead a normal life relatively quickly and easily with the right tools and insight.
If you need support on your journey of recovery from depression, fill out our new client inquiry to get started or contact us if you have questions or need resources. If we can’t accommodate you, we’ll help you find someone who can.