Major Depressive Disorder

Major depressive disorder is a serious, pervasive condition in which symptoms are overwhelming and debilitating.

According to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, symptoms include a despondent state “as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful)”; noticeably reduced interest or gratification in all, or almost all, activities; a substantial decrease in weight without dieting or increase in weight, or diminished or increased in appetite nearly every day; an inability to sleep or excessive sleeping; lethargy or decreased vigor; feelings of inadequacy or disproportionate/ inappropriate self-reproach; reduced capacity to think or concentrate, or uncertainty; persistent thoughts of death, intermittent suicidal ideation without a particular plan, or a suicide attempt or a definite plan for achieving suicide. Five or more of the aforementioned symptoms must be present most of the day, nearly every day, for at least two weeks. Symptoms must also cause significant difficulties functioning in daily life (American Psychiatric Association 2013.

A person with this disorder would appear listless, exhausted or uncaring. S/he might have red, glassy or wet looking eyes, with a lack of focus and the tendency to be downcast or avoiding eye contact. General appearance would likely be unkempt with an obvious lack of interest in self-care. Movements are sluggish and appear slow or exaggerated. Speech may be muted, slow and lacking in expressiveness. The person might seem bored or irritated in conversation. My former physician of 20 years (before retirement) notated in my medical record that I was experiencing MDD when I had little to report as happening in my life, as compared with a previous visit. 

I do not think the media has sensationalized the disorder, but coverage is far from unbiased.  Depression is heavily stigmatized as laziness or attention seeking behavior or it is summarily dismissed as a flaw in perception. Even if depression is acknowledged, the individual is expected to “snap out of it” or change the way he or she thinks. I cannot support this assessment with any specific examples other than my own experience, with nurses, friends and social media. 

Medication has been shown to be an effective treatment for MDD. 

According to Barlow and Durand, “[f]our basic types of antidepressant medications are used to treat depressive disorders: selective-serotonin reuptake inhibi– tors (SSRIs), mixed reuptake inhibitors, tricyclic antidepressants, and monoamine oxidase (MAO) inhibitors” (2014, p. 246). They go on to say that approximately half of the patients prescribed antidepressants find some relief, while half of those achieve normal or nearly normal levels of functioning (Barlow and Durand, 2014, p. 247)

 

 

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders, fifth edition [Ebrary Reader version] Retrieved from http://dsm.psychiatryonline.org.proxy.cecybrary.com/doi/full/10.1176/appi.books.9780890425596.dsm04#BCFEJHED

 

Barlow D.H. & M. Durand (2014).  Abnormal Psychology: An Integrative Approach, zSeventh Edition [Ebrary Reader version] Retrieved from https://online.vitalsource.com/#/books/9781285755618/cfi/246!/4/4@0.00:0.00

 

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