What Is Major Depressive Disorder?
When most people talk about depression, they usually mean the emotion of feeling sad or unhappy. Everyone feels "blue" or "down in the dumps" every now and then, and this normal. Feeling this way does not usually mean that a person has a depressive disorder.
Depressed people are not simply "feeling blue." When health care professionals talk about depression, they refer to a medical illness with many physical symptoms, feelings, and thoughts that affect every aspect of someone's life. Even though the emotion of depression affects everyone to some degree, the medical illness afflicts only some people.
Depression is not a sign of weakness. People with a depressive illness can't just "pull themselves together" or "tough it out" and get better. Without treatment, the symptoms of depressive disorders can last for months, even years. Fortunately, appropriate treatment can help most people with depression feel better.
There are three common types of depressive disorders: major depressive disorder (MDD), dysthymia and bipolar disorder.
Major Depression (MDD)
The "essential features" that health care professionals look for in people who are suffering from Major Depressive Disorder (MDD), are:
- a severe depressed mood, or
- a loss of interest in things that the depressed person usually enjoys, or
- an inability to experience pleasure in things that the depressed person usually enjoys.
Sometimes people don't necessarily feel "blue;" the depressed mood can come across as irritability, fear or worry. People usually describe their depression as "living in a black hole," being "overwhelmed by dread" or being "drained." Others might complain about "being down in the dumps" or life being "boring and dull."
The second essential feature physicians look for is the presence of "biological" symptoms such as: changes in sleep, unintentional weight loss or gain, a lack of energy or fatigue, reduced attention span and a low sex drive.
People who suffer from MDD may also experience a number of physical symptoms such as headaches, stomach aches, and muscle tension. The psychological signs and symptoms of depression include a diminished ability to think or make decisions, negative thinking about the past (guilt), the present (low self-esteem), the future (hopelessness), and thoughts about death and suicide.
In MDD, all of these symptoms interfere with peoples' ability to work, go to school, sleep, eat, and enjoy life. In order to be diagnosed as MDD, these symptoms have to last for two weeks or more. Some people may experience only one episode of MDD in their life.
However, once people have had one episode it's more likely that they'll experience several more depressive episodes.
Dysthymia
Compared to major depression, dysthymia (or dysthymic disorder) is a more moderate form of depression. People who suffer from dysthymia experience less severe symptoms of depression but experience them more often (month after month or year after year). People with dysthymia may laugh or tell a joke and occasionally enjoy themselves, but generally their mood is low and they often become upset over matters that others take in stride. It's not uncommon to hear dysthymics say "they never feel happy."
Dysthymia may not be as disabling as MDD but it keeps people from functioning and feeling well. Many people with dysthymia experience major depressive episodes in their lives. People with dysthymia often mistake their dysthymia with their personality, believing that they are simply unhappy and gloomy.
Bipolar Disorder
At The Depression Center we emphasize the understanding and treatment of major depression and dysthymia. However, we believe that it is important that you also understand something about bipolar disorder, which we'll explain in the next section.