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Mood Disorders

Major Depressive Disorder

Major Depressive Disorder is the subject of much discussion and research. Clinically, it can be defined as a constant state of poor mood, low self-esteem and a loss of interest or satisfaction in activites that were normally enjoyable. However, the definition and treatment has evolved over centuries and we are left with an incomplete understanding of the illness. Physicians will diagnose Major Depressive Disorder (MDD) based on patients’ self-reported symptoms, symptoms from family or friends and a mental status examination. It is a complicated and difficult disorder to understand and it affects countless lives all over the world.

Signs

Symptoms of MDD vary and are less understood than most diseases or disorders. However, when depression impacts a persons well-being and functioning, it can be defined as MDD. MDD puts a strain on relationships with friends and family, affects school or work life and can harm a person’s overall health, including sleeping and eating habits. Most-common symptoms include an all-encompassing low-mood and a disinterest in day-to-day activities. People with MDD may have feelings of worthlessness, self-hatred and helplessness. Other symptoms include poor memory and concentration, a withdrawal from social networks and situations, reduced sex drive and thoughts of suicide. Depression has many symptoms and the difference between MDD and Depression is the all-encompassing strain on life. MDD is a worsened condition, one that prohibits day-to-day life. However, MDD can come from a prolonged depressive state, in the form of an episode. It is important to seek treatment if you are experiencing any of these signs.

Causes

The causes of depression or Major Depressive Disorder are still incomplete. A model theorized by psychiatrist George L. Engel, called the Biopsychosocial Model, has been cited as a source for understanding the cause of depression.  He explains that biological, pyschological and social factors all contribute to the development of depression. He believed that there are certain people more prone to symptoms of depression, due to a pre-existing vulnerability. Combined with a stressful period in a persons life, or a period of substance abuse, could also trigger a depressive state. 3 neurochemicals in the brain have been linked to depression: serotonin, norepinephrine and dopamine. It is believed that an inbalance in these neurochemicals in the brain might be the cause of depression. Norepinephrine may be related to alertness, anxiety, energy and attention. Serotonin may be related to compulsions, anxiety and obsessions, and dopomine to motivation, pleasure and reward. Physicians can treat depression by diagnosing the neurochemicals that need to be raised or altered in a patient.

Management

There are a number of treatments available to people struggling with depression. The right treatment can be determined by your physician or qualified psychologist or psychiatrist.

An assessment will be made, recording current circumstances and symptoms, a family background and biographical history. An assessment of the consumption of mood-altering substances is also important, as it can have an effect on the treatment of the condition. These substances include alcohol and drug use, prescriptions and illegals. A mental state examination, analyzing the patients current mood and potential for harm, will be assessed as well. Once a disorder is assessed, there are three common treatments for MDD: pyschotherapy, medication and electroconvulsive therapy. Pyschotherapy is an effective tool for those experiencing depressive states. It should be delivered by practicing psychologists or psychiatrists and qualified social workers and counsellors. Medication, specifically anti-depressants, should only be used in the cases of severe depression. Best results occur when medication is combined with pyschotherapy. Electroconvulsive Therapy or ECT is reserved for cases of extremely severe MDD, where medication and pyschotherapy have been unsuccessful. Also, in cases where treatment is needed very quickly, ECT is an option. ECT should be treated as a last resort option for battling depression. The side and long-term affects are incomplete and debate on its safety and effectiveness continues. Be sure to research on your own before seeking medical attention; information can be found online.  It is important to convey honest and accurate information to your medical practitioner as it affects their treatment.

Prognosis

Major Depressive episodes usually resolve themselves over time, treated or otherwise. 80% of patients suffering their first episode will face at least one other episode in their lifetime. The average for people with MDD, is four in a lifetime. Recurrence is more likely if treatment is incomplete. For some, depression is a lifelong battle, requiring ongoing treatment and medication. However, with the right treatment and help, it is a manageable disorder and should be addressed as such. Depression can be associated with unemployment and poverty but it can be generalized to times of great stress or duress. Depressed individuals have a shorter life expectancy, partly due to the risk of suicide. They are also more susceptible to risk of other health problems, including heart disease. Major depression is the leading cause of disease burden in developed countries and the fourth-leading cause worldwide. Failure to seek treatment, and a failure to provide the correct treatment, are two leading causes in the growth of depression. It is important that we understand and are able to accept depression and Major Depressive Disorders, in order to properly treat and care for people who are struggling. Awareness and treatment have to coincide to ensure a united fight against a misunderstood illness.

 

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