What is the most common feature of depressive disorders?

Sadness is a natural part of the human experience. People may feel sad or depressed when a loved one passes away or when they’re going through a life challenge, such as a divorce or serious illness.

These feelings are usually short-lived. When someone experiences persistent and intense feelings of sadness for extended periods, then they may have a mood disorder such as major depressive disorder (MDD).

MDD, also referred to as clinical depression, is a significant medical condition that can affect many areas of your life. It impacts mood and behavior as well as various physical functions, such as appetite and sleep.

MDD is one of the most common mental health conditions in the United States. Data suggests that more than 7.8 percent of U.S. adults experienced a major depressive episode in 2019.

Some people with MDD never seek treatment. However, most people with the disorder can learn to cope and function with treatment. Medications, psychotherapy, and other methods can effectively treat people with MDD and help them manage their symptoms.

Your doctor or a mental health professional can diagnose major depressive disorder based on your symptoms, feelings, and behaviors.

Typically, you’ll be asked specific questions or given a questionnaire so health professionals can better determine whether you have MDD or another condition.

To be diagnosed with MDD, you need to meet the symptom criteria listed in the “Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).” This manual helps medical professionals diagnose mental health conditions.

According to its criteria:

• you must experience a change in your previous functioning
• symptoms must occur for a period of 2 or more weeks
• at least one symptom is either depressed mood or loss of interest or pleasure

You must also experience 5 or more of the following symptoms in the 2-week period:

• You feel sad or irritable most of the day, nearly every day.
• You’re less interested in most activities you once enjoyed.
• You suddenly lose or gain weight or have a change in appetite.
• You have trouble falling asleep or want to sleep more than usual.
• You experience feelings of restlessness.
• You feel unusually tired and have a lack of energy.
• You feel worthless or guilty, often about things that wouldn’t usually make you feel that way.
• You have difficulty concentrating, thinking, or making decisions.
• You think about harming yourself or suicide.

Symptoms parents should be aware of in their teens include the following:

• onset or increased use of substances (i.e., alcohol, smoking)
• poorer academic performance
• problems with peers
• increased social withdrawal/isolation

The exact cause of MDD isn’t known. However, several factors can increase your risk of developing the condition.

A combination of genes and stress can affect brain chemistry and reduce the ability to maintain mood stability.

Changes in the balance of hormones might also contribute to the development of MDD.

MDD may also be triggered by:

• alcohol or drug use
• certain medical conditions, such as cancer or hypothyroidism
• particular types of medications, including steroids
• abuse during childhood

MDD is often treated with medication and psychotherapy. Some lifestyle adjustments can also help ease certain symptoms.

People who have severe MDD or have thoughts of harming themselves may need to stay in a hospital during treatment. Some might also need to take part in an outpatient treatment program until symptoms improve.

Medications

Primary care providers often start treatment for MDD by prescribing antidepressant medications.

Selective serotonin reuptake inhibitors (SSRIs)

SSRIs are a frequently prescribed type of antidepressant. SSRIs work by helping inhibit the breakdown of serotonin in the brain, resulting in higher amounts of this neurotransmitter.

Serotonin is a brain chemical that’s believed to be responsible for mood. It may help improve mood and produce healthy sleeping patterns.

People with MDD are often thought to have low levels of serotonin. An SSRI can relieve symptoms of MDD by increasing the amount of serotonin available in the brain.

SSRIs include well-known drugs such as fluoxetine (Prozac) and citalopram (Celexa). They have a relatively low incidence of side effects that most people tolerate well.

Similar to SSRIs, serotonin-norepinephrine reuptake inhibitors (SNRIs) are another type of antidepressant often prescribed. These affect serotonin and norepinephrine.

Other medications

Tricyclic antidepressants and medications known as atypical antidepressants, such as bupropion (Wellbutrin), may be used when other drugs haven’t helped.

These drugs can cause several side effects, including weight gain and sleepiness. As with any medication, benefits and side effects need to be weighed carefully with your doctor.

Some medications used to treat MDD aren’t safe while you’re pregnant or breastfeeding. Make sure you speak with a healthcare professional if you become pregnant, you’re planning to become pregnant, or you’re breastfeeding.

Psychotherapy

Psychotherapy, also known as psychological therapy or talk therapy, can effectively treat people with MDD. It involves meeting with a therapist regularly to talk about your condition and related issues.

Psychotherapy can help you:

• adjust to a crisis or other stressful event
• working toward achieving a balanced perspective of a given situation and acting in accordance with values instead of based upon mood
• improve your communication skills
• find better ways to cope with challenges and solve problems
• increase your self-esteem
• regain a sense of satisfaction and control in your life

Your healthcare professional may also recommend other types of therapy, such as cognitive behavioral therapy or interpersonal therapy. If you don’t already have a healthcare professional, the Healthline FindCare tool can help you find a physician in your area.

Another possible treatment is group therapy, which allows you to share your feelings with people who can relate to what you’re going through.

Lifestyle changes

In addition to taking medications and participating in therapy, you can help improve MDD symptoms by making some changes to your daily habits.

Dietary changes

Nutritious foods benefit your mind and body, and while no foods can cure depression, certain healthy food choices can benefit your mental well-being.

Consider eating foods:

• containing omega-3 fatty acids, such as salmon
• rich in B vitamins, such as beans and whole grains
• with magnesium, which is found in nuts, seeds, and yogurt

Avoid alcohol and certain processed foods

It’s beneficial to avoid alcohol because it’s a nervous system depressant that worsens your symptoms.

Get plenty of exercise

Although MDD can make you feel very tired, it’s essential to be physically active. Exercising, especially outdoors and in moderate sunlight, can boost your mood and make you feel better.

Sleep well

It’s vital to get enough sleep each night, which can vary from person to person but typically ranges between 7 to 9 hours.

People with depression often have trouble sleeping. Speak with a doctor if you’re having trouble sleeping or oversleeping.

While someone with MDD can feel hopeless at times, it’s important to remember that the disorder can be treated successfully. There is hope.

To improve your outlook, it’s critical to stick with your treatment plan. Don’t miss therapy sessions or follow-up appointments with your healthcare professional.

Never stop taking your medications unless your therapist or healthcare professional advises you to.

On days when you feel particularly depressed despite treatment, it can be helpful to call a local crisis or mental health service or the National Suicide Prevention Lifeline. Resources are available.

A friendly, supportive voice could be just what you need to get you through a difficult time.

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