Major depressive disorder therapies, symptoms, and causes

Depression is one of the most common mental health conditions in the U.S., but it’s also one of the most treatable. Through a combination of talk therapy, medication management, brain stimulation therapies, and lifestyle changes, you can learn how to manage depressive symptoms and live a more balanced and fulfilling life. 

What is major depressive disorder (MDD)?

Major depressive disorder (MDD) is a mood disorder that causes persistent feelings of sadness, hopelessness, and despair. Also called depression or clinical depression, MDD is a mental health condition that affects how you think, feel, and interact with others. When left untreated, MDD symptoms can last for weeks, months, or even years. 

MDD is one of the most common mental health conditions in the U.S., with more than 8.3% of adults experiencing a major depressive episode in 2021. It affects people of all ages, genders, races, and ethnicities but is more common in women than men and among people reporting two or more races.

MDD versus sadness

Sadness is an emotion, while MDD is a diagnosable mental health condition. Persistent sadness is actually a symptom of mood disorders like depression. Here are two tips to help differentiate sadness from MDD. 

• Cause: Sadness is typically caused by a specific trigger, while the cause of MDD isn’t always clear. 
• Duration: With sadness, a person’s low mood will typically pass or lessen with time, while symptoms of MDD last longer than two weeks.

What are common symptoms of MDD?

MDD causes a wide range of emotional, physical, and behavioral symptoms, so the condition will look a little different for each person. To be diagnosed with MDD, a person must exhibit five or more of the following symptoms for most of the day for at least two weeks, with two of the symptoms being low mood and a loss of interest in activities.

Emotional symptoms:

• Persistent sad, anxious, or empty mood
• Feelings of hopelessness and worthlessness
• Feelings of irritability, frustration, or restlessness

Physical symptoms:

• Tiredness, fatigue, or low energy
• Changes in sleep patterns, like trouble sleeping or oversleeping 
• Changes in appetite or weight 

Cognitive and behavioral symptoms:

• Loss of interest or pleasure in hobbies and activities
• Difficulty concentrating, remembering, and making decisions
• Thoughts of death, suicidal ideation, or suicide attempts

Other potential signs of MDD include impulsivity, increased substance use, changes in sexual desire and performance, and isolating from family and friends. 

What are the most effective therapies for MDD?

MDD can feel debilitating when left untreated, but there are several evidence-based treatments that can effectively reduce depressive symptoms.

Talk therapy

Working with a therapist can help people with MDD manage distressing events, increase their self-esteem, and gain control in life. There are several types of talk therapy that are effective for coping with depressive symptoms. 

• Cognitive behavioral therapy (CBT): CBT focuses on the connection between people’s thoughts, feelings, and behaviors. Through various techniques, people learn to challenge negative thoughts, manage difficult situations, and create positive change in their lives.

• Interpersonal therapy (IPT): IPT is based on the idea that improving interpersonal relationships and social functioning can help improve mood and reduce depressive symptoms. 

• Psychodynamic therapy: Psychodynamic therapy involves learning how your past shapes your current behavior and offers insight into how to improve your present situation.

• Dialectical behavior therapy (DBT): DBT was originally created to treat borderline personality disorder (BPD), but it can also help manage depression. With DBT, people learn how to identify and regulate intense emotions and use mindfulness skills to manage depressive symptoms.

Brain stimulation therapies

Brain stimulation therapy — which uses electricity, implants, or magnets to activate parts of the brain — is another option for managing mood disorders like MDD. 

• Electroconvulsive therapy (ECT): ECT treats depression by using electrical currents to induce controlled seizures under general anesthesia. It leads to substantial improvement in approximately 80% of people with severe major depression. It’s best for those who aren’t responding to medication or are over the age of 60.
• Vagus nerve stimulation (VNS): VNS is another brain stimulation technique that can manage depression that’s not responding to other treatments. It involves implanting an electrical pulse generator under the skin to stimulate the vagus nerve, a major nerve that carries signals between the brain, heart, and digestive system.
• Repetitive transcranial magnetic stimulation (rTMS): This procedure places magnetic fields against a person’s scalp to stimulate nerve cells in the brain to improve mood and other symptoms of major depression. Unlike ECT and VNS, rTMS is a non-invasive procedure because it doesn’t involve surgery or cutting the skin.

Are there other treatments for MDD?

Medication and lifestyle changes can also help reduce symptoms and improve overall quality of life for people with MDD.

Medication

Many people benefit from adding a prescription medication, like an antidepressant, to their treatment plan. Antidepressants were created to alleviate symptoms of severe depression and help people feel emotionally stable enough to follow their normal routine. 

There are multiple antidepressants approved for MDD, so it’s important to work with a psychiatrist or other qualified mental health professional to find the best antidepressant for you. Categories of antidepressants include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors.

Lifestyle changes 

In addition to talk therapy and medication, there are several lifestyle changes that can benefit people with MDD.

• Eat a balanced diet. One way to protect your mental health is to consume a balanced diet full of fruits, vegetables, whole grains, fish, and antioxidants. Conversely, consuming ultra-processed foods — like soda, ice cream, and chips — may increase the risk of depressive symptoms.

• Prioritize sleep. There’s a strong association between depression and sleep problems, so prioritize getting enough rest. The recommended amount of sleep for an average adult is seven or more hours per night.

• Try relaxation techniques. Whether it’s yoga, meditation, or deep breathing exercises, relaxation techniques can help improve your mood and make it easier for you to manage day-to-day stress. 

• Connect with others. There’s a strong association between social support and mental health, so find ways to connect with other people. Whether it’s joining a book club, walking with a friend, or simply saying hello to your neighbor each morning, connection can help improve mental wellness. 

What causes MDD?

MDD is thought to have multiple causes, including biological, genetic, social, and environmental factors. For example, people with a family history of depression may be more likely to develop MDD. MDD can also be caused by environmental factors, like significant life changes or adverse childhood experiences like abuse or neglect. Substance use issues and physical health problems, like cancer and chronic pain, may contribute to MDD as well.

Find a therapist today with Rula

If you’re living with major depressive disorder, please know that you’re not alone. Depression is one of the most common mental health conditions in the U.S. And Rula understands how important it is to find a therapist who can help you manage your symptoms and improve your overall quality of life. 

In just a few clicks, Rula can connect you with a therapist who has experience treating whatever you’re experiencing, takes your insurance, and can meet with you as soon as tomorrow. And if necessary, we can also refer you to a psychiatrist if you end up needing medications to manage your symptoms. 

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