Major Depressive Disorder
Conditions We Treat
ADHD Testing
What is Major Depressive Disorder?
Major Depressive Disorder (MDD) is a debilitating mental health condition characterized by persistent sadness, hopelessness, and a lack of interest or pleasure in nearly all activities. It significantly impairs emotional well-being, cognitive functioning, and the ability to manage daily responsibilities. MDD may present as a single depressive episode or occur recurrently, often requiring long-term management and care.
Symptoms of MDD
Individuals with MDD may experience a range of emotional, cognitive, and physical symptoms. These symptoms must be present for at least two weeks and represent a change from previous functioning.
- Depressed mood most of the day, nearly every day, often reported as feeling sad, empty, or hopeless.
- Markedly diminished interest or pleasure in all or almost all activities, even those once found enjoyable (anhedonia).
- Significant weight loss or gain, or noticeable changes in appetite nearly every day.
- Insomnia or hypersomnia, disrupting normal sleep patterns and functioning.
- Psychomotor agitation or retardation, observed by others as either restlessness or slowed movements.
- Fatigue or loss of energy, even after adequate rest.
- Feelings of worthlessness or excessive guilt, which may be delusional.
- Diminished ability to think or concentrate, impacting decisions and productivity.
- Recurrent thoughts of death or suicide, including ideation, attempts, or planning.
Diagnosis and Evaluation
A thorough diagnostic process is essential to confirm MDD and guide effective treatment planning.
1. Clinical Interview
- In-depth assessment by a qualified mental health professional to evaluate symptoms, their duration, and their effect on daily life.
- May involve structured or semi-structured interviews to ensure comprehensive understanding.
2. Use of Standardized Tools
- Screening tools such as the PHQ-9 or Beck Depression Inventory (BDI) help assess symptom severity and monitor treatment response.
- These tools assist in accurate diagnosis and treatment planning.
3. Rule Out Other Causes
- Lab tests and physical exams help exclude medical conditions (e.g., thyroid issues, anemia) or medication effects that may mimic depression.
- Substance use assessments are also considered.
4. Assess Risk
- Evaluation for suicidal ideation, plans, or behaviors is critical.
- Clinicians assess immediate and long-term safety concerns and hospitalization needs if warranted.
Treatment Options
MDD is highly treatable with a combination of pharmacological, psychological, lifestyle, and advanced interventions.
1. Medication Management:
- Antidepressants such as SSRIs (e.g., fluoxetine, sertraline) and SNRIs (e.g., venlafaxine, duloxetine) help regulate brain chemistry.
- Mood stabilizers or atypical antipsychotics (e.g., aripiprazole) may be added in treatment-resistant cases.
- Long-term monitoring helps manage side effects and maintain response.
2. Psychotherapy
- Cognitive Behavioral Therapy (CBT) addresses distorted thinking and helps develop healthier emotional responses.
- Interpersonal Therapy (IPT) focuses on relationship issues and life transitions that contribute to depressive symptoms.
- Behavioral Activation encourages re-engagement in rewarding activities to combat withdrawal and apathy.
3. Lifestyle and Wellness
- Regular physical exercise is linked to reduced symptoms and improved mental health.
- A balanced diet and consistent sleep schedule help stabilize mood and energy.
- Social support and community involvement can reduce isolation and enhance emotional well-being.
4. Advanced Treatments
- Electroconvulsive Therapy (ECT) is effective for severe or treatment-resistant depression and works by stimulating brain activity under anesthesia.
- Transcranial Magnetic Stimulation (TMS) is a non-invasive method that uses magnetic fields to activate mood-related areas in the brain.
- Other innovative options like ketamine infusions or esketamine nasal spray may be considered for complex cases under specialist care.
