Major Depressive Disorder

We experience a lot of challenges in our daily life. As we live, we try our very

best to improve ourselves. We go to school to learn academically, we learn values and

lessons about life as a whole by doing house chores, taking up responsibilities and by

learning from mistakes. People may also have the need, and sometimes have the want,

for money, fame, glory, recognition, respect, and pride. Normally, we experience

stresses, but our body and mind cope up with the needed rest and recovery. However,

some people experience difficulty in recovering from stresses. It may take them a few

days, few weeks, few months, few years, or even a whole lifetime. Life becomes a lot

worse to them, even to the point that they will push themselves to self-harm and even

death. This condition is called depression, and this paper will revolve much on

depression, and also major depressive disorder.

According to the National Institute for Mental Health, depression is a broad and

heterogeneous diagnosis, characterized by depressed mood and/or loss of pleasure in

most activities. Depression may also be characterized with having low self-esteem and

by a loss of attention or liking in normal day-to-day activities.

As defined by the National Institute of Clinical Excellence, depression refers to an

extensive scope of mental health problems described by the absence of a positive affect

low mood and a range of associated emotional, cognitive, physical and behavioral

symptoms. Distinguishing the mood changes between major depression and those

occurring ‘normally’ remains problematic: persistence, severity, the presence of other

distinction.

Generally, moods in a major depressive disorder are underactive to situation,

continuing low all through all day. Behavioral and physical symptoms usually include

tearfulness, irritability or having a bad temper, social withdrawal, sleeping problems,

worsening of pre-existing discomforts, lowered appetite which leads sometimes leading

to significant weight loss, a lack of libido or desire for sexual activity, and fatigue. Along

with it is a loss of concern and satisfaction in everyday life, mental state of guilt,

insignificance with regards to self and justified self-punishment, as are lowered self-

esteem, loss of confidence, feelings of helplessness, suicidal ideation and attempts at

self-harm or suicide. Changes in reasoning include reduced concentration and

attention, pessimistic and regularly negative thoughts about oneself. Depression is also

often go along with anxiety, or mixed depression and anxiety, which can be diagnosed

depending on the symptoms that comprise the most relating to clinical psychology.

Furthermore, depression varies with age. The young, relating to people at around

twenty years of age, show more behavioral symptoms and older adults more somatic

symptoms, physical or relating to the body, and fewer complaints of behavior problems.

Also, those with more severe and manifestations, including physical slowness or anxiety

and a range of somatic symptoms, are often referred to as melancholic depressions, or

depression with melancholia. According to the Merriam-Webster dictionary, melancholia

is a mental condition and especially a manic-depressive condition characterized by

extreme depression, bodily complaints, and often hallucinations and delusions.

film A Beautiful Mind, directed by Ron Howard, features a genius mathematician with

paranoid schizophrenia and endures delusional episodes. The film is a 2001 American

biographical drama film based on the life of John Nash, a Nobel Laureate in Economics.

The film The Machinist by director Brad Anderson features a character with severe

insomnia, to the point where the character have not slept for a year, complicating to

paranoia, delusional episodes, and obsessive-compulsive disorder.

According to the National Institute of Mental Health, there is no distinct

acknowledged cause of depression. Instead, it probably results from a combination of

biochemical, environmental, genetic, and psychological factors. Research shows that

depressive disorders are disorders of the brain. Brain-imaging technologies, such as

magnetic resonance imaging (MRI), have shown that the brains of clinically depressed

people differ compared to those of people without depression. The parts of the brain

responsible for regulating appetite, behavior, mood, sleep, and thinking, appear to

function abnormally. In addition, important neurotransmitters act to be out of balance.

Neurotransmitters are chemicals that transmit neural signals between synapses of

neurons. An example of which is serotonin, a neurotransmitter that regulates appetite,

behaviour, memory and learning, mood, muscle contraction, sleep, and temperature.

Some forms of depression tend to appear in families, suggesting a genetic link.

Nevertheless, depression can also occur in people without ancestral origin of

depression. People may have a higher risk of depression from the effect of multiple

genes acting out together with environmental factors and other stimuli. Moreover,

physical trauma, loss of family members and loved ones, a demanding relationship
relating to the family or at work, or any nerve-wracking circumstances may trigger a

depressive episode. Successive depressive episodes may occur with or without an

obvious trigger.

Depression is more common among compared to men. Biological, hormonal, life

cycle, and psychosocial factors unique to women may be associated to women having a

higher depression rate. Hormones can directly affect brain chemistry that control mood.

For instance, women are typically exposed to depression right after giving birth. This

happens when there are hormonal and physical changes, along with the new

responsibility of caring for the child. This is also known as “baby blues” by new mothers.

Some will develop postpartum or postnatal depression, which lead mothers to be

inconsistent with childcare. Women with postnatal depression often focus more on the

negative actions of childcare, resulting in poor dealing with the child’s needs. Some

women may also be vulnerable to a severe form of premenstrual syndrome (PMS),

sometimes called premenstrual dysphonic disorder (PMDD), an illness brought about

from the hormonal changes that usually occur around ovulation and before

menstruation. During the shift into menopause, some women experience a bigger risk

for depression. The recurrent rise and fall of estrogen and other hormones may affect

the brain chemistry that is associated with depressive illness. Lastly, many women face

the extra hassles of responsibilities in the home and at work, caring for children and

elderly parents, and other life problems.

Men regularly experience depression in a different way than women, and may

have different ways of dealing with the symptoms. Men are more likely to accept having

bad temper, fatigue, and loss of interest in day-to-day activities, and sleep disorders,
while women are more likely to admit to feelings of sadness, worthlessness and even

excessive guilt. Men are more likely than women to turn to alcohol or drugs when they

are depressed, or become frustrated, discouraged, irritable, angry and sometimes

abusive. Some men throw themselves into their work to avoid talking about their

depression with family or friends, or engage in reckless, risky behavior. And even

though more women attempt suicide, many more men die by suicide in the United

States.

A child with depression may pretend to be sick, refuse to go to school, become

clingy to a parent, or worry that a loved one may die. Older children may be bad

tempered, get into trouble at school, be negative and irritable, and feel taken the wrong

way. Because these signs may be considered as normal mood swings usual of children

as they experience developmental periods, it may be difficult to correctly diagnose a

young person with depression (Conway et al, 2006).

Depression in adolescence comes at a time of great personal change. It happens

when boys and girls are forming an identity separate from their parents, coping with

gender concerns and developing sexuality, and making decisions for the first time in

their lives. Depression in adolescence commonly exists with other disorders such as

anxiety, disruptive behavior, eating disorders or substance abuse. It can also lead to

increased risk for suicide.

Depression is a highly treatable disorder, even at the worst degree of illness. As

intuition would say about many illnesses, the earlier that treatment can begin, the more

effective it is and the greater the chance that reappearance of the disease can be

stopped. The first step to getting appropriate treatment is to visit a doctor. The doctor
will conduct a complete diagnostic assessment. He should discuss any family history of

depression, and get a complete history of symptoms, such as when, how severe,

frequency, and first-aid treatment. He should also ask if the patient is using alcohol or

drugs, and whether the patient is thinking about death or suicide. Once diagnosed, a

person with depression can be treated with a number of methods. The most common

treatments are medication and psychotherapy.

The author would like to promote awareness about depression. It really has a big

effect on people, and the negative far outweighs the benefits. Yes, it lets the person

affected learn on how to appreciate life better and to take care of his body, yet he would

really have the difficulty to do so. Depression is curse, and can even bring death.
References:

Depression. 2008. National Institute of Mental Health. Publication no. 08 3561.

Retrieved from http://www.nimh.nih.gov

Depression: Management of depression in primary and secondary care. National

Collaborating Centre for Mental Health. National Clinical Practice Guideline

Number 23. Retrieved from http://www.nice.org.uk

Depression. 2009. National Collaborating Centre for Mental Health. NICE clinical

guidelines 90 and 91. Retrieved from http://www.nice.org.uk

Field, T. (2010 February). Postpartum depression effects on early interactions,

parenting, and safety practices: A review. Infant Behavior and Development.

Retrieved November 30, 2013.

Akins, R, et al. (2008 September). Comorbid Depression and ADHD in Children and

Adolescents. Psychiatric Times. Retrieved from

http://www.psychiatrictimes.com/adhd/comorbid-depression-and-adhd-children-

and-adolescents

Unknown author. Unknown date of publication. Major Depressive Disorder. Armenian

Medical Network. Retrieved from http://www.health.am/psy/major-depressive-

disorder/

Melancholia. (n.d.). Merriam-Webster.com. Retrieved January 14, 2014, from

http://www.merriam-webster.com/dictionary/melancholia
Howard, Ronn, Grazer, Brian (Producers). Howard, Ron (Director). 2001. A Beautiful

Mind. Imagine Entertainment (Studio). Motion picture. United States of America.

Fernández, Carlos, Fernández, Julio, Nava, Antonia (Producers). Anderson, Brad.

2004. El Maquinista (Spain), The Machinist (English). Filmax Entertainment,

Canal+ España, Instituto de la Cinematografía y de las Artes Audiovisuales

(ICAA), ICF (Producers). Spain, United States of America.