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Major Depressive Disorder
(MDD)

What is Major Depressive Disorder? 

Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable. Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease a person’s ability to function at work and at home.

General Statistics

  • Major depressive disorder affects approximately 17.3 million American adults, or about 7.1% of the U.S. population age 18 and older, in a given year. (National Institute of Mental Health “Major Depression”, 2017)

  • Major depressive disorder is more prevalent in women than in men. (Journal of the American Medical Association, 2003; Jun 18; 289(23): 3095-105)

  • 1.9 million children, 3 – 17, have diagnosed depression. (Centers for Disease Control “Data and Statistics on Children’s Mental Health”, 2018)

  • Adults with a depressive disorder or symptoms have a 64 percent greater risk of developing coronary artery disease. (National Institute of Health, Heart disease and depression: A two-way relationship, 2017)

What is Depression?

Depression is the leading cause of disability in the world; in the United States, close to ten percent of adults struggle with the disease. But because it’s a mental illness, it can be a lot harder to understand than, say, high cholesterol. Helen M. Farrell examines the symptoms and treatments of depression, and gives some tips for how you might help a friend who is suffering.

Articles

ARTICLES ABOUT DEPRESSION

Talking About Depression Is Uncomfortable, but Necessary

By Kayleigh Muir 

"We need to break through the uncomfortable barrier in order to really help someone. Being uncomfortable for a few seconds, minutes or hours is worth it if it saves a life. Seems a bit dramatic but it’s true. I was once contemplating my suicide and if it would hurt. However depressed and suicidal I was, I got a message on Facebook from my partner, just asking how I was. That saved my life. She saved my life without even knowing it. The littlest things can keep a person living. Remember that."

The Unexpected Symptoms I Didn't Realize 'Screamed' Depression

By Brianna Miedema 

"... many other organizations have started their own 12-step programs, proving to be an effective means for some if not many to get help from themselves and their ailments. Post-traumatic stress disorder (PTSD) does not have a 12-step program. Here is mine."

When I Heard Someone Say Some Depressed People 'Don't Want to Get Better'

By Angela Abernathie 

"The comment was about how some depressed people don’t want to get better because they get used to feeling that way, so they just don’t try. Wow. But for those of us with clinical depression (or anxiety, bipolar disorder, etc.), more often than not we do want to get better. That is why we take our medications and go to therapy. Just like patients get treatment and have follow-up visits with their doctors. The list could go on of conditions that are medical and are, therefore, medically treated."

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The Chemistry Behind MDD

THE CHEMISTRY
BEHIND
DEPRESSION

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Increasingly sophisticated forms of brain imaging — such as positron emission tomography (PET), single-photon emission computed tomography (SPECT), and functional magnetic resonance imaging (fMRI) — permit a much closer look at the working brain than was possible in the past. An fMRI scan, for example, can track changes that take place when a region of the brain responds during various tasks. A PET or SPECT scan can map the brain by measuring the distribution and density of neurotransmitter receptors in certain areas.

Use of this technology has led to a better understanding of which brain regions regulate mood and how other functions, such as memory, may be affected by depression. Areas that play a significant role in depression are the amygdala, the thalamus, and the hippocampus (see Figure 1).

Research shows that the hippocampus is smaller in some depressed people. For example, in one fMRI study published in The Journal of Neuroscience, investigators studied 24 women who had a history of depression. On average, the hippocampus was 9% to 13% smaller in depressed women compared with those who were not depressed. The more bouts of depression a woman had, the smaller the hippocampus. Stress, which plays a role in depression, may be a key factor here, since experts believe stress can suppress the production of new neurons (nerve cells) in the hippocampus.

Researchers are exploring possible links between sluggish production of new neurons in the hippocampus and low moods. An interesting fact about antidepressants supports this theory. These medications immediately boost the concentration of chemical messengers in the brain (neurotransmitters). Yet people typically don't begin to feel better for several weeks or longer. Experts have long wondered why, if depression were primarily the result of low levels of neurotransmitters, people don't feel better as soon as levels of neurotransmitters increase.

The answer may be that mood only improves as nerves grow and form new connections, a process that takes weeks. In fact, animal studies have shown that antidepressants do spur the growth and enhanced branching of nerve cells in the hippocampus. So, the theory holds, the real value of these medications may be in generating new neurons (a process called neurogenesis), strengthening nerve cell connections, and improving the exchange of information between nerve circuits. If that's the case, depression medications could be developed that specifically promote neurogenesis, with the hope that patients would see quicker results than with current treatments."

How Does Treatment Help MDD?

HOW DOES TREATMENT HELP?

"Living with depression can be difficult, but treatment can help improve your quality of life. Talk to your doctor about possible options.

You may successfully manage symptoms with one form of treatment, or you may find that a combination of treatments works best. It’s common to combine medical treatments and lifestyle therapies, including the following:

Medications

Your doctor may prescribe antidepressants, antianxiety, or antipsychotic medications.

Each type of medication that’s used to treat depression has benefits and potential risks.

Psychotherapy

Speaking with a therapist can help you learn skills to cope with negative feelings. You may also benefit from family or group therapy sessions.

Light Therapy

Exposure to doses of white light can help regulate mood and improve symptoms of depression. This therapy is commonly used in seasonal affective disorder (which is now called major depressive disorder with seasonal pattern).

Alternative Therapies

Ask your doctor about acupuncture or meditation. Some herbal supplements are also used to treat depression, like St. John’s wort, SAMe, and fish oil.

Talk with your doctor before taking a supplement or combining a supplement with prescription medication because some supplements can react with certain medications. Some supplements may also worsen depression or reduce the effectiveness of medication.

Exercise

Aim for 30 minutes of physical activity three to five days a week. Exercise can increase your body’s production of endorphins, which are hormones that improve your mood.

Avoid Alcohol and Drugs

Drinking or using drugs may make you feel better for a little bit. But in the long run, these substances can make depression and anxiety symptoms worse.

Learn How To Say No

Feeling overwhelmed can worsen anxiety and depression symptoms. Setting boundaries in your professional and personal life can help you feel better.

Take Care of Yourself

You can also improve symptoms of depression by taking care of yourself. This includes getting plenty of sleep, eating a healthy diet, avoiding negative people, and participating in enjoyable activities.

Sometimes depression doesn’t respond to medication. Your doctor may recommend other treatment options if your symptoms don’t improve.

These include electroconvulsive therapy, or transcranial magnetic stimulation to treat depression and improve your mood."

Books That Effectively Portray MDD

BOOKS THAT EFFECTIVELY PORTRAY MDD

TRIGGER WARNING: Suicidal Ideation, Depression

Check a website like https://www.doesthedogdie.com/ to make sure it won't be too triggering for you!

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Veronika Decides to Die

by Paulo Caelho

Overview

"In Veronika Decides to Die, Paulo Coelho takes the reader on a distinctly modern quest to find meaning in a culture overshadowed by angst, soulless routine, and pervasive conformity. Based on events in Coelho's own life, Veronika Decides to Die questions the meaning of madness and celebrates individuals who do not fit into patterns society considers to be normal. Poignant and illuminating, it is a dazzling portrait of a young woman at the crossroads of despair and liberation, and a poetic, exuberant appreciation of each day as a renewed opportunity."

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By The Time You Read This I'll Be Dead

by Julie Anne Peters

Overview

"Daelyn Rice is broken beyond repair, and after a string of botched suicide attempts, she’s determined to get her death right. She starts visiting a website for “completers”— www. through-the-light.com.

While she’s on the site, Daelyn blogs about her life, uncovering a history of bullying that goes back to kindergarten. When she’s not on the Web, Daelyn’s at her private school, where she’s known as the freak who doesn’t talk.

Then, a boy named Santana begins to sit with her after school while she’s waiting to for her parents to pick her up. Even though she’s made it clear that she wants to be left alone, Santana won’t give up. And it’s too late for Daelyn to be letting people into her life... isn't it?"

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It's Kind of a Funny Story

by Ned Vizzini

Overview

"Ambitious New York City teenager Craig Gilner is determined to succeed at life - which means getting into the right high school to get into the right job. But once Craig aces his way into Manhattan's Executive Pre-Professional High School, the pressure becomes unbearable. He stops eating and sleeping until, one night, he nearly kills himself.

Craig's suicidal episode gets him checked into a mental hospital, where his new neighbors include a transsexual sex addict, a girl who has scarred her own face with scissors, and the self-elected President Armelio. There, Craig is finally able to confront the sources of his anxiety.

Ned Vizzini, who himself spent time in a psychiatric hospital, has created a remarkably moving tale about the sometimes unexpected road to happiness."

Celebrity Advocates

CELEBRITIES WHO ADVOCATE

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“'As I grew older, I found a way to release myself from those darker thoughts through music. Music was my way of overcoming a lot of pain and anxiety. If you give yourself to your creativity and imagination, it can help you overcome almost anything and really enable you to feel free and powerful.'... 'I’ve suffered through depression and anxiety my entire life, I still suffer with it every single day,' she explained."

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"James Franco, who covered OUT's September issue, told the magazine that he struggled with depression early in his career. "I have a very addictive personality," he said. 'When I was a teenager I got over certain addictions, and that's when I started acting, at age 17. I really threw myself into it, and that became everything, to the point where I didn't even socialize. And then after, like, 10 years of that, at age 27, I realized, man, I'm so depressed. On the surface my life seems pretty good -- I have a career and everything -- but I feel isolated and lonely.'"

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