Major Depression

It is a disease in which the part(s) of the brain which regulates mood is not functioning well (for various reasons). Certain parts of the brain are underactive while another part is overactive. The balance of activity is off. In addition, in some individuals, part of the brain (namely, the hippocampus) has decreased in size.

It is not just a sad mood. In fact, someone can suffer from Major Depression and not have a sad mood at all. People who suffer from MD report a significant decrease in enjoyment in usual activities. They usually have sleep problems which can either be difficulty falling asleep, staying asleep, awakening too early or wanting to sleep too much. Appetite may increase or decrease. Sexual drive is usually decreased. Concentration may be impaired. Thoughts are often focused upon hopelessness and worthlessness. Depressed people may consider suicide and act on these impulses. Finally, sometimes Major Depression can distort one’s thinking so severely, that the individual may become delusional; that is, he/she may have fixed, false beliefs such as paranoid beliefs of being harmed or even more bizarre thoughts that may sound “crazy”.

Fortunately, treatment for Major Depression is very effective. There are many types of psychotherapy and many medicines which can resolve the symptoms. Cognitive-behavioral psychotherapy helps the individual to identify how his/her thought patterns actually play a role in regulating one’s emotions. Therefore, by learning to modify one’s thoughts (those that may be distorted–e.g. “I am a bad person”) can lead to improvement in negative feelings.

Ideally, the combination of psychotherapy and medicine should be administered. This increases the likelihood of resolving the Major Depression. It takes a number of weeks but it is extremely important to help the individual not only respond to treatment (decrease in intensity of symptoms) but actually to reach remission (the absence of all symptoms). The individual who continues to experience even minor symptoms is at significant risk for developing a relapse.

Although Major Depression is highly treatable, for most people, it is a chronic, relapsing disease. People who experience an episode have a 50% risk of developing another episode in their future. If one has experienced two episodes, he/she has a 70% chance of developing a third episode. Like diabetes, major depression can be well-managed, but it should never be minimized.