A Guide to Mental Disorders

Major Depressive Disorder ✓

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest in things and activities you once enjoyed. It can also cause difficulty with thinking, memory, eating and sleeping.

It's normal to feel sad about or grieve over difficult life situations, such as losing your job or a divorce. But depression is different in that it persists practically every day for at least two weeks and involves other symptoms than sadness alone.

More than just a bout of the blues, depression isn't a weakness and you can't simply "snap out" of it. Depression may require long-term treatment. But don't get discouraged. Most people with depression feel better with medication, psychotherapy or both.

There are several types of depressive disorders. Clinical depression, or major depressive disorder, is often just called "depression." It's the most severe type of depression.

What are the signs and symptoms of major depressive disorder?
Although depression may occur only once during your life, people typically have multiple episodes. During these episodes, symptoms occur most of the day, nearly every day and may include:
- Feelings of sadness, tearfulness, emptiness or hopelessness
- Angry outbursts, irritability or frustration, even over small matters
- Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
- Sleep disturbances, including insomnia or sleeping too much
- Tiredness and lack of energy, so even small tasks take extra effort
- Reduced appetite and weight loss or increased cravings for food and weight gain
- Anxiety, agitation or restlessness
- Slowed thinking, speaking or body movements
- Feelings of worthlessness or guilt, fixating on past failures or self-blame
- Trouble thinking, concentrating, making decisions and remembering things
- Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
- Unexplained physical problems, such as back pain or headaches

For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others. Some people may feel generally miserable or unhappy without really knowing why.

Common signs and symptoms of depression in children and teenagers are similar to those of adults, but there can be some differences.

In younger children, symptoms of depression may include:
- Sadness
- Irritability
- Clinginess
- Worry
- Aches and pains
- Refusing to go to school
- Being underweight

In teens, symptoms may include:
- Sadness
- Irritability
- Feeling negative and worthless
- Anger
- Poor performance or poor attendance at school
- Feeling misunderstood and extremely sensitive
- Using recreational drugs or alcohol
- Eating or sleeping too much
- Self-harm
- Loss of interest in normal activities
- Avoidance of social interaction

Depression is not a normal part of growing older, and it should never be taken lightly. Unfortunately, depression often goes undiagnosed and untreated in older adults, and they may feel reluctant to seek help

Symptoms of depression may be different or less obvious in older adults, such as:
- Memory difficulties or personality changes
- Physical aches or pain
- Fatigue, loss of appetite, sleep problems or loss of interest in sex — not caused by a medical condition or medication
- Often wanting to stay at home, rather than going out to socialize or doing new things
- Suicidal thinking or feelings, especially in older men

Types of depression?
Symptoms caused by major depression can vary from person to person. To clarify the type of depression you have, your doctor may add one or more specifiers. A specifier means that you have depression with specific features, such as:
- Anxious distress — depression with unusual restlessness or worry about possible events or loss of control
- Mixed features — simultaneous depression and mania, which includes elevated self-esteem, talking too much and increased energy
- Melancholic features — severe depression with lack of response to something that used to bring pleasure and associated with early morning awakening, worsened mood in the morning, major changes in appetite, and feelings of guilt, agitation or sluggishness
- Atypical features — depression that includes the ability to temporarily be cheered by happy events, increased appetite, excessive need for sleep, sensitivity to rejection, and a heavy feeling in the arms or legs
- Psychotic features — depression accompanied by delusions or hallucinations, which may involve personal inadequacy or other negative themes
- Catatonia — depression that includes motor activity that involves either uncontrollable and purposeless movement or fixed and inflexible posture
- Peripartum onset — depression that occurs during pregnancy or in the weeks or months after delivery (postpartum)
- Seasonal pattern — depression related to changes in seasons and reduced exposure to sunlight