Major Depressive Disorder (MDD)
MDD is a cluster of syndromes that comprises a mental disorder, which is marked by declined moods, followed by a decline in self-esteem and not being interested in pleasurable tasks. Its features involve a clinical course, marked by major depressive periods. These take like a fortnight, marked by low moods and displeasure. The condition is also referred to as major depression, unipolar depression and clinical depression.
The disorder is disabling and comprises an individual’s lifestyle and family, loss of appetite and sleep distractions, which compromises one’s health (Greden, 2001). The patients of this medical condition end up committing suicide. The reason as to why I chose the topic is because it affects my life and many people around me in school and at home.
Having the condition has affected my lifestyle, school work, social life and has compromised my career since I lose pleasure in all activities. I even devalue life as I find my self contemplating on suicide during the phases of depression.
MDD affects people differently with different symptoms such as weight loss, pessimism, feeling guilty, loss of concentration, insomnia or hypersomnia, sleeping disorders, fatigue, hopelessness, irritability, loss of self-worth, disinterest in life and in severe cases, delusions and hallucinations may result.
The disorder affects more of females as compared to males (Deb & Bhattacharjee, 2009). The occurrence of the disorder may be linked to other medical close to 20.0 % to 25.0% of patients with conditions related to cancer, prolonged pain, diabetes, stroke, hypothyroidism, medications e.g. sedatives as well as myocardial infarction, which worsens these conditions (Deb & Bhattacharjee, 2009).
Health conditions that accompany MDD include drug abuse, panic, anxiety, obsessive-compulsive disorder, anorexia nervosa, Bulimia Nervosa and borderline personality disorder (Deb & Bhattacharjee, 2009).
According to one study dubbed the ‘epidemiology of Major Depressive Disorder’ aimed at determining the prevalence of MDD. The study design used face to face research in 48 homes in the U.S by interviewing individuals over eighteen years. From the study, the MDD prevalence for a lifetime was 16.2% and that over one year was 6.6% and stated to be “10.4% mild, 38.6% moderate, 38.0% severe, and 12.9% very severe” (Kessler et al, 2003).
Role impairment showed 59.3% over a year where 51.6% of the cases sought medical attention and were being treated for MDD. Treatment proved enough for 41.9% of the cases, adding up to 21.7% MDD treatment annually. The study concludes that MDD was a common condition with its distribution being extensive in the population. It is linked to severe symptoms and role impairment.
There has been a rise in treating MDD, which offers hope for its management although lack of enough treatment is still a critical issue. The study maintains that “Emphasis on screening and expansion of treatment needs to be accompanied by a parallel emphasis on treatment quality improvement” (Kessler et al, 2003)
Another study regarding MDD on 3,258 adults is presented. According to the study, “MDD was found to affect women more than men by a ratio of nearly 2 to 1. The lifetime prevalence rate for both sexes combined was 8.6%. The period prevalence rates for both sexes combined were 3.2% and 4.6%, for 6 mo and 1 yr, respectively.
The age of onset for MDD showed a wide range, with over 75% of cases having an onset prior to age 30 yrs. The presence of a recurrent MDD was associated with an increased risk of substance abuse, panic disorder, and dysthymia, whereas a single MDD episode was not associated with increased comorbidity” (Spaner et al, 1994).
The prevalence of MDD according to Culture, sex and age is obvious. Culture for instance affects the communication and experiences regarding MDD where it is mostly experienced as somatic in nature and not by guilt of low moods. Some complain of nerves as well as headaches particularly for Latinos as well as those from Mediterranean origin.
Others complain of weakness or fatigue especially the Chinese and Asian people while other talk of heart problems such as those in the Middle East to refer to the depressive feeling. MDD occurs twice as many times as in adolescents and mature women as compared to adolescents and mature males (Deb & Bhattacharjee, 2009).
The prevalence of MDD is high for individuals aged 25 to 44 years of all genders and lower for those aged 65 and above. Its onset may be at any age but is mostly notable during mid twenties.
Studies related to MDD have shown a broad rage of outcomes for the population assessment of the condition. The lifetime risk for MDD in population samples vary from 10.0% to 25.0% for males while the point prevalence of MDD in adult population samples varies from 2.0 to 3.0 % for males.
MDD is 1.5 to 3 times greater for 1st degree relatives of patients with MDD as compared to the general population. Besides, it has been indicated that alcohol dependence is high in mature 1st degree relatives as well as a higher rate of hyperactivity disorder for children of patients with MDD (Deb & Bhattacharjee, 2009).
MDD has been attributed to various fatalities where approximately fifteen percent of patients end up committing suicide. Epidemiological studies points that the fatalities of those aged over fifty five years with MDD have risen by four times in the recent years.
Management of MDD
Treatment of MDD may involve use of antidepressants such as Selective serotonin re-uptake inhibitors (SSRIs) or Serotonin norepinephrine reuptake inhibitors (SNRIs). Antipsychotic medications are recommended for the ones with severe psychotic symptoms. These drugs needs to be taken for an extensive period and may be combined with supplements like Lithium & thyroid hormone for their efficiency of antidepressants, to prevent recurrence of the condition and avoid situations of treatment-resistant depression (Herrman, 2009).
Additionally, talk therapy is very efficient and may involve counseling on one’s thoughts and behaviors. Cognitive Behavioral Therapy is one such procedure, which utilize the modeling of thoughts and feelings as reflected in the behavior of an individual. This method repels negative thoughts. Psychotherapy is essential in the understanding of the causes of the problem in relation to their behavior, thinking and feelings.
Patients may also be put under Electroconvulsive therapy (ECT) especially ones contemplating suicide in order to enhance their moods, for ones with treatment-resistant depression and ones those with psychotic symptoms. Besides, Transcranial magnetic stimulation (TMS) utilizes magnetic pulses directed towards affected brain sections and may be done after carrying out an ECT (Greden, 2001).
The cause of MDD is not proven though many studies indicate it could result from chemical instability in the brain. This may be as a result of genetic predisposition and interaction with the environment. The factors that are known to trigger MDD include drug use, socio-economic constrains and medical conditions.
MDD is known to result to several fatalities and therefore it requires to be managed through pharmacological or talk therapies. Open communication is also essential for patients to gain assistance before the disorder destroys a person completely. Such patients needs to be well monitored without being left alone, else they contemplate of suicide.
Deb, S. and Bhattacharjee, A. (2009). Mental Depression: The Silent Killer. New Delhi: Concept Publishing Company.
Greden, J. F. (2001). Treatment of Recurrent Depression, Volume 20, Issue 5. Washington, DC: American Psychiatric Publishing, Inc.
Herrman, H., Maj, M, and Sartorius, N. (2009). Depressive Disorders. New York: John Wiley and Sons.
Kessler, C. R. et al. (2003). “The epidemiology of Major Depressive Disorder: Results from Comorbidity Survey Replication (NCS-R).” The Journal of the American Medical Association, 289(23):3095-3105. doi: 10.1001/jama.289.23.3095. Retrieved on April 25, 2011 from http://jama.ama- assn.org/content/289/23/3095.short
Spaner, D., Bland, R. C. and Newman, S. C. (1994). “Major Depressive Disorder.” Acta Psychiatrica Scandinavica, Vol 89(376, Suppl), 7-15. doi: 10.1111/j.16000447.1994.tb05786.x. Retrieved on April 25, 2011 from http://psycnet.apa.org/psycinfo/1994-25582-001