Major Depressive Disorder [Clinical Depression]: Types, Symptoms & Treatments in 2024

May 6, 202412 min
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What is Major Depressive Disorder [C Depression]?

Major depressive disorder (MDD) is a mental health condition in which an individual experiences a constant state of low mood for more than two weeks. It may include feelings of sadness, irritation, and emptiness along with a loss of pleasure in life. The individual may find that they are no longer interested in things that previously brought them joy and are unable to keep up with the demands of their daily lives.  

According to The 2017 National Mental Health Survey (NMHS) of India, around 23 million adults need care for depressive disorders at any given point in time. While we are yet to receive the latest reports of NMHS, it is evident that these numbers have significantly increased post-pandemic.

The symptoms of depression can take a significant toll on the individual as the loss of energy and interest can cause difficulties in keeping up with all aspects of life, including but not limited to health, interpersonal relationships, work, and personal goals. 

While it can be quite daunting to be experiencing depressive symptoms, the good news is that depression is a treatable condition. This article takes a deep dive into understanding what Major Depressive Disorder looks like and the treatment options that are available for it.

Who is Affected by Clinical Depression[MDD]?

Depression is the most prevalent mental illness that affects people of all ages, genders, and socioeconomic backgrounds across the globe. The prevalence of depression has been increasing worldwide. In 2015, major depressive disorder (DD) ranked third among all causes of disability across the world.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), symptoms of clinical depression (MDD) can appear at any age. Among the US population, symptoms have been found to first occur between puberty and young adulthood. However, it is not uncommon to experience depressive feelings for the first time later in life. 

Major Depressive Disorder - A women sat on a chair with a depression

How common is Clinical Depression in India?

In India, depression is the most common diagnosis given in mental health primary care settings. It is estimated that nearly one–third of the people who seek mental health-related services are experiencing some depressive symptoms. While the exact number of people affected is not available as it is often underreported and also due to various limitations in conducting such studies, it is safe to infer that depression is a significant public health concern and warrants treatment considerations.

What Causes Major Depressive Disorder?

Multiple factors can cause Major Depressive Disorder. We discuss some of them below. It is important to note that while these factors make a person more susceptible to depression, it is not definitive that a person will experience a depressive episode because of it.  

  1. Genetics: Individuals with a family history of depressive symptoms are more prone to develop MDD symptoms than individuals with no family history. 
  2. Environmental: A history of trauma, adverse childhood experiences, and stressful life events can lead to symptoms of depression. 
  3. Social: A lack of adequate resources, low social support, and marginalized identities are at higher risk of clinical depression.
  4. Cognitive: thinking errors, negative worldviews, and feelings of helplessness and hopelessness can make one more susceptible to depression. 

What are the Symptoms of Major Depressive Disorder?

Depression is an umbrella term for a spectrum of depressive feelings, symptoms, and thoughts whereas Major Depressive Symptoms is a specific presentation of depressive symptoms.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), Major Depressive Disorder is marked by a low mood and/or reduced interest in pleasurable activities for at least two continuous weeks. 

 MDD is often accompanied by an array of physical and emotional symptoms. The physical symptoms include fluctuations in appetite, sleep, and body weight. The individual may socially isolate themselves and experience intense restlessness, low energy, and constant tiredness.

The emotional symptoms often have a negative impact on an individual’s self-concept where they may experience frequent crying spells and feelings of excess guilt. There is an impending sense of hopelessness, helplessness, and worthlessness. In extreme severities of depression, some also express wishes to end their life to escape the emotional pain that they experience.

While depression is a debilitating condition, know that help is available. Check out Mave Health’s network of mental health professionals at Therapy Club and its flagship product, Arc to start your journey today.

How is a Major Depressive Disorder[clinical depression] Diagnosed?

In India, only an RCI-registered clinical psychologist and a psychiatrist can give a formal diagnosis of major depressive disorder. While psychiatrists can prescribe medications for MDD symptoms, clinical psychologists can conduct assessments and treatments for MDD. 

Initially, the clinical psychologist seeks to understand the patient’s background thoroughly – they may ask questions about the depressive symptoms, medical and mental health history, family, work, relationships, etc. The purpose of asking these questions is to understand various factors contributing to the distress and how they can be treated.

Additionally, the clinical psychologist may also conduct some psychological tests to have an objective overview of the depressive symptoms. All the findings are integrated to formulate a diagnosis and a treatment plan. 

The diagnosis of depressive symptoms varies with the nature, duration, and possible causes of our depressive feelings. While it can be useful to get a diagnosis for medications and clerical purposes (e.g., to request accommodations at the workplace), it is not a necessary condition to access mental health counseling and psychotherapy.

How is Major Depressive Disorder[clinical depression] Treated? 

Since the symptoms of major depressive disorders occur due to the interaction of biological and environmental factors, a holistic approach to treatment works best. This includes a combination of psychotherapy, medications, and lifestyle changes.

The patient can opt for several interventions based on the nature and severity of their symptoms, and available treatment resources. It is best to discuss the treatment options with your mental healthcare provider. 

Clinical Depression diagonised and treatment - Girl is meditating for MDD

#5 Different Treatment Modalities for Major Depressive Disorder[clinical depression] in 2024 

The depressive symptoms are caused due to the interaction of personal, sociocultural, and biological factors. Thus, the treatment of major depressive disorder requires a multi-pronged approach, and thankfully a lot of options are available.  

1. Pharmacotherapy 

Pharmacotherapy involves the use of psychiatric medications for managing symptoms of clinical depression. It can help to clear mental space and build emotional capacity to manage daily tasks and engage in therapeutic work which is essential for long-term benefits.  

2. Counseling and psychotherapy 

Counseling and psychotherapy help the patient to understand how the environment and personal history shape their experience with MDD. It enables them to have a larger view of their struggles and develop skills to deal with them. 

There are many types of psychotherapeutic interventions available for the treatment of MDD. Some of them include Cognitive Behavioral Therapy (CBT), Solution–Focused Behavioral Therapy (SFBT), Psychodynamic Psychotherapy, etc. 

  1. Cognitive Behavioral Therapy (CBT) helps the individual to identify unhelpful thoughts and behaviors that are keeping them stuck and generate a more adaptive worldview and habits.  
  2. Solution-focused Behavioral Therapy (SFBT) helps the client to ground in the present moment, tap into their inner resources, and generate their own solutions to the challenges to create a life that is authentic to them.  
  3. Psychodynamic Psychotherapy is a depth-focused therapy that explores the patient’s unconscious mind and relational experiences to find repetitive patterns that are keeping them stuck in the present distress, enabling them to make more conscious choices. 

3. Lifestyle modification

The symptoms of MDD can disrupt our biological and social rhythms, affecting essential bodily functions like appetite and sleep. Taking small, actionable steps towards restoring these systems even when it seems counterintuitive is a vital step in recovery from clinical depression. 

A. Dietary modification

The data suggests that there is a relationship between MDD and malnutrition. A lack of critical nutrients and a disorganized dietary pattern can contribute to MDD symptoms. Thus, it is important to treat nutritional deficiencies and strive towards eating healthy meals.

Ultra-processed products are foods that do not have whole food ingredients (e.g., carbonated beverages and mass-produced snacks). According to a research study, UPF may raise the chance of developing depressive symptoms, particularly in people who exercise less.

A lot of people tend to gravitate towards substance use, like alcohol, to find relief from the intensity of their depressive symptoms. While drinking alcohol can make you feel good in the moment when you are depressed, it is not good in the long run. Alcohol acts as a depressant, which means it lowers your mental functioning (e.g., thinking abilities) and can worsen your MDD symptoms.

B. Get plenty of exercise

The loss of energy and a constant state of fatigue make it harder to engage in active movement, creating an endless loop of depressive symptoms. Moving your body in accessible ways moves us closer to recovery. You can sit in the sunlight, go for a walk, play your favorite sport, workout at the gym, etc. While it feels hard, try to move your body in a way that feels good.  

C. Sleep well

Clinical depression can mess up the sleep cycle – you may sleep more or less than usual. Try practicing sleep hygiene – a set of behaviors that promotes good sleep quality. It can look like creating a comfortable sleep atmosphere, turning your screens off, listening to calm music, etc. 

5. Medications 

A combination of psychiatric medications like SSRIs and anxiolytics can help treat major depressive disorder. An optimum dosage reduces the severity of the symptoms to improve general functioning. It is important to take medications under the consultation of a psychiatrist to find a combination that works best for you and has the least side effects. 

Medical Procedures for Clinical Depression

There are some medical procedures like Electroconvulsive Therapy available to treat major depressive disorder. ECT uses electrical stimulation that is assumed to alter brain chemistry in a way that can promptly alleviate the symptoms of some mental health issues. While it is proven to be a highly effective form of treatment for depressive disorders, it may have some side effects. It is best to make treatment decisions with your healthcare provider.

Transcranial Direct Current Stimulation (tDCS) is a safe, reliable, and user-friendly technology that has proven to be effective for depressive symptoms. It is a non–invasive technology that works best in combination with psychotherapy and medications. 

If you're interested in learning more about tDCS for mental health, check out Arc, the first clinically validated tDCS-based device in India created by Mave Health. The best part about Arc is that it is a wearable gadget whose treatment protocol can be easily followed within the comfort of your home. To find out more, schedule a consultation session with Mave Health here.

What happens if MDD is not treated?

Major depressive disorder is a complex mental health condition that affects all aspects of life. If untreated, the individual may find it difficult to engage in daily tasks, experience a lack of pleasure, poor quality of life, and lower life satisfaction. The person may isolate themselves from friends and family, leading to increased isolation and interpersonal conflicts. It may cause problems at work leading to a poor performance review or other consequences.

While MDD takes an extreme toll on the person, it is encouraging to know that help is available. If you suspect that you are struggling with depression, reach out to a mental health professional today.

What can I do if I have Clinical Depression[MDD]?

If you suspect that you have clinical depression (MDD), know that you are not alone and help is available. Reach out to a mental health professional to understand your treatment options. You can check out Mave Health’s Therapy Club - the largest mental health platform in India to start your mental health journey today.

When should I see my Healthcare provider about Clinical Depression?

You can see your healthcare provider at any point you need support with clinical depression. If you are experiencing depressive symptoms consistently for more than two weeks and it is affecting your daily life – it is a sign to seek immediate consultation.

FAQ 

How long does Depression Treatment take to start working?

The time for the depression treatment to start working varies with each individual. According to the American Psychological Association (2010), psychiatric medications may show signs as early as 1 – 2 weeks and continue up to 12 weeks. However, the full effects of a prescription may require 1 – 2 months to kick in.  

Similarly in psychotherapy, a patient should start experiencing some improvement within 1 month. If not, it is a good point to evaluate what is not working with your therapist to make changes in the treatment plan. 

Can I prevent Clinical Depression (major depressive disorder)?

There is no clear answer about whether you can prevent clinical depression or not as it occurs due to the interaction of multiple factors which are beyond your control. However, developing a capacity for self-reflection and dealing with life stressors significantly improves treatment outcomes. It can look like a greater capacity to manage symptoms, reduction in severity and frequency of episodes, and increased life quality. 

What are the possible complications of clinical depression?

Clinical depression is associated with a huge burden of care, reduced life quality, and a greater risk for multiple physical and mental health conditions. It can also put a strain on a patient’s daily life, interpersonal relationships, and work. The good news is that clinical depression is a treatable condition. Reach out to a mental health professional to get the support you deserve. 

Is MDD the same as depression?

No, MDD is not the same as depression. Depression can be used as an umbrella term for multiple depressive disorders that exist on a spectrum and vary in severity and duration. Major depressive disorder is a specific type of depression where an individual is experiencing depressive symptoms consistently for two or more weeks.   

Is MDD considered a serious mental illness?

Any mental illness requires care and consideration. So yes, MDD is a serious mental health condition. A person may face varying levels of challenges depending upon the severity of the symptoms and the resources which are available to them. Reach out to a psychologist to find support for your mental health needs.

Can MDD be cured?

No, MDD can be managed but whether it can be cured or not varies from individual to individual, as MDD is caused by a lot of factors that are beyond a patient’s control, mental health treatment is limited in its scope. However, there are exciting innovations in the field of mental health that have a great treatment potential for MDD.

A person can recover from major depressive disorder with the right treatment and support. It is important to take of one’s health even after one is no longer struggling as there is a chance for reoccurrence. Talk to your healthcare provider to understand what recovery from depression may look like for you. 

Is MDD a disability?

Yes, MDD can be a mental health disability based on the severity of the symptoms and the extent to which they interfere with a patient’s life. 

Can people with MDD work?

Yes, people with MDD can work. To build inclusive workspaces, we must be aware of the stigma and bias against mental illness which is still rampant in today’s world. Be a champion of mental health by advocating for accommodations for mental health needs at work. 

When does a person suffering from depression start feeling better?

A depressive episode is cyclical in nature. In the beginning, a person may be confused and overwhelmed by what they are experiencing. Once they start seeking help, things start to improve gradually. During this journey, they may face a lot of setbacks and challenges which can be adequately dealt with with the help of a psychologist and loved ones. No matter what you are experiencing, know that help is available. Reach out to a mental health professional today.

CONCLUSION 

Although Depression is a serious mental health condition and it may feel overwhelming in the beginning, once you start seeking help, things start to improve gradually. During this journey, you may face setbacks and challenges, however, you can overcome them with the right treatment, support, and assistance. Thankfully, there are a lot of treatment options available for the management of depressive symptoms. A combination of medications, psychotherapy, and lifestyle changes are shown to be highly effective in treating clinical depression. If you are looking to consult a therapist for your mental health-related struggles, Check out Mave Health’s network of mental health professionals at Therapy Club and its flagship product, Arc to start your journey today.

REFERENCES 

American Psychiatric Association, D. S. M. T. F., & American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (Vol. 5, No. 5). Washington, DC: American Psychiatric Association.

American Psychiatric Association. (2010). Treating major depressive disorder: A quick reference guide. Washington, DC: American Psychiatric Association, 1-28.

Arvind, B. A., Gururaj, G., Loganathan, S., Amudhan, S., Varghese, M., Benegal, V., ... & Shibukumar, T. M. (2019). Prevalence and socioeconomic impact of depressive disorders in India: multisite population-based cross-sectional study. BMJ open, 9(6), e027250.

Jog, M. V., Wang, D. J., & Narr, K. L. (2019). A review of transcranial direct current stimulation (tDCS) for the individualized treatment of depressive symptoms. Personalized Medicine in Psychiatry17, 17-22.

Mayo Clinic (n.d.). Electroconvulsive Therapy.

National Collaborating Centre for Mental Health (UK. (2011). Common mental health disorders. In Common mental health disorders: Identification and pathways to care. British Psychological Society (UK).

Ortega, M. A., Fraile-Martínez, Ó., García-Montero, C., Alvarez-Mon, M. A., Lahera, G., Monserrat, J., ... & De Mon, M. A. (2022). The biological role of nutrients, food, and dietary patterns in the prevention and clinical management of major depressive disorder. Nutrients14(15), 3099.

Solomon, D., Aderaw, Z., & Tegegne, T. K. (2017). Minimum dietary diversity and associated factors among children aged 6–23 months in Addis Ababa, Ethiopia. International journal for equity in health16, 1-9.

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Mave
Clinical Psychologist