About Depression and Major Depressive Disorder

Imagine for a moment that we sit down across from each other and I tell you that I’m going to test your knowledge about behavioral health diagnoses. I will do that by holding up a card with words on it and ask you to tell me everything you know about that word or words. Ready? Here goes. I hold up the first card and it says, “Depression.”

With a look on your face that excitedly says, “I know this one!” you launch into a confident discussion of diagnostic criteria. The look on your face quickly changes to surprised confusion when you notice my head moving left and right in the silent universal symbol of disapproval that says, “No, that’s not right.” The instruction begins when I tell you, “The correct answer is that depression a normal human emotion, not a mental illness.” What? Stay calm and read on.

Human beings are endowed with a rich and deep palette of emotional colors. We experience the exquisitely pleasant highs of childbirth, marriage ceremonies, graduations, good sex, and our favorite team winning the big game. We also experience the deep and painful lows of divorce and breakups, funerals, job loss, and our favorite team losing the big game. Although feeling these comparatively extreme emotions adds richness to our lives, it’s also exhausting and not productive for long periods. We spend most of our time in the middle of the emotional spectrum, and our brain helps us regulate our moods.

Depression is not a medical term because it is a normal human emotion that everyone feels. When we feel depressed we instinctively engage in activities that make us feel pleasure and our mood eventually improves back to the middle of the emotional spectrum. Sad and depressed people leave funerals to attend social gatherings featuring a multitude of pleasure-inducing activities; interpersonal connection, touching, hugging, eating, and laughing over common memories and experiences. After other such lows in our lives, having french fries with a friend after a romantic break-up, or a hunting trip with buddies serve the same purpose. We tend to feel better afterward.

What is Major Depressive Disorder?

Major Depressive Disorder is the medical term to describe the problem when people feel depressed (normal) and lose the ability to feel pleasure (not normal). In that condition, people feel down and cannot lift themselves. If they remain in that condition more days than not for more than 14 days, they are candidates for a diagnosis of Major Depressive Disorder.

Other symptoms are required for the diagnosis and may include motivation and energy changes, sleep disturbances, feelings of guilt, decreased sex drive, a sense of cognitive dulling, or thoughts of suicide. However, the primary problem in Major Depressive Disorder is anhedonia, the inability to feel pleasure. Anhedonia is what distinguishes normal depressive states from Major Depressive Disorder. People elevate themselves out of depression by feeling pleasure, but in Major Depressive Disorder, they can’t. They need help.

Major Depressive Disorder is a significant personal and public health problem. The National Institute of Mental Health reports that in the United States, 16.2 million (6.7%) adults had a major depressive episode in 2016. Women (8.5%) experience major depression about twice as much as men (4.8%). Adults ages 18-25 have the highest rates of depression (10.9%). Whites (7.4%) have higher rates than Hispanics (5.6%) or Blacks (5.0%) or Asians (3.9%). However, Native Americans and Alaskan Natives have even higher rates (8.7%), and people reporting two or more races have the highest rates (10.5%). Adolescents ages 12-17 have similar statistics that are about twice as high across all categories, with the highest rates in 16-year-olds (17.4%).

Fortunately, Major Depressive Disorder can be treated once it is diagnosed properly. Sadly, 37% of adults and 60% of adolescents do not receive any treatment. We must do better. If you had a cough or fever that was concerning, you’d seek a medical opinion and help. Even if you were told it’s a minor problem and will resolve without treatment, at least you would have appropriately responded to warning signs.

Please don’t ignore the warning signs of Major Depressive Disorder. If you notice that you or those you love are feeling depressed and normally pleasant activities have lost their appeal, get help. It’s not normal to be in that condition. It’s better to be on the side of caution and get a medical opinion before deciding on your own that the depression isn’t something more serious.

At HCO Behavioral Health, we offer therapy and treatment for depression. We can help, but we can’t help if we don’t know you’re there. Make contact with us today and Let’s Deal with it Together.