Major depressive disorder (MDD) is a common and serious mental illness characterized by depressed mood, loss of interest, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, poor concentration, and thoughts of death or suicide. It affects over 16 million American adults in a given year. The causes are multifactorial including genetic, psychological, and environmental factors. Treatment involves medication such as SSRIs, psychotherapy including cognitive behavioral therapy, lifestyle changes, and in severe cases electroconvulsive therapy.

1. MAJOR DEPRESSIVE
DISORDER
BY: SYED MOHAMMAD ARISH AYUB

2. MAJOR DEPRESSIVE
DISORDER
• CLINICAL DEPRESSION
• CONTINUOUS FEELING OF SORROW
• LOSS OF INTEREST
• CHANGES IN FEELINGS, THOUGHTS AND
BEHAVIOR
• OCCURS MOST OF THE DAY
• DAILY BASIS OF WORK NOT COMPLETED

3. MAJOR DEPRESSIVE
DISORDER
•MDD AFFECTS MORE THAN 16.1
MILLION AMERICAN ADULTS, OR
ABOUT 6.7%OF THE U.S. POPULATION
AGE 18 AND OLDER IN A GIVEN YEAR
•MORE COMMON IN WOMEN THAN
MEN

4. TYPES OF
MAJOR
DEPRESSIVE
DISORDER
Seasonal affective disorder
Psychotic depression
Postpartum depression
Melancholic depression
Catatonic depression
Premenstrual Dysphoric Disorder
Atypical Depression
Persistent depressive disorder
Bipolar disorder

5. TYPES OF
MAJOR DEPRESSIVE
DISORDER
SEASONAL AFFECTIVE DISORDER:
• MOSTLY IN WINTER/ LESS SUNLIGHT
PSYCHOTIC DEPRESSION:
• ILLNESS
• GUILT
• PAST TRAUMA

6. TYPES OF
MAJOR DEPRESSIVE
DISORDER
POSTPARTUM DEPRESSION:
•NEW MOTHERS
•INCOMPLETE DAILY TASKS

7. TYPES OF MAJOR DEPRESSIVE
DISORDER
MELANCHOLIC DEPRESSION:
•COMMON SIGNS OF DEPRESSION
• WEIGHT IMBALANCE
•LOSS OF MOTIVATION AND INTEREST
•CATATONIC DEPRESSION:
•SPEECHLESS AND MOTIONLESS FOR SOME TIME

8. TYPES OF MAJOR DEPRESSIVE
DISORDER
PREMENSTRUAL DYSPHORIC DISORDER (PMDD):
• SERIOUS THAN PMS
• DEPRESSED MOOD AND ANXIETY
• SUICIDAL THOUGHTS
• INABILITY TO DO DAILY WORK
ATYPICAL DEPRESSION:
• OVERSLEEPING/OVEREATING
• WEIGHT IN THE ARMS AND LEGS
• RELATIONSHIP PROBLEMS

9. TYPES OF MAJOR DEPRESSIVE
DISORDER
BIPOLAR DISORDER:
● DIFFERENT FROM DEPRESSION
● EPISODES OF LOW MOODS
PERSISTENT DEPRESSIVE DISORDER:
• DYSTHYMIA
• MAJOR DEPRESSION WITH LESS SERIOUS SYMPTOMS.

10. ETIOLOGY

11. ETIOLOGY
•MULTIFACTORIAL
•GENETIC,
PSYCHOLOGICAL, AND
ENVIRONMENTAL

12. GENETIC FACTOR:
• 50% IS GENETIC FOUND THROUGH THE
TWIN STUDIES
• CAUSED BY COMBINATION OF GENES
SUCH AS COMT AND 5-HTTLPR OR
SEROTONIN TRANSPORTER PROMOTOR
GENE’S SHORT ALLELE HAS BEEN
CONNECTED WITH INCREASED RISK OF
DEPRESSION.

13. PSYCHOLOGICAL AND
BIOLOGICAL FACTORS:
• STRESS
• TRAUMA
• NEGATIVE EVENTS
• HORMONAL CHANGES- THYROID,
MENOPAUSE,
• LOW SELF- ESTEEM
• SERIOUS MEDICAL CONDITIONS-HIV,
CARDIOVASCULAR DISEASES
• ABNORMAL LEVELS OF SEROTONIN,
NORADRENALINE, DOPAMINE

14. ENVIRONMENTAL FACTORS:
•NOISE POLLUTION, ELECTRICAL POLLUTION, NATURAL DISASTERS
•FOOD ADDITIVES AND PRESERVATIVES, PESTICIDES
•DRUGS: ALCOHOL AND MEDICATIONS

15. CLINICAL FEATURES
OF
MAJOR DEPRESSIVE
DISORDER

16. COMMON FEATURES ARE:
• DEPRESSED MOOD MOST THE DAYS NEARLY EVERYDAY
• FEELING WORTHLESSNESS OR GUILT
• DIMINISHED INTEREST OR PLEASURE OF DOING WORK
• WEIGHT LOSS
• FATIGUE OR LOSS OF ENERGY
• INABILITY TO THINK OR CONCENTRATE

17. •ALWAYS THINKS OF COMMITTING SUICIDE
•REDUCTION FROM SEXUAL INTEREST OR DESIRE
•SIGNIFICANT LOSS OR GAIN OF WEIGHT
•DECREASED ENERGY, TIREDNESS
•MEMORY LOSS

18. SIG – E – CAPS
•SLEEP CHANGES
•INTEREST LOSS
•GUILT
•ENERGY
•COGNITION OR LACK OF CONCENTRATION
•APPETITE LOSS
•PSYCHOMOTOR
•SUICIDE

19. MDD IN CHILDREN
•SADNESS
•IRRITABILITY
•CLINGINESS
•REFUSING TO GO TO SCHOOL
•BEING UNDERWEIGHT

20. MDD IN TEENS
•ANGER
•FEELING NEGATIVE AND WORTHLESS
•POOR PERFORMANCE AND POOR ATTENDANCE
•FEELING MISUNDERSTOOD

21. MDD IN OLDER ADULTS
•MEMORIES PROBLEM
•PHYSICAL PAIN OR ACHES
•SLEEP PROBLEM
•LOSS OF INTEREST IN SEX
•SOCIAL WITHDRAWAL
•SUICIDAL THINKING OR FEELING

22. APPEARANCE
•NEGLECTED DRESS AND GROOMING
•FACIAL FEATURES TURNING DOWNWARDS, SHOULDER BENT,
INCLINED HEAD, DOWNWARD GAZE

23. SLEEP DISTURBANCE
•MAY HAVE MILD INSOMNIA OR TYPICAL INSOMNIA
•HYPER INSOMNIA
•INITIAL INSOMNIA
•SPEECH – DECREASED IN VOLUME, MUTENESS
•SHOE EEG ABNORMALITIES

24. HIGH RISK OF MDD
•CHRONIC INSOMNIA OR FATIGUE
•CHRONIC PAIN
•ACUTE CARDIOVASCULAR EVENTS
•SUBSTANCE ABUSE DISORDER

25. DIAGNOSTIC CRITERIA
OF
MAJOR DEPRESSIVE
DISORDER

26. DSM-5 (MAJOR DEPRESSIVE DISORDER)
• FIVE (OR MORE) OF THE FOLLOWING SYMPTOMS HAVE BEEN PRESENT DURING
THE SAME 2 WEEK PERIOD AND REPRESENT A CHANGE FROM PREVIOUS
FUNCTIONING
• AND AT LEAST ONE OF THE SYMPTOMS IS EITHER
(1)DEPRESSED MOOD OR
(2) LOSS OF INTEREST OR PLEASURE.

27. DEPRESSED MOOD – A) SUBJECTIVE – FEELS SAD , EMPTY ,HOPELESS
B) OBSERVATIVE- APPEARS TEARFUL
DIMINISHED INTEREST OR PLEASURE
INSOMNIA OR HYPERSOMNIA-

28. PSYCHOMOTOR AGITATION ORE RETARDATION NEARLY EVERYDAY
FATIGUE OR LOSS OF ENERGY

29. DIMINISHED ABILITY TO THINK OR CONCENTRATE , OR INDECISIVENESS
RECURRENT THOUGHTS OF DEATH-

30. FEELING OF GUILT-
SIGNIFICANT WEIGHT LOSS-

31. DIFFERENTIAL DIAGNOSIS
OF
MAJOR DEPRESSIVE
DISORDER

32. DIFFERENTIAL DIAGNOSIS
• MANIC EPISODES WITH IRRITABLE MOOD OR MIXED EPISODES.
• MOOD DISORDERS DUE TO ANOTHER MEDICAL CONDITIONS.
• SUBSTANCE INDUCE DISORDERS OR BIPOLAR DISORDER.

33. DIFFERENTIAL DIAGNOSIS
• ATTENTION-DEFICIT/HYPERACTIVE DISORDER.
• ADJUSTMENT DISORDER WITH DEPRESSED MOOD.
• SADNESS

34. TREATMENT
OF
MAJOR DEPRESSIVE
DISORDER

35. TREATMENT
• MEDICATION:-
1. SELECTIVE SEROTONIN REUPTAKE
INHIBITORS (SSRIS) :- IT INCREASES THE
SEROTONIN (A NEUROTRANSMITTER) LEVELS IN
THE BRAIN, WHICH IS KNOWN TO CONTROL
EMOTIONS.
2. ANTIDEPRESSANTS: RELAX THE MIND.
• PSYCHOTHERAPY
• COGNITIVE BEHAVIORAL THERAPY(CBT)
• ELECTROCONVULSIVE THERAPY (ECT)

36. • LIFESTYLE CHANGES:-
1. EATING RIGHT.
2. AVOIDING ALCOHOL AND CERTAIN
PROCESSED FOODS.
3. GETTING PLENTY OF EXERCISE.
4. SLEEPING WELL.

37. REFERENCES
• LIEBER, A. (N.D.). WHAT IS MAJOR DEPRESSION? THE SIGNS, SYMPTOMS &
TREATMENT. RETRIEVED FROM
HTTPS://WWW.PSYCOM.NET/DEPRESSION.CENTRAL.MAJOR.HTML.
• GENETICS OF BRAIN FUNCTION. (N.D.). MAJOR DEPRESSION AND GENETICS.
RETRIEVED FROM
HTTP://MED.STANFORD.EDU/DEPRESSIONGENETICS/MDDANDGENES.HTML.
• GULF BEND MHMR CENTER. (N.D.). RETRIEVED FROM
HTTPS://WWW.GULFBEND.ORG/.
• HTTPS://SCHOLAR.GOOGLE.COM/SCHOLAR?Q=MAJOR+DEPRESSIVE+DISORDER&HL=EN&AS_SDT=0&A
S_VIS=1&OI=SCHOLART

38. •HTTPS://WWW.CELL.COM/FULLTEXT/S0896-6273(00)00112-4
•HTTPS://ONLINELIBRARY.WILEY.COM/DOI/ABS/10.1002/DA.22217
•HTTPS://WWW.WEBMD.COM/DEPRESSION/GUIDE/MAJOR-
DEPRESSION
•HTTPS://WWW.HEALTH.HARVARD.EDU/A_TO_Z/MAJOR-DEPRESSION-
A-TO-Z

39. THANK YOU