Major Depressive Disorder (MDD), also known as clinical depression, is characterized by at least two weeks of depressed mood, loss of interest in activities, and reduced energy. It is the most common type of mood disorder. MDD has biological causes such as genetic predisposition and abnormal brain structures and neurotransmitter levels. It also has psychological and social causes like difficult relationships, life stressors, and cognitive styles. Treatment involves antidepressant medications like SSRIs to restore chemical balances in the brain as well as psychotherapy and counseling.

1. MAJOR DEPRESSIVE
DISORDERS
MOOD DISORDER
B Y
N A G O O R G H A N Y, R U Z A I C A
J U N I O R I N T E R N , V M U .

2. OVERVIEW
• Major Depressive Disorder is also known as Major Depression, Clinical
Depressionor Unipolar Disease.
• The term depression was derived from the Latin verb deprimere - "to
press down".
• The most Common type of Mood Disorders.
• At least 2 weeks of a major depressive episode which causes significant
distress or disability
• No history of mania or hypomania
• Not due to a medical or substance use disorder

4. HOW DOES DEPRESSION FEEL?

5. SYMPTOMS
• In typical depressive episodes, the person experiences
–depressed mood
–loss of interest and enjoyment (anhedonia), and
–reducedenergy
• leading to diminished activity for at least 2 weeks. Many people with
depression also suffer from anxietysymptoms and medically unexplained
somaticsymptoms.

6. SYMPTOMS
•Usually significant weight loss and decrease in appetite
–Increase in appetite and weight can occur, but not commonly
•Feeling worthless, immense guilt, and regret
•Frequent insomnia or hypersomnia
•Fatigue, loss of energy frequently, lethargy
•Markedly less ability to think and concentrate
•Recurring thoughts of death
–These are serious thoughts, sometimes even with plans or attempts for
suicide

7. CAUSES of MDD
• Biological factors
– geneticpredisposition,
– brainstructures,
– neurotransmitters
• Personality Styles
• Socio-cultural factors
– Divorce
– Death
– Child Abuse
• Early family relationships
• Cognitive styles

8. GENETIC FACTORS
• Family studies:
Relatives of those with MDD are two to three times more likely to have a mood
disorder (usually major depression).
• Twin studies:
If one identical twin has a depressive disorder the other twin is 3 times more
likely than a fraternal twin to have the disorder .
• Severe depressive episodes may have stronger genetic
contribution than less severe episodes.
• Heritability rates are higher for females.

9. Brainstructureabnormalities(MRIfindings)
• Low Frontal lobe volume and increase ventricular volume
• Smaller hippocampus – important serotonin receptor
Neurotransmitters
• Monoamine hypothesis.
• Low levels of serotonin (norepinephrine,and/or dopamine)
deregulates the activity of other neurotransmitters and leads
to mood destabilization and depression.
Endocrinesystem
• Elevated cortisol levels
• Increased level of Growth Hormone (Prepubertal Children)

10. Psychological Causes
One psychological theory is the Attachment Theory.
The Attachment Theory predicts a relationship between depressive
disorder in adulthood and the quality of the earlier bond between the
infant and their adult caregiver.

11. SUBTYPES
5 subtypes recognized by the DSM-IV
(Diagnostic and Statistical Manual of Mental Disorder)
• Melancholic Depression
• Atypical Depression
• Catatonic Depression
• Postpartum Depression
• Seasonal Affective Disorder

12. DIAGNOSIS
• Self report and complains or observation of others
• Self screening Instruments
– Patient Health Questionnaire-9
– Beck Depression Inventory (BDI) or the Beck Depression Inventory-II (BDI-
II)
– Zung Self-Rating Depression Scale: A 20-item survey.
• Rating perform by the Consultant
– Hamilton Depression Rating Scale (HDRS)
– Geriatric Depression Scale

15. TREATMENT
• Medicinal
– Antidepressants (sertraline, citalopram)
• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin/norepinephrine reuptake inhibitors (SNRIs)
• Atypical antidepressants
• Tricyclic antidepressants (TCAs)
• Monoamine oxidase inhibitors (MAOIs)
• work by restoring chemicals in the brain to the right levels
- Tranquilizers

16. • Therapy
– Cognitive Behavioral Therapy
• focuses on fighting off negative thoughts
– Psychotherapy
• focuses on issues behind thoughts and feelings
– Group Therapy
• share problems with other people in the same situation
– Electroconvulsive therapy
• in severe cases of major depression.