What is depression? In this lesson, we’ll look closer at depressive disorders, including the diagnostic criteria, causes, and treatments of major depressive disorder.
Laurie is blue. She’s recently broken up with her boyfriend, she’s failing her statistics class, and she’s really worried she might get kicked out of school. She feels sad all the time, and isn’t interested in hanging out with her friends, and is always tired despite sleeping most of the day. Not only that, she’s lost her appetite and is having trouble concentrating in school.
Laurie might be suffering from a depressive disorder, a mood disorder that involves feeling sad and losing interest in things that are normally interesting to the person. There is more than one type of depressive disorder. Major depressive disorder is what most people think of when they think of depression.
It involves long periods of severe sadness or loss of interest and other symptoms as well.But there’s another type of depressive episode, called dysthymia, which is a less severe form of major depressive disorder. Dysthymia is chronic (that is, it lasts a long time), but the symptoms are not as severe.
So which one does Laurie have? Imagine that you’re her psychologist. It’s your job to figure out if Laurie has major depressive disorder or dysthymia.
In order to figure that out, you consult a book called the Diagnostic and Statistical Manual of Mental Disorders, or DSM for short. This book lists the criteria required to be diagnosed with a psychological disorder. To check if Laurie has major depressive disorder, you turn to the page with the diagnostic criteria for that disorder and you compare her symptoms to those in the book.1. Depressed mood and/or loss of interest in pleasurable things.
Laurie is feeling sad and she doesn’t want to hang out with her friends, so she has both of these symptoms and meets this criterion.2. At least 3 or 4 other symptoms.A patient needs a total of five symptoms, including depressed mood and/or loss of interest in pleasurable things. Other possible symptoms include changes in appetite, sleeping too much or having insomnia, movement issues, fatigue, feelings of worthlessness or guilt, trouble concentrating, or thinking and recurrent thoughts of death or suicide.
Remember that Laurie has both depressed mood and loss of interest in pleasurable things. She needs to display at least three other symptoms in order to have a total of five symptoms. She’s tired all the time, sleeps much more than usual, has lost her appetite and is having trouble concentrating. Since she has a total of six symptoms, she meets this criterion.3.
The symptoms have been present almost every day for at least two weeks.Laurie’s been feeling this way for a while, so we can check this one off.4. There are no manic episodes.
Sometimes, depression is mirrored with manic episodes, when the patient feels energized, ambitious and on top of the world. If that’s the case, the patient is not diagnosed with major depressive disorder. But Laurie only has depressive symptoms, so she meets this criterion.5. The symptoms cause distress or impairment.Laurie is having trouble in school and doesn’t like feeling this way.
Because she is impaired at school and experiencing distress, we can check this one off.6. The symptoms cannot be explained by a physical illness or by bereavement.Everyone feels down after they lose someone they love. If symptoms of depression occur in the first two months after losing a loved one or if they are caused by a physical problem, the patient is not diagnosed with major depressive disorder.
But Laurie is fine physically, and no one has died recently, so she meets this criterion.Since she meets all six criteria, we can diagnose Laurie with major depressive disorder.
Causes and Treatment
So, we know that Laurie has major depressive disorder.
But how did she get it? What causes depression? Psychologists aren’t in agreement on the causes of depressive disorders. Some psychologists believe that it might be caused by biology. That is, there may be brain anomalies that could lead to depression. For example, Laurie might have a chemical imbalance in her brain that’s causing her depression.Support for the biological explanation lies in the fact that depression runs in families, and that medication to change the chemistry of a person’s brain works well with depressive patients.On the other hand, some psychologists look to the environment for explanations about the cause of depression.
Whether it’s childhood trauma or negative thought patterns, these psychologists believe that something other than biology is causing depression. Remember that Laurie’s boyfriend dumped her, and she’s struggling in school. Both of these are examples of environmental factors that might be causing her depression.Of course, most psychologists recognize that it’s probably a mixture of biology and environment that causes depressive disorders. And treatment reflects the hybrid view. The most effective treatment involves both drugs and talk therapy.
Since drugs support the biological view and talk therapy supports the environmental view, it stands to reason that a combination of the two might be responsible for the disorder.
Depressive disorders are mood disorders characterized by chronic negative feelings. When most people think of depression, they are thinking of major depressive disorder, a type of depressive disorder that involves losing interest in pleasurable things and feeling sad, among other symptoms. The symptoms of major depressive disorder usually last for two or more weeks, do not include manic symptoms and cannot be explained by other conditions. There are two possible causes of depressive disorders: biology and environment.
Treatment includes drugs and talk therapy.
After watching this lesson, you should be able to identify and explain the symptoms, causes, and treatment options for major depressive disorder.