A Quick Guide to the Hidden Struggles of Depression: Understanding Major Depressive Disorder and How to Overcome It
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Depression, known as Major Depressive Disorder (MDD), is an increasing mental health disorder in individuals worldwide. It occurs when an individual's mood is depressed for most of the day and they lose interest in most activities, even the activities they used to find enjoyable.
According to the World Health Organization (WHO), depression is expected to rank as the leading cause of disease burden globally by 2030.
Depression doesn’t always look the same for all people and cultures, its symptoms can manifest differently due to cultural norms, gender roles, or learned patterns of expression - for example, some cultures encourage masking distress, or women may minimize emotions because of caregiving expectations.
It can also show up holistically in the body, such as chronic gut issues, fatigue, appetite changes, or other physical complaints, which then ripple into social withdrawal and reduced quality of life.
Understanding depression is really important because various studies suggest that one in four people, i.e., 25% worldwide, will suffer from a mental health or neurological disorder at some point in their lives.
In this blog post, we will explore a quick overview and description of major depressive disorder, including its causes, symptoms, and treatment options.
What is Major Depressive Disorder (MDD)?
According to DSM-5 guidelines, MDD can be diagnosed in an individual if they have at least five symptoms out of the following nine symptoms every day for at least two weeks. One of these symptoms must be out of these 1) depressed mood or 2) loss of interest or pleasure.
Depressed mood: feeling of sadness and hopelessness for most of the day, nearly every day.
Loss of interest or pleasure: individuals may lose interest in most activities.
Fatigue or tiredness: A constant feeling of fatigue and lack of energy.
Insomnia or hypersomnia: difficulty sleeping (insomnia) or sleeping more than normal (hypersomnia) for most days.
Significant weight changes: weight loss or gain, or changes in appetite.
Lack of concentration—difficulty focusing, thinking, or making decisions.
Feelings of worthlessness or excessive guilt—Individuals may blame themselves for everything and feel guilty.
Psychomotor changes: having a slowing down of thought and physical movement or the opposite; these changes are often noticed by others.
Thoughts of ending their life—frequent thoughts of death These types of thoughts come very frequently to individuals.
Causes of MDD
Biological Factors
Major Depressive Disorder has a significant biological factor, with a lifetime prevalence of 8% to 25%. Women are twice as likely to develop MDD compared to men, due to factors like hormonal changes and childbirth.
Although statistics show depression is more common in women, men may underreport their struggles due to stigma, and it can often appear as irritability, anger, or physical health complaints.
Research suggests that the prevalence of depression has increased in recent generations, with rates nearing 20–25%.
This rise may be linked to the growing use of drugs and alcohol. Additionally, a person who experiences one depressive episode has a 50% chance of experiencing another; this likelihood increases to 75% after two episodes and 90% after three episodes.
Cognitive Factors
Negative thought patterns are a primary cognitive cause of MDD. Individuals with consistent negative thought patterns like hopelessness, worthlessness, and helplessness are at a higher risk of developing depression.
For example, if someone believes they are the problem and their situation is hopeless, so they cannot change, these thoughts can trigger depressive episodes.
Interpersonal Factors
Individuals who are antisocial, lack quality relationships, or experience social isolation are at a higher risk of depression. Traumatic life experiences, like the loss of a loved one or emotional abandonment, can also trigger depressive episodes.
Additionally, social isolation due to any reason can evoke the feelings of loneliness and despair that may lead to MDD.
Treatments for Major Depressive Disorder
There are different methods used to treat MDD, but the two most popular ones are medication and psychotherapy. Combining these treatments has been proven to be more successful in many circumstances.
Medications
Medications are prescribed when benefits outweigh side effects, and many side effects are manageable.
Two popular types of antidepressants are used to treat depression, but there can be side effects such as nervousness, restlessness, and sexual problems, such as reduced sexual desire.
Two most popular medications used in the treatment are:-
Selective Serotonin Reuptake Inhibitors (SSRIs): These are the most commonly prescribed antidepressants and include fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft).
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): This includes venlafaxine (Effexor) and duloxetine (Cymbalta).
It’s natural to worry about side effects. Doctors weigh the risks against the benefits carefully, and many people find their functioning improves greatly with the right medication. Side effects vary and can often be managed or reduced over time
Psychotherapy
Two types of psychotherapy are particularly effective in treating depression:
Cognitive Behavioral Therapy (CBT): CBT is used to fix mindsets or restructure thoughts (cognitive restructuring). Different methods, like rationalization of thoughts, behavioral activation, and mindfulness, are used to alter the negative thought patterns of patients.
Interpersonal Therapy (IPT): IPT focuses on improving interpersonal relationships and social functioning to reduce depressive symptoms.
Therapy is not one-size-fits-all. Beyond CBT and IPT, approaches like psychodynamic or mindfulness-based therapy may help.
The most important factor is that clients feel safe, understood, and that their cultural background and values are considered.
Electroconvulsive Therapy (ECT)
In some extreme cases, electroconvulsive therapy (ECT) may be used. In this, carefully monitored electrical stimulation under anesthesia is used. It has some side effects, like memory loss, but it is effective in the short term.
Note from therapist
“In my clinical work, I see that depression doesn’t always follow a neat diagnostic label. It can show up situationally, come in waves, or be tied to a mix of biological, relational, cultural, and even intergenerational factors.
Sometimes it even manifests physically - through gut health, fatigue, appetite changes, or other chronic symptoms - which can lead to social withdrawal and greater isolation.
And When it comes to looking for therapy, consider whether you prefer virtual or in-person sessions, the therapist’s specialty, cultural background, fees, and insurance.
Most therapists also offer a free consultation, which gives you the chance to connect and see if you feel comfortable before making the commitment. Many clients describe therapy as one of the most supportive spaces they’ve ever had.
“It’s important to know that there isn’t just one ‘right’ way to heal. What works for one person may not work for another - and that’s okay. Therapy can be integrative, meaning it may draw on many different sources of healing.
For some, this includes faith or spirituality; for others, traditional rituals and remedies, community support, or medical approaches like medication. The most important thing is working with a therapist who tailors the process to your background, values, and traditions, so healing feels authentic and meaningful to you.” — Supriya Verma.
About the Reviewer
Supriya Verma, Registered Psychotherapist (Qualifying), MA
Supriya offers culturally sensitive, trauma-informed therapy with a warm and collaborative approach. She helps individuals with emotional healing, ADHD and stress management, relationship patterns, and reconnecting with their inner clarity—always at a pace that honours their unique story.(Learn More)
Conclusion
In conclusion Major depressive disorder (MDD) is a complex mental health disorder that affects so many people worldwide.
Understanding its causes, symptoms, and treatment options is important because it is not just a temporary feeling of sadness; it is a serious disorder that can affect an individual’s life and well-being.
If you or someone you know is struggling with depression, it is really important, and I would encourage you to seek professional help. Remember, there is nothing wrong with you for feeling this way; you are not weak, and you are not the problem; it is not your fault; it is a disorder and should be treated like one, and with proper support and help, recovery is possible.
Resources
For US
National Suicide Prevention Lifeline
Phone: 1-800-273-TALK (8255)
Website: Suicide Prevention Lifeline
Crisis Text Line
Text: HOME to 741741
Website: Crisis Text Line
National Alliance on Mental Illness (NAMI)
Website: NAMI
Mental Health America (MHA)
Website: MHA
For canada
Crisis Services Canada
Phone: 1-833-456-4566
Text: 45645
Website: Crisis Services Canada
Kids Help Phone
Phone: 1-800-668-6868
Website: Kids Help Phone
Centre for Addiction and Mental Health (CAMH)
Website: CAMH
Canadian Mental Health Association (CMHA)
Website: CMHA
References
Malhi, G. S., & Mann, J. J. (2018). Depression. The Lancet, 392(10161), 2299–2312. https://doi.org/10.1016/s0140-6736(18)31948-2.
The World Health Report 2001: Mental Disorders affect one in four people. (2001, September 28). https://www.who.int/news/item/28-09-2001-the-world-health-report-2001-mental-disorders-affect-one-in-four-people.
Weiner, I. B., & Craighead, W. E. (2010). The Corsini Encyclopedia of Psychology, Volume 3. John Wiley & Sons. https://amzn.to/4cr3WlB
Weiner, I. B., & Craighead, W. E. (2010a). The Corsini Encyclopedia of Psychology, Volume 2. John Wiley & Sons. http://books.google.ie/books?id=pa5vKqntwikC&printsec=frontcover&dq=The+Corsini+Encyclopedia+of+Psychology,+Volume&hl=&cd=2&source=gbs_ap
Bains, N., & Abdijadid, S. (2023, April 10). Major Depressive Disorder. StatPearls - NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK559078/.