major depressive disorder

Depression is a severe disorder, and one that can often go undetected in som
e people's lives because it can creep up on you. Depression doesn't need to
strike all at once; it can be a gradual and nearly unnoticeable withdrawal f
rom your active life and enjoyment of living. Or it can be caused by a clear
 event, such as the breakup of a long-term relationship, a divorce, family p
roblems, etc. Finding and understanding the causes of depression isn't nearl
y as important as getting appropriate and effective treatment for it. 

Grief after the death or loss of a loved one is common and not considered de
pression in the usual sense. Teenagers going through the usual mood swings c
ommon to that age usually don't experience clinical depression either. Depre
ssion usually strikes adults, and twice as many women as men. It is theorize
d that men express their depressive feelings in more external ways that ofte
n don't get diagnosed as depression. For example, men may spend more time or
 energy focused on an activity to the exclusion of all other activities, or
may have difficult controlling outbursts of rage or anger. These types of re
actions can be symptoms of depression. 

Clinical Findings:
A person who suffers from a major depressive disorder (sometimes also referr
ed to as clinical depression or major depression) must either have a depress
ed mood or a loss of interest or pleasure in daily activities consistently f
or at least a 2 week period. This mood must represent a change from the pers
on's normal mood. Social, occupational, educational or other important funct
ioning must also be negatively impaired by the change in mood. For instance,
 a person who has missed work or school because of their depression, or has
stopped attending classes altogether or attending usual social engagements.

Clinical depression is characterized by the presence of the majority of thes
e symptoms: 

1. Depressed mood most of the day, nearly every day, as indicated by either
subjective report (e.g., feeling sad or empty) or observation made by others
 (e.g., appears tearful). (In children and adolescents, this may be characte
rized as an irritable mood.) 
2. Markedly diminished interest or pleasure in all, or almost all, activitie
s most of the day, nearly every day 
3. Significant weight loss when not dieting or weight gain (e.g., a change o
f more than 5% of body weight in a month), or decrease or increase in appeti
te nearly every day. 
4. Insomnia or hypersomnia nearly every day 
5. Psychomotor agitation or retardation nearly every day; Fatigue or loss of
 energy nearly every day 
6. Feelings of worthlessness or excessive or inappropriate guilt nearly ever
y day 
7. Diminished ability to think or concentrate, or indecisiveness, nearly eve
ry day 
8. Recurrent thoughts of death (not just fear of dying), recurrent suicidal
ideation without a specific plan, or a suicide attempt or a specific plan fo
r committing suicide 
In addition, for a diagnosis of major depression to be made, the symptoms mu
st not be better accounted for by Bereavement, i.e., after the loss of a lov
ed one, the symptoms persist for longer than 2 months or are characterized b
y marked functional impairment, morbid preoccupation with worthlessness, sui
cidal ideation, psychotic symptoms, or psychomotor retardation. 

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