Major depressive episode
| Major depressive episode | |
|---|---|
| Specialty | Psychiatry |
| Symptoms | Low mood; loss of interest/pleasure; difficulty with concentration; fatigue; excessive guilt; thoughts of death/suicide |
| Complications | Self-harm; suicide; difficulty functioning in everyday life |
| Duration | Average of 3-12 months, but can last for weeks or years |
| Risk factors | Family history; acute stresses (major life changes, adverse life experiences); chronic health problems; genetic predisposition |
| Diagnostic method | Based on symptoms as outlined in the DSM-5 and ICD |
| Differential diagnosis | Any psychotic disorders; Adjustment disorder; Anxiety disorder; Bipolar disorder; Gender dysphoria; Personality disorder; Substance use disorder |
| Treatment | Psychotherapy; antidepressant medication |
| Medication | Antidepressants |
| Frequency | 13-20% (lifetime risk) |
A major depressive episode (MDE) is a period characterized by symptoms of major depressive disorder (MDD). Those affected primarily exhibit a depressed mood for at least two weeks or more, and a loss of interest or pleasure in everyday activities. Other symptoms can include feelings of emptiness, hopelessness, anxiety, worthlessness, guilt, irritability, changes in appetite, difficulties in concentration, difficulties remembering details, making decisions, and thoughts of suicide. Insomnia or hypersomnia and aches, pains, or digestive problems that are resistant to treatment may also be present.
Although the exact origin of depression is unclear, it is believed to involve biological, psychological, and social aspects. Socioeconomic status, life experience, genetics, and personality traits are believed to be factors in the development of depression and may represent an increased risk of developing a major depressive episode.
In the 19th century, the term "depression" was first used as "mental depression", suggesting depression as essentially a mood or affect disorder. In modern times, depression, more often severe cases, is more noted as an absence of pleasure, with feelings of emptiness and flatness.
In the United States and Canada, the costs associated with major depression are comparable to those related to heart disease, diabetes, and back problems and are greater than the costs of hypertension. According to the Nordic Journal of Psychiatry, there is a direct correlation between a major depressive episode and unemployment.
Treatments for a major depressive episode include psychotherapy and antidepressants. Electroconvulsive therapy and transcranial magnetic stimulation may be used in cases that do not respond to other treatments. Recovery chance is higher when medication and therapy are combined in moderate-to-severe cases, although in more severe cases, hospitalization or intensive outpatient treatment may be required.
Depression can produce more years lived with disability than war, HIV/AIDS, and cancer combined. It is the leading cause of disability in the world; according to WHO (see here).