Clinical depression, formally known as Major Depressive Disorder in the Diagnostic and Statistical Manual of Mental Disorders IV-TR, refers to a mental state characterized by a chronically depressed mood, persistent feelings of sadness, lack of pleasure, and adverse physiological symptoms. A 2005 study in "Archives of General Psychiatry" found that almost 17 percent of Americans experience an episode of clinical depression at some point. Many theories offer detailed accounts of the workings of this disorder, each with different foci and methods.
History
Traces of depression exist throughout written history. In Ancient Greece, for example, the term "melancholia" referred to long lasting states of sadness, despair, anger or fears brought about by an imbalance of bodily fluids. In the early 20th century, long after the abandonment of fluid-related theories, Sigmund Freud began to emphasize the psychological roots of depression, such as subjective loss and unconscious emotional processes. Many other biological, behavioral and social theories have emerged in the 20th and 21st centuries.
Causes
Each theory of clinical depression contains an account of its causes, and each theory underscores different contributors. Proponents of a behavioral account might use learning principles--such as operant conditioning through reinforcement, reward, and punishment--to explain depressive symptoms. Biological theorists may speak about depression as an imbalance of chemicals in the brain called neurotransmitters, while social-cognitive theorists may reference dysfunctional thought patterns. Empirical evidence supports each theory, according to "Current Psychotherapies." Although some mental health professionals adhere purely to one of these theories, many take an eclectic approach and view clinical depression as a multi-faceted phenomenon.
Symptoms
The Diagnostic and Statistical Manual of Mental Disorders IV-TR characterizes a single episode of Major Depressive Disorder as the presence of depressed mood, loss of pleasure, and three of the following for a period of more than two weeks: weight gain/loss, insomnia or hypersomnia, observable "slowness" and psychological fatigue, physiological fatigue, and feelings of worthlessness/guilt.
Treatment
Regardless of their preferred theory of the causes of clinical depression, family doctors, psychologists, psychiatrists and counselors treat clinical depression with antidepressant medication and psychotherapy. Scientific evidence--such as a 2004 research report in the "Journal of the American Medical Association"--suggests that both are beneficial treatments, and that a combination of the two may work even better. Consult a licensed professional for more information about an individualized treatment plan.
Warning
Avoid treatments for depression that have not undergone scientific study. A 2010 article published on MayoClinic.com warns that many available treatments for depression, including St. John's Wort and massage therapy, have not shown the same safety, benefit or efficacy as antidepressant medications or psychotherapy. Further, the article notes that many alternative medical treatments for depression pose substantial risks, as they may be unregulated. Speak with a professional to gain the best information about these modalities.
References
- "Diagnostic and Statistical Manual of Mental Disorders IV-TR"; American Psychiatric Association; 2000
- PubMed.gov: "Archives of General Psychiatry"; Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders; Ronald Kessler, Ph.D. et al.; June 2005
- "Current Psychotherapies" 8th edition; Raymond Corsini, Ph.D., and Danny Wedding, Ph.D., MPH; 2008
- "JAMA"; Fluoxetine, Cognitive-Behavioral Therapy; John March et al.; 2004
- MayoClinic.com: Alternative Medicine
