A depressive episode is not a sign of personal weakness. Instead, it is a complex condition, rooted in biological and psychosocial changes that we are still to fully understand. But, the diagnosis of major depressive disorder is also not an end-all diagnosis that leaves no hope in sight. In this article, we look at the most common misconceptions surrounding the major depressive disorder.
According to the latest data published by the National Institute of Mental Health, major depressive disorder has become the leading cause of impairment and disability, affecting 17.3 million adults in the United States. This number represents 7.1% of all U.S. adults who encountered at least one major depressive episode. The data also paint a dark picture of lack of access to adequate assessment, diagnosis and treatment options: 35% of U.S. adults with major depressive episodes did not receive any treatment (NIMH, 2019.)
The World Health Organization also reports that major depressive disorder (MDD) has become a leading cause of disability worldwide, with 300 million people affected. MDD contributed to 800,000 suicides, making it the second leading cause of death among adults aged 15-29.
Obviously, major depressive disorder is a severe and life-threatening condition, yet so many people are not diagnosed and treated. The quality of their life diminishes with each recurrent depressive episode, as their ability to work and socialize weakens.
A significant reason behind the lack of adequate treatment lies in misunderstanding what depression is and what isn’t. The modern media combined with unfiltered social media streams often obscure the distinction between the facts and myths about depression. The lack of education on mental health issues gives rise to the social stigma many people face when they try to address their mental health issues.
Here are the most common and usually the most damaging myths about depression and the major depressive disorders:
A major depressive disorder is far more than sadness or weakness
Even though depression can have multiple forms and come in varying intensity, it is never a sign of personal weakness. A depressive episode is also not a transient feeling of boredom, low mood or dissatisfaction with the current life situation.
The myth that depression is somehow a sign of personal weakness can be very harmful. A person who was able to function in daily tasks regularly, and then became unable to leave the bed or take a shower hasn’t suddenly become weak or lazy. A new mother who became suicidal shortly after childbirth is not weak in any way.
When faced with a loved one who displays symptoms similar to these people tend to offer perhaps well-intentioned, but counterproductive advice to “snap out of it” or “just be your old self!” The burden of guilt and shame depressed people feel when they compare their current life situation with how they were able to function before their symptoms took hold can often be an obstacle in seeking help.
A major depressive disorder is also different from sadness and grief. Sadness comes after emotionally intense events such as the death of a loved one, tragedy or a natural disaster is a normal reaction to loss. The grieving process lasts; however long it takes the person to come to terms with the loss, but it still has a different quality than depression. However, only trained and qualified psychiatrists and psychologists are adequately equipped to assess and understand this difference.
A major depressive disorder is not a “one size fits all” condition
Not everyone diagnosed with MDD experiences the same set of symptoms or at the same intensity. Even though it is easier for us to generalize and label people so we can “understand” them easier, the psychiatrists differentiate between mild, moderate or severe depressive episodes.
While some people diagnosed with MDD experience only one depressive episode, which consists of two weeks or more of persistent depressed mood marked with some or all of the following major depressive disorder symptoms:
- Feelings of hopelessness, guilt, self-blame
- Marked loss of interest in activities and interactions with other people one used to enjoy
- Loss of energy and feeling tired all the time
- Sleep changes – either insomnia or hypersomnia
- Changes in appetite – either loss of appetite or overeating
- Suicidal thoughts and attempts at own life
Anxiety is frequently mixed in as do physical symptoms such as varying aches and pains, frequent headaches or stomach upset.
Alongside the intensity of the current symptoms, the professional assessment of the depression also takes into account the events that preceded the symptoms, as in, for example, the childbirth that can be linked to the onset of Postpartum Depression. Severely traumatic events can also be behind the current symptoms, in some cases.
Recurrent or chronic depression that is a major depressive disorder with more or less ongoing depressive episodes across the span of two years or more (also known as persistent depressive disorder) is the most severe and most incapacitating form of MDD that changes the quality of life of the affected person, sometimes permanently.
Major depressive disorder treatment has advanced beyond just medication
The most common treatment for the MDD people usually know about involves antidepressant medicines. And, even though there is plenty of misinformation surrounding this type of therapy, too, antidepressants are so far, our first line of help. However, as NIMH’s latest survey shows, the antidepressant treatment for major depressive disorder is by far the least common: only 6% of all U.S adults rely on medication alone.
As the survey uncovers, an estimated 65% receive combined care by a health professional and medication treatment.
The additions to medication treatment involve psychotherapy and counseling, together with options for medication-resistant MDD that involves Deep transcranial magnetic stimulation, also known as Deep TMS (dTMS) or, in the chronic cases when person’s life is in danger, Electroconvulsive Therapy (ECT.)
The last two treatment options are particularly important for people who are living with chronic major depressive disorder. Deep TMS (dTMS), for example, is an in-office, FDA approved, non-drug, non-invasive treatment that stimulates the neuronal circuits in the prefrontal cortex, which is under-functioning in people with MDD. This low-stress procedure administers electromagnetic pulses without any sedation or anesthesia and has proven to be effective in 3 out of 4 patients, within 4-6 weeks of treatment.
FDA-approved Brainsway dTMS device can only be found at Dr. Patel’s office in Tucson.
The chronic, medication-resistant major depressive disorder is not a hopeless and end-all diagnosis that it used to be.
Major depressive disorder treatments help, but there are no simple solutions
The years of research and practice in treating the major depressive disorder, despite all the progress made, unveil a sad but real fact: there are no clear-cut and straightforward answers when it comes to treating and managing a chronic depression.
The professional treatment and consistent therapeutic help create a basis for one to be able to function in everyday life, the long-term strategy for managing chronic depression has to rely on integrative practices that empower the affected person to re-build own capacities to cope with the symptoms.
Many people with major depressive episodes in the past lead productive and satisfying lives. Mindfulness, acceptance, meditation, and self-care are the most powerful tools for this task. However, only a well-trained, experienced team of psychiatrists and psychologists can address each symptom and offer adequate treatment options tailored specifically to each patient’s needs.
The major depressive disorder requires professional help as much as, if not more, any other health condition would.
It is easier to manage the major depressive disorder with MDD support groups
A major depressive episode, especially when it is severe and recurrent, wreaks havoc on one’s interpersonal relationships. The long-term lack of interest in socializing and simply the lack of energy to participate in social events can lead to progressive isolation.
In turn, the isolation creates a self-feeding cycle of feeling lonely, hopeless and feeling unloved. Loneliness alone contributes to a higher incidence of depressive symptoms, and people who are already affected by chronic MDD tend to suffer the most.
Other people hold a unique healing power in that they can support and inspire each other. Sharing advice on how to manage daily tasks when they seem impossible or just leaving a caring message is something major depressive disorder support groups do exceptionally well.
Knowing other people are facing the same challenges, the compassion and the sense of community can be a motivating moment to break the cycle and get help for MDD. Because the relief is here.