How To Treat Major Depressive Disorder

Over 8 percent of adults in the US struggle with major depressive disorder, representing over 20 million individuals. More than feeling sad, major depressive disorder or clinical depression is a diagnosed mental health condition characterized by recurring and consistent feelings of hopelessness, low mood, and low self-worth. Is there an easy way to how to treat major depressive disorder.

Our understanding of depression categorizes it as a mental health condition fostered and exacerbated by biological, social, and psychological factors. More than just a matter of circumstance, genetics, or chemical imbalance, depression is often combined. Treatment, as such, is usually also holistic and all-encompassing.

While first-line treatments such as antidepressants are a well-known component of treating depression, they are rarely the only component of a treatment plan for depressive disorders.

Your doctor may discuss different modalities, such as one-on-one and group therapy, family therapy, alternative treatments, and treatments for comorbid or co-occurring conditions, such as anxiety, substance use disorder, or trauma disorders.

What is Major Depressive Disorder? 

Major depressive disorder is characterized as a mood disorder with long-term and severe depressive symptoms. Patients diagnosed with major depressive disorder may exhibit feelings of hopelessness and worthlessness, discuss suicide or talk frequently about death, have had experience with suicidal ideation, or have had a suicide attempt.

Major depressive disorder affects people to the degree that impacts their livelihood, education, and family life. Major depressive disorder can be disabling – statistics show that among the 20 million+ adults diagnosed with a depressive episode in 2020, an estimated 14.8 million had a severe impairment due to their depression.

Other Mood Disorders

There are other forms of depression, as well as other mood disorders. While major depressive disorder is the most common, symptoms of mild depression may indicate dysthymia or persistent depressive disorder. Depression can also come and go and peak during certain times of the year. This is called a seasonal depressive disorder.

While many forms of depression involve biopsychosocial factors, some cases are more influenced by certain factors than others. Premenstrual dysphoric disorder, for example, is a debilitating and chronic mood disorder triggered by hormonal changes during menstruation, occurring on most menstrual cycles for the affected patient.

Bipolar disorder is another common mood disorder, unique in that it is characterized by symptoms of depression and a series of symptoms described as mania. In contrast to depression, manic symptoms include unexplained euphoria, boundless energy, restlessness, excessive risk-taking behavior, and feelings of grandiosity.

How To Treat Major Depressive Disorder

Treatment for major depressive disorder centers around psychotherapy and medication but isn’t limited to these two avenues. There are other treatments for depression if first-line treatments are found ineffective.

Antidepressants

Antidepressants are a class of medication that treats depression, typically by targeting the availability of certain neurotransmitters (serotonin, norepinephrine, and/or dopamine).

Most doctors prescribe selective serotonin reuptake inhibitors (SSRIs) to patients with depressive disorders. These increase the availability of the neurotransmitter serotonin. However, they also come with common side effects. Patients may opt to try multiple SSRIs to find a medication with limited or no side effects.

Outdated or underused antidepressants, such as tricyclic antidepressants and serotonin and norepinephrine reuptake inhibitors (SNRIs), are still used to treat treatment-resistant depression or other mental health conditions where they are effective. Some antidepressants are rarely prescribed due to certain limiting factors, such as monoamine oxidase inhibitors (MAOIs) which can have deadly interactions with certain foods and other side effects.

Antidepressants that don’t fall into the previous categories are called atypical antidepressants.

Cognitive Behavioral Therapy

Cognitive-behavioral therapy (CBT) is the gold standard for psychotherapy or talk therapy to treat major depressive disorder.

CBT involves helping patients identify and recontextualize negative thoughts and, in turn, reduce negative emotions. In conjunction with medication, CBT aims to help depressive patients differentiate between ideas that are exacerbated or promoted by the disorder and other thoughts.

Isolating and challenging these negative thoughts helps patients realize that things aren’t as hopeless as they feel and have more power over their thoughts and feelings than they knew. Studies show that CBT in conjunction with medication is much more effective than medication alone.

Transcranial Magnetic Stimulation

Research shows that cases of treatment-resistant depression can benefit from transcranial magnetic stimulation as a treatment method. Transcranial magnetic stimulation involves using a particular technology that sends magnetic waves a few millimeters past the skull through the use of headgear outfitted with magnetic coils.

These magnetic waves are targeted at a specific portion of the patient’s prefrontal cortex, plotted out via MRI technology beforehand. Through multiple sessions, the waves affect brain activity in a brain section that is usually overactive for people with depression. A double-blind, randomized controlled trial found that up to 80 percent of patients going through a treatment course of transcranial magnetic stimulation felt a remission in depressive symptoms.  TMS is only one of several alternative therapies being tested and applied to patients with depression.

The Importance of Lifestyle Changes

Environmental factors can play a role in exacerbating depressive symptoms, but they can also play a reverse function as protective factors against depression and additional treatment.

For example, a patient with significant depression probably won’t feel better and overcome their depression through exercise, a better diet, and more social activity alone. But combining these factors with medication and therapy may help improve recovery.

Someone who struggles with depression on a chronic level may experience negative thoughts and depressive feelings for the rest of their life. However, certain habits and lifestyle changes can help develop that person’s resilience against these thoughts, let them counteract feelings of worthlessness with evidence of self-worth, and can lessen the frequency of low mood episodes through diet and exercise.

Overcome Major Depressive Disorder

Treatments for depression depend on what kind of depression a person faces. Someone with seasonal depression may be better suited for light therapy than someone with PMDD. Bipolar disorder can be treated with mood-stabilizing medication such as lithium, while major depressive disorder isn’t treated with the same medication.

Reaching out and getting a proper diagnosis from a medical professional is the first step toward overcoming depressive thoughts and symptoms.