Major Depressive Disorder (MDD) is a very common mental ailment commonly known as clinical depression. It affects a major part of the population and can become life-threatening. It can lead to morbidity and mortality and influence patients towards suicide.
The disorder also hampers the personal relationships and the normal functioning of the individual in his daily life. Patients sometimes take recourse to drugs and substance abuse, and their professional life gets disrupted. Treatment can reduce the symptoms to a level of 70 to 80% in persons affected with MDD.
Pathophysiology of Depression
The Pathophysiology of MDD is not very clear says Doctor Raj from Icy Health https://icyhealth.com though there are studies that show similar patterns in their findings. Genetics have a big role to play in the disorder, and family background is also important. Psychosocial interventions like school and workplace also contribute to the causes.
Dysfunction of the hypothalamic-pituitary-adrenal axis (HPA axis), which produces abnormal hormone secretions to stress, also can cause the onset of MDD. Anomalies in the central nervous system’s serotonin performance have also been suggested as a factor by a few studies.
Neurotransmitters like dopamine (DA), norepinephrine (NE), brain-derived neurotrophic factor (BDNF) and glutamate also have a role to play in the pathophysiology of MDD. Age and disease-related onset of MDD can change the brain structure, which inhibits the normal activity of the circuit of emotion regulation.
Statistics on Major Depressive Disorder
- 14.8 million American adults suffer from MDD every year, which accounts for about 6.7% of the US population over the age of 18
- It is the number one cause of disability for Americans aged 15 to 44.3 years
- MDD is more common in women than men
- The median age of development is 32.5 years, though it can occur at any age
- MDD affects 1 in every 33 children and 1 in every 8 adolescents
- People with medical records of MDD are 4 times more likely to suffer from a heart attack. They are also at higher risk of relapse and risk of death
- Depression is included in one of the 3 top workplace issues in the US
- 2/3 of the 30,000 reported suicides in the USA are caused by depression
Clinical Picture of Depression (Symptoms)
The symptoms of depression vary from person to person, though there are some common patterns. The following are some type of common symptoms faced by patients:
- Constant feelings of sadness and melancholy
- Decreased interest in activities or pleasure
- Change in weight and appetite
- Change in sleep pattern: Insomnia or oversleeping
- Failing performance at school. Decrease in grades, loss of interest in studies, insufficient effort, missing school, not caring about school work.
- Trouble at maintaining relationships. Usually quiet or irritable with family and peers
- Tiredness, fatigue and loss of concentration
- Feelings of low self-confidence, guilt and worthlessness
- Suicidal thoughts, feelings and tendencies. Similar behaviour towards self-harm
Treatment of MDD
Treatment of MDD is started with evaluation by a psychiatrist. It is then followed with medication and psychotherapy by a licensed psychologist. MDD is treatable, and early diagnosis and assistance make way for an early recovery. It is generally a trial-and-error method where the psychologist tries to develop a suitable treatment plan for each individual.
Antidepressants are commonly given and take 2 – 4 weeks to show their effects. Symptoms generally start getting better, and continued medication can make many of them disappear. Counseling or psychotherapy increases the chances of recovery. The process is long-term and requires time and commitment from both the doctor and the patient.
Nursing Intervention in Depression
Generally, a patient will need nurses only in severe cases of MDD. They can assist the family to help the victim and ensuring proper medication and care. Nurses may also promote positive communication and keep the mind of the patient off negative thoughts. Nurses can also be engaged in maintaining supervision and keeping the patient from harming himself or others.