MAJOR DEPRESSION
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Major Depression
Dorthy Longshaw
Psychology 1010-038
MAJOR DEPRESSION
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Abstract
Major depression is a form of depression with feelings of sadness and despair a loss of
interest in previous sources of pleasure. The symptoms of depression can vary based on the
person and since they are not always the same can be hard to diagnose and treat. Major
depression is often subcategorized into 4 categories: psychotic, catatonic, melancholic and
atypical. There are a variety of causes including: genetic, environmental, psychological and
biochemical factors. Depression is treated by seeing a doctor or mental health provider attending
counseling and or taking medications.
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Major Depression
What is depression? Depression is a common mental disorder that presents with
depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep
or appetite, low energy, and poor concentration (“Depression”, 2012). Depression is a serious
medical illness that involves the brain. It’s more than just a feeling of being “down in the dumps”
or “blue” for a few days. Depression is common, affecting about 121 million people worldwide.
Depression can be reliably diagnosed by a primary care physician. Antidepressant medications
and brief, structured forms of psychotherapy are effective for 60-80 % of those affected and can
be delivered in primary care (“Depression”, 2012). There are several different forms of
depression: major depression, dysthymic disorder, minor depression, manic depressive disorder
and seasonal affective disorder. In this paper I will go more in-depth into major depression which
is also called clinical depression or unipolar depression its symptoms, subcategories, causes, and
treatment.
The symptoms interfere with the ability to work, eat, sleep, study and enjoy life. These
symptoms include sadness, loss of interest in things previously enjoyed doing, change in weight,
difficulty sleeping, energy loss, feeling worthless and thoughts of suicide. Symptoms of
depression can vary based on the person and since they are not always the same can be hard to
diagnose and treat. In fact they may accompany various physical disorders, including thyroid and
adrenal gland disorders, benign and malignant brain tumors, stroke, AIDS, Parkinson's disease,
and multiple sclerosis (Coryell, 2009). Someone with this type of depression usually has several
episodes. Major depression is often subcategorized into 4 categories: psychotic, catatonic,
melancholic and atypical.
Psychotic: more technically known as major depressive disorder with psychotic features.
This is a far less common disorder than simple depression. Psychotic depression is
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characterized by not only depressive symptoms, but also by hallucinations (seeing or
hearing things that aren’t really there) or delusions (irrational thoughts and fears). Often
psychotically depressed people become paranoid or come to believe that their thoughts
are not their own (thought insertion) or that others can ‘hear’ their thoughts (thought
broadcasting)( Mental Health, 2012).
Catatonic: This subgroup is characterized by severe psychomotor retardation or excessive
purposeless activity.
Catatonic disorders are a group of symptoms characterized by disturbances in motor
(muscular movement) behavior that may have either a psychological or a physiological
basis. The best-known of these symptoms is immobility, which is a rigid positioning of
the body held for a considerable length of time. Patients diagnosed with a catatonic
disorder may maintain their body position for hours, days, weeks or even months at a
time. Alternately, catatonic symptoms may look like agitated, purposeless movements
that are seemingly unrelated to the person's environment (Sternberg, 2012).
Melancholic: This subgroup is characterized by loss of pleasure in nearly all activities,
inability to respond to pleasurable stimuli, unchanging emotional expression, excessive or
inappropriate guilt, early morning awakening, marked psychomotor retardation or agitation, and
significant anorexia or weight loss (Coryell, 2009).
Atypical: This subgroup is characterized by a brightened mood in response to positive
events and rejection sensitivity, resulting in depressed overreaction to perceived criticism or
rejection, feelings of leaden paralysis or energy, weight gain or increased appetite, and
hypersomnia. Symptoms tend to worsen as the day passes (Coryell 2009). Atypical depression
often starts in the teenage years and is more common in women than in men (Mayo Clinic staff,
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2012). Despite the name, atypical depression isn't uncommon or unusual. If you have atypical
depression, certain key signs and symptoms tend to occur. These include increased hunger,
weight gain, sleeping a lot, feeling that your arms and legs are heavy, and difficulty maintaining
relationships (Mayo Clinic staff, 2012).
So what causes a person to become depressed? The exact cause of depression is not
known. There are a variety of causes including: genetic, environmental, psychological and
biochemical factors. “However it is generally believed that clinical depression is most often
caused by the influence of more than just one or two factors” (“Causes,” 2012). I will go into
each of these causes more in depth.
Depression is more common among first-degree relatives of depressed patients, and
concordance between identical twins is high. Also, genetic factors probably influence the
development of depressive responses to adverse events (Coryell, 2009). However genetics is not
always the cause of a person becoming depressed and anyone of any age or gender is susceptible
to becoming depressed even without a family history of depression.
Environmental causes of depression are concerned with factors that are outside of
ourselves. They are not directly related to brain function, inherited traits from parents,
medical illnesses, or anything else that may take place within us. Instead, environmental
events are those things that happen in the course of our everyday lives. These may
include situations such as prolonged stress at home or work, coping with the loss of a
loved one, or traumatic events (“Environmental,” 2012).
There are a broad range of psychological causes including major life stresses, especially
separations and losses. People who are introverted and who have anxious tendencies may be
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more likely to develop a depressive disorder. Such people often do not develop the social skills
to adjust to life pressures. Depression may also develop in people with other mental disorders.
Other theories focus on changes in neurotransmitter levels. “These Biochemical factors,
including abnormal regulation of cholinergic, catecholaminergic (noradrenergic or
dopaminergic), and serotonergic (5-hydroxytryptamine) neurotransmission. Neuroendocrine
dysregulation may be a factor, with particular emphasis on 3 axes: hypothalamic-pituitaryadrenal, hypothalamic-pituitary-thyroid, and growth hormone” (Coryell, 2009).
How is depression treated? The cause of your depression helps to determine the
treatment. If you are experiencing depression due to environmental causes sometimes treatment
is not necessary if you can build emotional skills and make healthy lifestyle choices. In these
cases seeing a therapist and finding the cause of the depressive symptoms can be beneficial.
In some cases, a primary care doctor can prescribe medications to relieve depression
symptoms. However, many people need to see a doctor who specializes in diagnosing
and treating mental health conditions (psychiatrist). Many people with depression also
benefit from seeing a psychologist or other mental health counselor (Mayo Clinic Staff,
2012).
There are several types of antidepressant medication to treat depression it is important for a
patient and his doctor to find which one works best.
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Selective Serotonin Reuptake Inhibitors. These are usually the first method
because they are safer and cause fewer side effects examples of SSRIs are Prozac,
Paxil, Zoloft, Celexa and Lexapro.

Serotonin and Norepinephrine Reuptake Inhibitors examples of SNRIs include
Cymbalta, Effexor XR and Prisiq.
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Norepinephrine and Dopamine Reuptake Inhibitors. The most common NDRI is
Wellbutrin
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Atypical antidepressants. In some cases these medications are added to other
antidepressants to help with sleep. These include Trazadone, Remeron and
Viibryd.
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Tricyclic antidepressants. Because of the side effects these generally are not
prescribed unless patient has tried an SSRI first. TCA include Impramine, Elavil
and at least a dozen others.
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Monoamine Oxadase Inhibitors. MAOIs such as Parnate, Nardil and Emsam are
usually prescribed as a last resort. (Mayo Clinic Staff, 2012).
Psychotherapy involves talking about your issues with a mental health provider.
Cognitive behavior therapy is the most common form helping patients identify negative thoughts
and behaviors and replacing them with positive ones. In severe cases hospitalization may be
required when a patient is in danger of harming self or others. Usually the most effective
treatment for depression is a combination of medication and psychotherapy (Mayo Clinic Staff,
2012).
Depression occurs twice as frequently in women as in men for reasons that are not fully
understood. More than one-half of those who experience a single episode of depression will
continue to have depressive episodes that occur as frequently as once or even twice a year.
Without treatment, the frequency of depressive illness as well as the severity of symptoms tends
to increase over time. Left untreated, depression can lead to suicide (Duckworth, 2009). There is
no real recovery from depression.
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References
“Causes Of Depression”. (2012). All About Depression.com. Retrieved from
http://allaboutdepression.com/cau_01.html
Coryell, W. (2009). “Depressive Disorders”. The Merck Manual: For Health Care Professionals.
Retrieved from
http://www.merckmanuals.com/professional/psychiatric_disorders/mood_disorders/depre
ssive_disorders.html
“Depression”. (2012). World Health Organization. Retrieved from
http://www.who.int/mental_health/management/depression/definition/en/index.html
Duckworth, K. (2009). Major Depression fact sheet. National Alliance of Mental Health:
Retrieved from
http://nami.org/Template.cfm?Section=Depression&Template=/ContentManagement/Co
“Environmental Causes Of Depression”. (2012). All about depression.com. Retrieved from
http://allaboutdepression.com/cau_04.html
Mayo Clinic Staff. (2012). “Treatments and drugs”. Mayo Clinic. Retrieved from
http://www.mayoclinic.com/health/depression/DS00175/DSECTION=treatments-anddrugs
Mental Health, N. (2012). Psychotic Depression. Psych Central. Retrieved from
http://psychcentral.com/lib/2007/psychotic-depression/
Sternberg, B. (2012). Catatonic Disorders. Encyclopedia of Mental Disorders. Retrieved from
http://www.minddisorders.com/Br-Del/Catatonic-disorders.html
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Reflections
I took Psychology to complete the core requierment in Social Sciences for general
education classes at the SLCC it also pertains to my major which is Social Work. I found the
class very interesting learning about the basics and the people who came up with the theories we
use and improve on today. I did a paper on Major Depression I started it the first week of class
and went and improved and edited it with help from the writing center for about two months. I
am really pleased with the content and sources I used to get the information. I presented it in
front of the class and that wasen’t near as scary as what I had worked myself up to believing it
would be. Overall I learned a lot about the forms of depression the symptoms, causes, and
treatment. I hope this knowledge will be benifical in my field of study.