Major Depression Essay Example

or impairing social life, employment, or other areas. They should not be related to substance abuse or other medical conditions and should not be better explained by certain psychotic disorders. Moreover, there should be no previous manic or hypomanic episode (American Psychiatric Association, 2013, p. 160-161).

According to the DSM-IV, males have a 5 to 12 percent lifetime chance of developing major depressive disorder (MDD), while females have a 10 to 25 percent chance (Aaron & Beck, 2009, p. 6). Currently, approximately 2 to 3 percent of males and 5-9 percent of females in the population are suffering from MDD (Aaron & Beck, 2009, p. 6).

The DSM-5 states that around7%of people in the United States experience MDD within a year. Individuals between ages18 and29 are three times more likely to have MDD compared to those who are aged60 or older (American Psychiatric Association,2013,p.15).

According to estimates, a small percentage of school-age youth and prepubertal children and adolescents experience depression. This percentage ranges from 2 to 3 percent for school-age youth and 5 to 8 percent for prepubertal children and adolescents (Lathom, 2014, p. 100). Additionally, Ryan (2005) discovered that about 30 percent of adolescents exhibit clinically significant symptoms of depression (as cited in Lathom, 2014, p. 100). However, it is likely that these estimates are not entirely accurate due to the often unnoticed nature of these symptoms (Lathom, 2014).

According to a study by Rotenstein et al. (2016), people in demanding and stressful occupations have a higher likelihood of experiencing Major Depressive Disorder (MDD). The study found that 27.2% of medical students had depression or symptoms of depression, with 11.1% having suicidal thoughts. Among those identified as depressed,

around 15.7% sought psychiatric treatment. While MDD can occur at any age, it is more common during puberty and peaks in early adulthood.

The American Psychiatric Association (2013, p. 165) states that major depressive disorder usually begins later in life. Supporting this, Barlow et al. (2018, p. 214) refer to a study conducted by Burke et al. (2007), which found that the average age of onset is 25 years old.

For around 40% of people, recovery from major depressive disorder typically begins within three months, and for 80%, it starts within one year.

According to the American Psychiatric Association (2013, p. 165), the duration of onset of Major Depressive Disorder (MDD) has an impact on both recovery time and the likelihood of recovery. If someone experiences MDD for a year, their recovery period will be longer compared to those with a six-month onset. Furthermore, individuals with a longer onset have a lower chance of recovering than those with a shorter onset.

The American Psychiatric Association (2013) also states that as the length of remission increases, the risk of MDD recurrence decreases. This risk is positively correlated with the severity of previous MDD episodes, negatively correlated with age at onset, and positively correlated with the number of prior episodes.

When depressive symptoms are present during remission, it indicates the reappearance of Major Depressive Disorder (MDD). Factors like psychotic features, prominent anxiety, and personality disorders can predict the reappearance of MDD (p. 165). Studies have shown that individuals with a family history of depression are more susceptible to experiencing a recurrence of MDD (Barlow et al., 2018, p. 210).

According to Barlow et al. (2018, p. 210), 85% of individuals who experience one

episode of depression are likely to have a second episode. The DSM-5 (2013) also recognizes that individuals initially diagnosed with major depressive disorder (MDD) may later be diagnosed with bipolar disorder instead. Factors that predict a later diagnosis of bipolar disorder include early onset of MDD during adolescence, the presence of psychotic features, and a family history of bipolar disorders.

According to the American Psychiatric Association (2013, p. 165), individuals with major depressive disorder and psychotic features have a higher chance of developing schizophrenia. The association also notes that younger individuals may experience symptoms such as excessive sleepiness and overeating, while older individuals are more prone to exhibiting melancholic symptoms like changes in movement (American Psychiatric Association, 2013, p. 166).

While there is a higher occurrence of Major Depressive Disorder (MDD) in females, gender disparities in terms of symptoms, progression, response to treatment, and functional implications are not significant. It is important to mention that women with MDD have a greater tendency towards suicidal thoughts compared to men; however, men are more likely to complete suicide (Aaron & Beck, 2009, p. 58). The exact cause of MDD remains unknown.

There is a theory that examines the social, biological (genetic), and psychological factors involved in the etiology of mood disorders. It has been found that biological factors such as early onset and multiple recurrences are associated with a higher likelihood of a genetic link in MDD (Tamatam, 2012). Psychologists have discovered that relatives of individuals with mood disorders have a two- to three-fold higher rate of also having mood disorders compared to a control group without individuals who have mood disorders (Lau & Eley, 2010; Klein, Lewinsohn, Rohde, Seeley,

& Durbin, 2002; Levinson, 2009 cited in Barlow et al., 2018). Moreover, when individuals with mood disorders experience early onset, increasing severity, and recurrence of MDD, their relatives have the highest rates of experiencing depression (Kendler et al., 2007; Klein et al., 2002; Weissman et al., 2005 cited in Barlow et al., 2018).

"Twin studies" provide the most reliable evidence of genetic contribution in MDD. These studies show that if one identical twin has a unipolar disorder, the chances of the other twin also having the disorder is approximately double compared to fraternal twins. For identical twins, the chance is around 43 percent, while for fraternal twins it is around 20 percent (McGuffin et al., 2003, as cited in Barlow et al., 2018, p. 227). According to Sullivan et al. (2000), genetic contribution to depression is estimated to be around 37 percent, with non-shared environmental factors accounting for 63 percent of the variance in depression. Shared environmental factors have minimal influence (as cited in Barlow et al., 2018, p.

Barlow et al. (2018, p. 226) found that major depressive disorder (MDD) exhibits gender differences in genetic influence. The study reveals that women have a greater genetic impact, accounting for approximately 40 percent contribution, while men have significantly lower contribution.

Sullivan et al. (2000) discovered that genetic factors account for around 37 percent of depression, while non-shared environmental factors explain 63 percent of the variation in depression. Shared environmental factors have minimal impact on depression (as cited in Barlow et al., 2018, p. 227). According to Barlow et al., (2018), psychological factors, specifically stressful life events, play a significant role in the genetic contribution to depression. These psychological experiences

can account for 60 to 80 percent of the causes of depression (p. 229). Individuals with Major Depressive Disorder (MDD) frequently report encountering stressful life events such as job loss, divorce, parenthood, or transitioning from education to career (p.

Barlow et al. (2018) conducted a study that found individuals who have faced a stressful life event while experiencing depression are more prone to having a negative response to treatment and longer recovery periods. In addition, Seligman's research in 1975 observed that dogs and rats become depressed when they feel helpless and unable to control occasional electric shocks (as cited in Barlow et al., 2018). Similarly, people may also experience depression if they believe they lack the ability to change an undesirable situation (Barlow et al., 2018).

Negative Cognitive Styles can cause depression because they are based on negative interpretations of daily events, according to Aaron & Beck (2009). People with depression often have a pessimistic view of the world, their future, and themselves, which makes it difficult for them to succeed (Aaron & Beck, 2009, 298-300). On the other hand, social factors play a significant role in the development of depression, especially when individuals experience interpersonal stress. Marital dissatisfaction is considered one of the most stressful types of interpersonal stress (Barlow et al., 2018, p. 233).

According to Bruce and Kim (1992), 21 percent of severely depressed women experienced a marital split, while around 17 percent of severely depressed men also went through the same situation, which is nine times higher than married men. Additionally, after going through a marital split, 14 percent of previously non-depressed men and 5 percent of previously non-depressed women developed severe depression for

the first time. Based on Barlow et al.'s (2018, p.233) findings, it was concluded that men's marital status may increase their vulnerability to depression. Therefore, having social support is crucial in preventing depression.

According to Barlow et al. (2018, p. 235), individuals who live alone have an approximately 80 percent higher risk of developing depression compared to those who live with others.

In the same source (Barlow et al., 2018, p. 235), another study found that among women facing difficult life crises, only 10 percent of those with confidant friends became depressed, while 37 percent without such friends experienced depression (Brown ; Harris, 1978).

The integrative theory model suggests that Major Depressive Disorder (MDD) development is influenced by biological, psychological, and social factors.

Those individuals who have vulnerabilities on a biological and psychological level are at the highest risk of experiencing MDD when they face stressful life events without support from friends or family members (Barlow et al., 2018).

Aaron ; Beck (2009) assert that individuals with Major Depressive Disorder (MDD) face a notable risk of suicide, with suicidal thoughts varying in intensity and ranging from passive considerations such as "I wish I were dead" to active intentions like "I want to kill myself" (235-236).

There are instances where suicidal attempts occur without prior planning, and individuals may feel a sense of relief when the urge subsides. The severity of Major Depressive Disorder (MDD) determines the nature of suicidal thoughts. For individuals with mild MDD, 31% express thoughts of suicide, usually in passive forms such as "I would be better off dead." Although they may find death appealing, their likelihood of attempting suicide is lower compared to those with more severe

MDD.

Patients with moderate MDD have suicidal wishes that are distinct, frequent, and enticing. These individuals may engage in impulsive or premeditated suicide attempts. Alongside direct attempts, they may also partake in dangerous activities like speeding, hoping for a fatal car accident. In contrast, patients experiencing severe MDD have even more intense suicidal wishes, as reported at a rate of 74% among severely depressed clients (p. 30).

The risk factors for suicide completion include being male, living alone or being single, and experiencing feelings of hopelessness. Borderline personality disorder is often found in individuals with major depressive disorder (MDD) and is a strong predictor of future suicide attempts (American Psychiatric Association, 2013, p. 16). Furthermore, MDD commonly coexists with other conditions such as substance-related disorders, panic disorder, obsessive-compulsive disorder, anorexia nervosa, bulimia nervosa, and borderline personality disorder (American Psychiatric Association, 2013).

Barlow et al. (2018) classified medications for treating depressive disorders into three categories: tricyclic antidepressants, monoamine oxidase inhibitors, and selective serotonin reuptake inhibitors (SSRIs) (p.237-238, 168).

The tricyclic antidepressants (TCAs) are frequently prescribed for depression, but their exact mechanism of action remains unclear. TCAs inhibit the reuptake of specific neurotransmitters and decrease neurochemical transitions, although the specifics of this process are not fully comprehended (Barlow et al., 2018, p. 237). Conversely, SSRIs hinder the presynaptic reuptake of serotonin, resulting in a transient increase in serotonin levels at the receptor site.

Prozac, a well-known SSRI, has certain side effects including physical agitation, sexual dysfunction, insomnia, and gastrointestinal upset (Barlow et al., 2018, p. 237). A meta-analysis conducted by Arroll et al. (2005) examined 15 studies in primary care settings that compared tricyclic antidepressants, SSRIs, and placebos. The analysis concluded that

both TCAs and SSRIs were more effective than placebos in treating MDD.

MAO blocks the enzyme monoamine oxidase, which breaks down neurotransmitters into norepinephrine and serotonin. Although the effects of MAO are similar to those of tricyclic antidepressants, MAO is used less frequently due to two major drawbacks. Firstly, consuming food or drinks containing tyramine can trigger severe hypertensive episodes and potentially result in death. Additionally, interacting with MAO inhibitors, common medications like cold medicines or other types of antidepressants can have fatal consequences (Barlow et al., 2018, p.).

Electroconvulsive therapy (ECT) involves administering a brief electric shock directly to the brain for less than one second. This causes patients to experience seizures and convulsions for a few minutes. The mechanism by which ECT is effective is still not fully understood. One hypothesis suggests that the electric shock induces structural alterations in the brain (Barlow et al., 2018).

When medication treatment response is poor, electroconvulsive therapy (ECT) may be considered as an option for severe depression. ECT was once notorious for its abusive use, but it is now recognized as a safe and reasonably effective treatment. ECT is typically used when other treatments fail to improve severe depression (Barlow et al., 2018, p.

239). Cognitive Therapy aims to address the unhealthy thinking patterns exhibited by individuals with MDD. This treatment focuses on identifying cognitive errors and replacing them with healthier and more realistic thinking patterns (Aaron ; Beck, 2009, p. 298-299).

Transcranial Magnetic Stimulation (TMS) involves placing a magnetic field generator on the scalp and creating a localized electromagnetic pulse. Initial research indicated its effectiveness for individuals with depression (George, Taylor, & Short, 2013, as cited in Barlow et al.,

2018, p. 240). However, a recent randomized clinical trial with 164 US Veterans conducted by Yesavage et al. (2018) revealed no difference in remission rates between the group receiving active treatment and the group receiving sham treatment. Yesavage et al. (2018) suggests that future treatments or studies should emphasize clinical surveillance, thorough monitoring of concomitant medication, and interaction with clinical staff to enhance treatment outcomes for resistant individuals.