Understanding Major Depressive Disorder: Key Diagnostic Criteria and Support Strategies

Understanding mental health, the key diagnostic criteria and support strategies for individuals who are struggling. In conversation with Rojisha Shahi from HEALTHY MINDS.

What are the key diagnostic criteria for major depressive disorder?

There are two key indicators to look for: the first is the physical symptoms, and the second is the emotional ones. Physical symptoms include loss of weight, [6 to 8 KG is in a month without changing your daily routine] poor hygiene, not taking care of yourself, having difficulty sleeping, and loss of appetite. Emotional symptoms include being constantly sad. It's not like you're constantly depressed; sorrow is just your default setting. Typically, these symptoms appear after 3 to 4 weeks. A few symptoms to detect depression include persistent melancholy, mood fluctuations, feeling like a burden to your loved ones, being antisocial, and a constant desire to be by yourself.

What are some lesser-known signs of depression that may be overlooked and can genetics and family history play a role in it?

A sign, that is mostly overlooked is high-functioning, depression. A person could go to work, perform well at their job or in their education, and have a generally positive outlook on life. Significantly, this has no impact on the person's life since their natural state is one of grief and they are working inside to regain normalcy. A normal mood is when you are not experiencing too many strong emotions, whether happy or sad.The concept of depression that we have Is being constantly sad and crying, being frustrated and constantly complaining but depression is more like a person could be functioning well, but he or she has stopped giving meaning to their lives. In a recent event, a Nepali TikToker, passed away when we looked at her contents she appeared cheerful and joyous, but from the inside, she was suffering. Additionally, genetics and family history can play a significant role in it.

What are some early warning signs that indicate someone may be at risk for developing depression?

Early signs of depression encompass disturbances in eating and sleeping patterns, neglect of self-care, sudden loss of interest in once-enjoyable activities, persistent feelings of sadness, and a pervasive sense of emptiness and lack of purpose. We often tend to overlook these indicators. If an individual starts isolating themselves, experiencing self-doubt, or undergoes a shift in personality—for instance, transitioning from being social and outgoing to becoming withdrawn and homebound, or modifying their eating and sleeping habits significantly, such as eating less frequently or experiencing disrupted sleep patterns—it could be an indication that they are at risk of developing depression.

How do you determine the appropriate treatment approach for an individual with depression?

Based on her personal experience, she believes that there are two options for addressing mental health struggles: therapy and medication. Medication is typically a shorter-term solution, while therapy requires a longer commitment. If someone has been struggling for an extended period, around 2 to 3 years, or if their condition is related to biological dysfunction like thyroid issues, she suggests considering medication. On the other hand, if the person's depression stems from interpersonal relationships or work stress, therapy is recommended. Ideally, a combination of medication and therapy would be the most effective approach to address mental health concerns. This integrated approach allows for addressing the underlying causes of mental health struggles while simultaneously managing symptoms and providing a comprehensive support system. Ultimately, the choice between therapy and medication should be based on the individual's specific circumstances.

What are the potential benefits and drawbacks of antidepressant medication?

Medication can be remarkably beneficial for individuals who have long-standing struggles with depression and anxiety. Compared to therapy, it offers a more convenient and efficient solution, as establishing trust and comfort with a therapist can be time-consuming, particularly when dealing with severe depression. The major advantage of medication is its effectiveness in alleviating symptoms of depression and anxiety. Unlike therapy, which may take a while to demonstrate significant progress, medication can yield noticeable improvements within one to two months. However, it's important to consider potential downsides. Weight gain is a possible drawback associated with certain medications used for depression and anxiety. It is worth noting that not all medications contribute to weight gain, and the degree of weight gain can vary among individuals. Another temporary drawback is that some individuals may experience a sense of lousiness or emotional numbness while on medication. However, this effect is typically transient and diminishes over time.

What are the potential long-term effects of untreated or inadequately treated depression?

The potential long-term consequences can be severe, including an increased risk of suicidal thoughts or attempts. Your relationships with loved ones may suffer, and your ability to function properly can be greatly compromised. You may witness your life falling apart before your eyes, losing meaning and purpose in the process. If left untreated or inadequately addressed, the situation can become life-threatening.

How do you differentiate between depression and other mental health conditions with similar symptoms?

Diagnosing mental health conditions can be challenging due to the overlap of symptoms, particularly in cases of anxiety and depression. Symptoms such as appetite loss, mood swings, and sleep disruptions can be shared between these conditions. She relies on the World Health Organization's criteria, known as the ICD, to determine diagnoses.

While initial observations may suggest depression or anxiety, it is essential to continuously monitor the patient to gain a deeper understanding of their specific condition. This process requires long-term attention and assessment. Initially, it may seem like the patient is experiencing depression or anxiety, but there could be underlying factors contributing to their symptoms.

How can family members and friends best support someone with depression without enabling unhealthy behaviors?

Often, our parents and friends tend to be dismissive when approached by someone seeking support. They may easily question or redirect the focus onto themselves, neglecting to acknowledge the invisible weight that the individual is carrying. It is crucial to foster empathy and remember that the person in distress is indeed suffering, even if we fail to recognize it as such. The first step towards providing meaningful support is to be less dismissive and truly listen to them. It's important to understand that their behaviors and actions may be influenced by underlying triggers, and by comprehending these triggers and cultivating empathy, we can effectively support them through their experience of depression.