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Major Depressive Disorder: What It Is and What It Does

Updated: Nov 13, 2019

Major Depressive Disorder affects 18M people in the U.S. in any given year and 300M worldwide.

Major Depressive Disorder (MDD), often called clinical depression or simply depression, "is one of the most debilitating conditions on [sic] the world, with severe depression rated in the same disability category as terminal stage cancer," according to Hope for Depression.

Try and remember that the next time it seems that someone with a depressive disorder is "just being lazy."

The exact root cause of MDD is not known, but simply put, it occurs when the brain produces too much cortisol (the body's main stress hormone) and cannot efficiently use its supply of serotonin (the "happiness" hormone). When the brain releases serotonin, it can essentially get "sucked back in" by the serotonin transporter, preventing most or all of the hormone from having its intended positive influence on our thoughts and moods. Together with an overabundance of cortisol, this creates feelings of sadness, worry and despair beyond the control of the person living with the condition.

Depressive disorders account for a whopping 99% of all mental illnesses, with psychotic disorders and Schizophrenia making up the other 1%. The "depression umbrella" (the group of illnesses that make up this category of conditions) includes such prevalent disorders as post-traumatic stress disorder (PTSD), postpartum depression (PPD), anxiety disorders and bipolar disorder (BPD) and does not always, but can lead to suicidal thoughts and tendencies.

Symptoms of MDD include:

  • Feelings of sadness, tearfulness, emptiness or hopelessness

  • Angry outbursts, irritability or frustration, even over small matters

  • Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports

  • Sleep disturbances, including insomnia or sleeping too much

  • Tiredness and lack of energy, so even small tasks take extra effort

  • Reduced appetite and weight loss or increased cravings for food and weight gain

  • Anxiety, agitation or restlessness

  • Slowed thinking, speaking or body movements

  • Feelings of worthlessness or guilt, fixating on past failures or self-blame

  • Trouble thinking, concentrating, making decisions and remembering things

  • Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide

  • Unexplained physical problems, such as back pain or headaches

(list compiled by the Mayo Clinic)

I am one of the "luckier" ones, in that I have never experienced suicidal episodes. I have never longed for death or been convinced that others would be better off if I were gone. Heartbreakingly, around 800,000 people worldwide each year aren't so lucky--and that number only accounts for those who actually go through with it, not those who "only" entertain the idea. This is why education and awareness are so important.

Otherwise, I, like many depressives, have experienced every single one of the items on this list at one point or another, to varying degrees. The symptoms involving sleep and appetite I've experienced on both sides; I've had problems with insomnia and oversleeping, and with both over- and under-eating. (I did recently lose a significant amount of weight, but I did it in a normal, healthy way.)

Going down the list, these are the ways in which I personally experience depression:

  • I often cry easily--you should see me during Supernatural season finales!

  • Little things like a slow internet connection can frustrate me to the point of anger--how in the world did I ever tolerate dial-up?

  • I have days where I don't even want to write, the thing I love most in the world other than my family. Fortunately, for me, my loss of interest does not extend to my role as a mother... unfortunately, it sometimes does extend to my role as a wife (I'm working on that). I cannot explain this. Maybe I see my husband as more self-sufficient than the kids (because he is, of course), leading to this dichotomy. It doesn't make sense, but it's the best explanation I can fathom.

  • I take Ambien for sleep every night (I'm on a permanent prescription, which doctors normally try to avoid like the plague), and I am not a morning person. It can be very hard for me to resist the urge to go back to bed after sending the kids to school, Ambien or no Ambien (I do sleep without it sometimes).

  • I am often exhausted for no reason, making the littlest tasks seem overwhelming; this often comes with severe, almost flu-like body aches, covering both the fifth and the last symptoms on the list.

  • It's impossible to guess on any given day what my appetite will be like. Very occasionally, I have to literally force myself to eat, which, if you've ever had to do that, you know is horrible.

  • I have general anxiety disorder, for which I take medication daily. My "thing" is phone calls: I hate making them, I hate taking them.

  • Slowed bodily processes are probably the symptom I experience least often, but it does happen to me occasionally. It puts forth a severely "spaced out" vibe.

  • Some days, it seems every thought I have is negative, and I cannot break out of that state. I worry about stupid things, like whether or not I'm cleaning the bathroom often enough, or fixate on whether or not I'm keeping up perfectly on some habit or another.

  • My memory is terrible. I will forget things that most people would have little to no trouble remembering, like doctor's appointments or the fact that I put water on the stove to boil ten minutes ago. I will draw blanks on the names of well-known celebrities or even common nouns. It drives me batshit.

Having read that, you're probably thinking, Wow, that sounds terrible. And, well... it is. I'm not going to lie.

The good news is, there are (non-medicinal) ways to alleviate the symptoms of depression, the most effective of which are physical exercise, socializing with close friends or family, a healthy and balanced diet and getting plenty of vitamin D via sunshine and daylight.

Knowing that, the problem becomes finding the motivation to do these things, and motivation is something depression quite often squashes or simply annihilates. It can be a vicious, frustrating cycle, and even the best medications won't just make your symptoms disappear, they only make them milder.

But it's not a hopeless situation, even though it might--often--feel that way. And that's the whole purpose of this blog: it sounds like a tired cliche, but I truly believe that if I can help just one person feel a little less alone and hopeless, then my job is done.

Wanna talk? Come find me on

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