Understanding

Major
Depression

Major Depression (MD)

is an illness that involves the
body, mood, and thoughts.
It affects the way a person eats
and sleeps, the way one feels
about oneself, and the way one
thinks about things.

MD is NOT a sign of
personal weakness or a
condition that can be
willed or wished away.

People with MD cannot

merely "pull themselves
together" and get better.
Without treatment,
symptoms can last for
weeks, months, or years.

Appropriate treatment, however,

CAN help most people who

suffer from depression.

MD: What does it look like?

Major depression (MD) is manifested by a
combination of symptoms that interfere with
the ability to work, study, sleep, eat, and enjoy
once pleasurable activities, including:

Loss of interest
Loss of sex drive
Restlessness/irritability
Insomnia
Thoughts of death/suicide
Guilt/worthlessness

Decreased energy or fatigue

Difficulty concentrating/remembering
Changes in appetite/weight
Changes in sleep patterns
Sad, anxious or empty mood
Hopelessness/pessimism

MD: What does it look like?

MD is often accompanied by persistent
physical symptoms that do not respond to
treatment, including:

Headaches
Chronic pain
Digestive disorders

MD: Getting a
diagnosis
Major depression CAN be treated!
The great majority of people with
depression (even those whose
depression is extremely severe)
can be helped.
Unfortunately, most people with a
depressive illness do not seek
treatment.

MD: Getting a
diagnosis
The first step to getting appropriate
treatment for depression is a
physical examination by a doctor.
Certain medications and medical
conditions can cause the same
symptoms as depression, and a
physician should rule out these
possibilities!

MD: Getting a
diagnosis
If a physical cause for the
depression is ruled out, a
psychological evaluation
should be done by the
physician or by referral to a
psychiatrist or psychologist.

MD: Depression in children

A child who is depressed might
pretend to be sick, refuse to go
to school, cling to a parent, or
worry that the parent may die.
Older children may sulk, get
into trouble at school, be
negative or grouchy, and feel
misunderstood.

MD: Depression in children

Because normal behaviors
vary from one childhood
stage to another, it can be
difficult to tell whether a child
is just going through a
temporary "phase" or is
suffering from depression.

MD: Depression in children

If you are worried about your
child, talk to your family doctor
or to the child's pediatrician in
order to rule out other causes
for the behavioural changes.

What Causes MD?

Genetic, psychological, physical and environmental factors all seem
to be involved in the onset of a depressive disorder.

Genetic
Factors

Psychological
Factors

Is depression inherited? Major depression can occur

generation after generation in some families, but it
can also occur in people who have no family history
of depression. Whether inherited or not, major
depressive disorder is often associated with changes
in brain structures or brain function.
People who are pessimists, who have low selfesteem, or who are readily overwhelmed by stress are
prone to depression. Whether this represents a
psychological predisposition or an early form of the
illness is not clear.

What Causes MD?

Many medical illnesses (like stroke, heart
attack, cancer) can result in depressive
episodes in some people.
Physical
Factors

A serious loss, difficult relationship, financial

problem, or any stressful change in life
patterns can trigger a depressive episode.
Environmental
Factors

MD: Treatment
Treatments include antidepressant medications and
psychotherapies. People with milder depression might do
well with psychotherapy alone, but people with moderate to
severe depression most often benefit from antidepressants.

MD: Treatment

+
Often a combined treatment works best - medication
to gain relatively quick symptom relief and
psychotherapy to learn more effective ways to deal
with life's problems (including depression).

MD: Treatment

Electroconvulsive therapy (ECT) can also be

useful, particularly for people whose depression
is severe or life threatening or who cannot take
antidepressant medication.

MD: Treatment

Depending on the patient's diagnosis and severity of

symptoms, the therapist may prescribe medication
and/or one of the several forms of psychotherapy that
have proven effective for depression.

MD: Medications
Medications for MD include:

Selective Serotonin Reuptake Inhibitors (SSRIs)

Tricyclic Antidepressants (TCAs)
Monoamine Oxidase Inhibitors (MAOIs)

Sometimes doctors have to try a variety of antidepressants before

finding the most effective medication or combination of medications.
Sometimes the dosage must be increased to be effective.
Although some improvements may be seen in the first few weeks,
anti-depressant medications must be taken regularly for 3 to 4
weeks (in some cases, as many as 8 weeks) before the full
therapeutic effect occurs!

MD: Medications
Dont Stop!
Some people are tempted to stop taking
their medication because they think that
the medication isn't helping.

Although side effects might appear before the

antidepressant activity does, it is important to keep
taking medication until it has a chance to work!

MD: Medications
Dont Stop!
Some people are tempted to stop
because they feel better and think that
they dont need the medication anymore.

Once you start feeling better, it is important to

continue the medication for at least 4-9 months
to prevent a recurrence of the depression.

MD: Medications
Dont Stop!
Some medications must be stopped gradually
to give the body time to adjust.

Never stop taking an antidepressant without

consulting your doctor for instructions on how
to safely discontinue the medication!

Want to know more about

Major Depression?
The information provided in this presentation is based on
information provided by the National Institute of Mental Health.
For more information about MD, visit their website at
www.nimh.nih.gov or talk to your family physician.

_______________________________
Image Credits
Slide 1: Paulo Correa aka Nookiez - http://www.sxc.hu/profile/nookiez

Sun Life Financial Chair

In Adolescent Mental Health

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