What is Major Depression?

Major depression is a serious mood disorder that negatively affects how you feel, think and act. 

Also known as major depressive disorder, major depression causes feelings of extreme sadness and a loss of interest in things you once enjoyed, and can interfere with your ability to carry out daily activities.

Major depression is more than temporary sadness or a passing blue mood. It isn’t a weakness or character flaw, but rather depression is a chemical imbalance in your brain that can be treated.

What Are the Symptoms of Major Depression?

Although people can experience the symptoms of major depression in different ways, the following include the most common symptoms:(1)

• Lasting sadness.

• Fatigue, low energy and lack of motivation.

• Loss of interest or pleasure.

• Changes in appetite and weight.

• Irritability.

• Difficulty concentrating and indecisiveness.

• Changes in sleep patterns, such as not being able to sleep and sleeping too much.

• Ongoing feelings of worthlessness, hopelessness or guilt.

• Thoughts of suicide, wishing to die or attempting suicide.

If you or someone you know is having thoughts of suicide, call or text 988. The 988 Suicide and Crisis Lifeline provides free and confidential support 24/7. 

How Common Is Major Depression?

Major depression is among the most common mental health disorders in the U.S. and can affect people of all ages, genders, races and ethnicities.(2) 

Depression is diagnosed in women twice as often as men. Although depression can occur at any age, on average, it first appears in people during their late teens to mid-twenties.(2)

In addition, people with a family member who has major depression are more likely to develop depression.(3) 

The following data for depression are from the 2021 National Survey on Drug Use and Health(4) and compiled by the National Institute of Mental Health:(5)

• Approximately 21 million adults – 8.3% of adults in the U.S. – experienced at least one major depressive episode in 2021.

• Major depressive episodes occurred more frequently among women (10.3%) compared to men (6.2%).

• A major depressive episode occurred most frequently in people between the ages of 18 and 25 years (18.6%).

• Approximately 5 million adolescents between the ages of 12 to 17 – 20.1% of adolescents in the U.S. – had at least one major depressive episode in 2021.

• Major depression was more common among adolescent girls (29.2%) compared to boys (11.5%).

How Is Major Depression Diagnosed?

By definition, major depression is diagnosed when a person has many of the symptoms listed above for at least two weeks. 

A diagnosis is made after a healthcare provider takes a careful history of your mood symptoms. They may do a physical exam or order medical tests to rule out other health conditions. They may also refer you to a mental health professional for evaluation.

How Is Major Depression Treated?

Early diagnosis and treatment of major depression is key to recovery.(1)

Treatments and strategies for managing the symptoms of depression include the following:

• Antidepressant medications may be prescribed to treat major depression and work by affecting the chemicals in the brain. It usually takes at least four to six weeks for these medications to have a full effect. In some cases, people may have to try different medications to get results. That’s why it’s important to work with your healthcare provider to find the most effective treatment for you.  

• Psychotherapy – also referred to as “talk therapy” – can help teach people with depression new ways to think and better deal with depressive feelings, as well as provide advice about how to improve relationships and manage stress.

• Electroconvulsive therapy (ECT) may be used to treat cases of severe depression that have not responded to medications. A mild electrical current is passed through the brain, which helps restore the normal balance of chemicals in the brain to improve symptoms.

• Transcranial magnetic stimulation (TMS) is a procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of major depression. It’s called a “noninvasive” procedure because it’s done without using surgery or anesthesia.

• Healthy lifestyle choices can play a role in helping to improve your mood, including exercising regularly, keeping good sleep habits, eating regular, healthy meals and avoiding the use of substances such as alcohol and drugs.

• Support groups can help provide an opportunity to share insights and inspire hope, resilience and connection with peers. To learn more about support groups for people with mood disorders and their families, visit the Depression and Bipolar Support Alliance (DBSA) website at: www.dbsalliance.org/support/

Anyone can experience major depression. The good news is that it is treatable. If you have symptoms of depression, be sure to talk to your healthcare provider. The sooner you get treatment, the sooner you can begin to feel better.

For more information about depression:

Anxiety & Depression Association of America (ADAA) adaa.org

Depression and Bipolar Support Alliance (DBSA) www.dbsalliance.org

Health Care Alliance for Response to Adolescent Depression (The HEARD Alliance) heardalliance.org

Hope for Depression Research Foundation hopefordepression.org

To Write Love on Her Arms (TWLOHA) twloha.com

For mental health and suicide prevention information and resources, visit the Rural Mental Health Resilience Program web page.

References:

1. Johns Hopkins Medicine. Health – Major Depression. Accessed at: hopkinsmedicine.org/health/conditions-and-diseases/major-depression 
2. American Psychiatric Association. Depression. Accessed at: psychiatry.org/patients-families/depression/what-is-depression
3. LeWine HE. Major Depression. Harvard Health Publishing March 10, 2022. Accessed at: health.harvard.edu/a_to_z/major-depression-a-to-z
4. Substance Abuse and Mental Health Services Administration. 2021 National Survey on Drug Use and Health. Accessed at:
samhsa.gov/data/release/2021-national-survey-drug-use-and-health-nsduh-releases 
5. National Institute of Mental Health. Mental Health Information – Major Depression. Accessed at: nimh.nih.gov/health/statistics/major-depression