Wednesday, 12 August 2015

What is Major Depressive Disorder? - Part 1


I began this blog by presenting a three-part series that I called "Another Group of Three" (Part 1, Part 2, Part 3). My aim was to outline three key aspects of my personality that operated together, in multiplicity, leading to my suicide attempt.

Major Depressive Disorder (MDD) is, by itself, dangerously debilitating if not diagnosed and treated; however, in my case it was coupled with constant exhaustion caused by my sleep apnea (which itself can cause depression) and my natural tendency to retreat into myself. The net result was an amplification of negative effects. To my thinking, it is analogous to the results of mixing alcohol with a sedative. Each operates on its own as a depressor thereby lowering brain stimuli. In combination, their depressive effect is multiplied perhaps causing this lowering of brain stimuli to become fatal. I may be overreaching, but it makes sense to me.

Thus far my blog's focus has been about the debilitating effect that MDD has had on me, my downward spiral into the Black, my resultant suicide attempt, and my journey through recovery. The posts I have written are very personal to me. Yet, while the personal nature of the debilitations of MDD foster a deepening disconnect from the world, creating a despairing loneliness in you, it is also true that there is a commonality of experience in all sufferers worldwide.

This post, then, is the first in a new series in which I will discuss Major Depressive Disorder in a more objective way.

I must stress that I am not a mental health professional. Should you require the help of a mental health professional, contact your family doctor immediately or go to your nearest hospital or walk-in clinic. IF YOU HAVE SUICIDAL THOUGHTS, PLEASE CALL 9-1-1 IMMEDIATELY AND SEEK THE HELP YOU ARE SO DESERVING OF. You are more worthy than you appreciate and you deserve the opportunity to heal.


When diagnosing a mental disorder, mental health professionals refer to a standard classification system called The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. The current edition, DSM-5, defines Major Depressive Disorder as follows:

  • A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.

    • 1. Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood.
    • 2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others).
    • 3. Significant weight loss when not dieting or weight gain (e.g., a change of more than 5 percent of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains.
    • 4. Insomnia or hypersomnia nearly every day. Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
    • 5. Fatigue or loss of energy nearly every day.
    • 6. Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
    • 7. Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).
    • 8. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

  • B. The symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning.

  • C. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism).

The key elements of Major Depressive Disorder are, therefore, duration, impairment in functioning over the entire duration, a lack of a physiological or general medical cause, and the presence of five (or more) affects throughout the entire duration which must include either depressed mood or loss of interest or pleasure.

Over the next few posts, I will explore these elements of MDD. I will also bring to your attention resources that may help you better understand MDD or, if you are a sufferer of the disorder, resources that may simply help you.

I remind you that I am not a mental health professional. I live with Major Depressive Disorder and, from time to time, I experience depressive episodes. The most recent depressive episode brought me to the brink of death and prompted my reaching out for help. My own research, the guidance and lessons shared by fellow-sufferers, the compassion of therapists, and so much more, have all inspired me to share what I have learned with you. It is information, it is not a diagnosis.

Please refer to this page for more on medical advice.

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