Major Depressive Disorder

Major Depressive Disorder (MDD) is a common and recurrent disorder. Often depression strikes during the prime of life and is estimated to impact 12% of all men, and 20% of women at some point during their lives. Depression can be effectively treated in the majority of people but causes personal anguish in individuals and families when left untreated.

The World Health Organization currently ranks depression as one of the most disabling diseases in the world. The devastating consequences of under treated depression include: difficulty in the workplace, absenteeism, problems with relationships, marital and family discord. The untold human suffering resulting from symptoms of depression and morbidity and mortality associated with other diseases make it costly in both human and economic terms. A recent report of theSurgeon General suggests that the lack of access to appropriate mental health services is one of the most compelling public health problems faced by the country today. Stigma, lack of appropriate resources, reimbursement and under detection all play a role.

What To Look For - if you may be experiencing major depression

If you have 5 or more of the following symptoms during a 2 week period and 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). ** In children and adolescents, can be irritable mood as well.
  2. markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
  3. significant weight loss when not dieting or weight gain (e.g., a change of more than 5% 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 (sleeping too much) nearly every day.
  5. psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).
  6. fatigue or loss of energy nearly every day.
  7. feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).
  8. diminished ability to think or concentrate, or indecisiveness, nearly every day.
  9. recurrent thoughts of death (not just fear of dying), recurrent suicidal thoughts without a specific plan, or a suicide attempt or a specific plan for committing suicide.

These symptoms cause:

  • significant distress or impairment in social, occupational, or other important areas of functioning,
  • 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),
  • and are not better accounted for by bereavement (i.e., after the loss of a loved one, the symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation).

If you feel that you are suffering from depression, please contact your healthcare professional for diagnosis and care. You may also take a secure, online screening test for depression.

Useful Links:

  1. Depression and Bipolar Support Alliance
  2. University of Michigan Depression Center
  3. NIMH on Major Depressive Disorder
  4. National Network of Depression Centers


  • Burns DD: Feeling Good. New York, William Morrow, 1980, 1999
  • Greenberger D, Padesky CA: Mind Over Mood. New York, Guilford Press, 1995
  • Shields B: Down Came the Rain. New York, Hyperion, 2005
  • Styron W: Darkness Visable: A Memoir of Madness. New York, Randon House, 1990
  • Wright JH, Basco MR: Getting Your Life Back: The Complete Guide to Recovery from Depression. New York, Touchstone, 2002

Adapted with permission from the University of Michigan Depression Center Web site.