Major depressive disorder (MDD), or clinical depression, is a common mood disorder that can affect anyone. Its most prevalent symptom includes persistent sadness and losing the ability to find pleasure in activities.

Sadness is a natural part of the human experience. People may feel sad or depressed when a loved one passes away or when they’re going through a life challenge, such as a divorce or serious illness.

These feelings are usually short-lived. When someone experiences persistent and intense feelings of sadness for extended periods, then they may have a mood disorder such as major depressive disorder (MDD).

MDD, also referred to as clinical depression, is a significant medical condition that can affect many areas of your life. It affects mood, behavior, and various physical functions, such as appetite and sleep.

MDD is one of the most common mental health conditions in the United States. Data suggests that more than 8.3% of U.S. adults experienced a major depressive episode in 2021.

Some people with MDD never get treatment. However, most people with the disorder can learn to cope and function with treatment. Medications, psychotherapy, and other methods can effectively treat people with MDD and help them manage their symptoms.

When to seek emergency help

If you think you may hurt yourself or attempt to take your own life, call 911 or your local emergency number immediately.

You may also want to consider these options:

  • Call a doctor or mental health professional.
  • Call a suicide hotline, such as the 988 Suicide & Crisis Lifeline at 988. Use 988 and press “1” to reach the Veterans Crisis Line.
  • Reach out to a close friend or loved one.

If you have a loved one who’s thinking about suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.

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Types of depression

MDD is one type of depression. Other types include:

Not everyone with depression will experience precisely the same symptoms, and the symptoms may also depend on the type of depression they have.

That said, a person living with MDD may experience some of the following emotions in a persistent way:

  • sadness or loss of interest in activities that usually bring pleasure
  • irritability
  • restlessness
  • “empty” feeling
  • hopelessness or pessimism

In addition, they may experience some of the following:

  • fatigue
  • difficulty sleeping or sleeping too much
  • difficulty eating or overeating
  • weight changes
  • headache
  • digestion problems
  • thoughts of suicide
  • engaging in high-risk behaviors
  • becoming withdrawn
  • substance use
  • isolation
  • difficulties with the responsibilities of school, work, or family life
  • sexual dysfunction

Symptoms in teens

Symptoms parents should be aware of in their teens include the following:

  • onset or increased use of substances (i.e., alcohol, smoking)
  • poorer academic performance
  • increased social withdrawal/isolation
  • increase in sudden shifts in moods
  • irritability and agitation
  • changes in behavior or an increase in behavioral problems

Symptoms in older adults

Depression symptoms in older adults are similar to other age groups. It’s sometimes called geriatric depression and can be a cause of physical pain in older adults that’s not explained by other medical conditions.

That said, it’s essential to rule out other medical conditions that may be mimicking depressive symptoms in older adults.

The exact cause of MDD is unknown, but researchers believe genetic and environmental factors can be triggers.

Having family members with depression may raise your chance of developing it. A combination of genes and stress can affect brain chemistry and lower your ability to maintain mood stability.

In addition, changes in the balance of hormones may also contribute to the development of MDD.

Possible triggers of MDD include:

A doctor or a mental health professional can diagnose MDD based on your symptoms, feelings, and behaviors.

Typically, you’ll be asked specific questions or given a questionnaire so health professionals can better determine whether you have MDD or another condition.

To be diagnosed with MDD, you need to meet the symptom criteria listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).

According to its criteria:

  • You must experience a change in your previous functioning.
  • Symptoms must occur for a period of 2 or more weeks.
  • At least one symptom is either depressed mood or loss of interest or pleasure.

You must also experience 5 or more of the symptoms listed in the manual in the 2-week period.

MDD is often treated with medication and psychotherapy. Some lifestyle adjustments can also help ease certain symptoms.

People who have severe MDD or have thoughts of harming themselves may need to stay in a hospital during treatment. Some might also need to take part in an outpatient treatment program until symptoms improve.

Medications

Primary care professionals often start treatment for MDD by prescribing antidepressant medications.

Selective serotonin reuptake inhibitors (SSRIs)

SSRIs are a frequently prescribed type of antidepressant. They work by helping inhibit the breakdown of serotonin in your brain, resulting in higher amounts of this neurotransmitter.

Serotonin is a brain chemical that’s believed to be responsible for mood. It may help improve mood and produce healthy sleeping patterns.

People with MDD are often thought to have low levels of serotonin. An SSRI may relieve symptoms of MDD by increasing the amount of serotonin available in your brain.

SSRIs include well-known drugs such as fluoxetine (Prozac) and citalopram (Celexa). They have a relatively low incidence of side effects that most people tolerate well.

Similar to SSRIs, serotonin-norepinephrine reuptake inhibitors (SNRIs) are another type of antidepressant that are often prescribed. These affect serotonin and norepinephrine, which help manage your fight-or-flight response.

Other medications

Tricyclic antidepressants and medications known as atypical antidepressants, such as bupropion (Wellbutrin), may be used when other drugs haven’t helped.

These drugs can cause several side effects, including weight gain and sleepiness. As with any medication, benefits and side effects need to be weighed carefully with a healthcare professional.

Stopping medications immediately can cause withdrawal symptoms. It’s important not to stop taking your medications unless a mental health or healthcare professional advises you to.

Some medications used to treat MDD aren’t safe while you’re pregnant or nursing. Make sure you speak with a healthcare professional if you become pregnant, you’re planning to become pregnant, or you’re nursing.

Psychotherapy

Psychotherapy, also known as psychological therapy or talk therapy, can effectively treat people with MDD. It involves meeting with a mental health professional regularly to talk about your condition and related issues.

Psychotherapy can help you:

  • adjust to a crisis or other stressful event
  • working toward achieving a balanced perspective of a given situation and acting in accordance with values instead of based on mood
  • improve your communication skills
  • find better ways to cope with challenges and solve problems
  • increase your self-esteem
  • regain a sense of satisfaction and control in your life

A mental health professional may also recommend other types of therapy, such as cognitive behavioral therapy or interpersonal therapy. If you don’t already have a mental health professional, the Healthline FindCare tool can help you find a professional in your area.

Another possible treatment is group therapy, which allows you to share your feelings with people who can relate to what you’re going through.

Online therapy options

Read our review of the best online therapy options to find the right fit for you.

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Lifestyle changes

In addition to taking medications and participating in therapy, you can help improve MDD symptoms by making some changes to your daily habits.

Dietary changes

Nutritious foods benefit your mind and body. While no foods can cure depression, certain healthful food choices can benefit your mental well-being.

Consider eating foods:

These can also be found in supplement form, but the Food and Drug Administration (FDA) hasn’t approved any natural products for depression. Speak with a healthcare professional before starting new supplements, especially if you take other medications.

Avoid alcohol and certain processed foods

It’s beneficial to avoid alcohol because it’s a nervous system depressant that worsens your symptoms. It has also been identified as a potential risk factor for depression.

Ultra-processed foods have also been associated with depressive symptoms.

Get plenty of exercise

Although MDD can make you feel very tired, it’s essential to be physically active. Physical activity, especially outdoors and in moderate sunlight, can boost your mood and make you feel better.

Sleep well

It’s vital to get enough sleep each night. This can vary from person to person but should be at least 7 hours.

People with depression often have trouble sleeping. Speak with a doctor if you’re having trouble sleeping or oversleeping.

SAMHSA’s National Helpline

The Substance Abuse and Mental Health Services Administration has a free, confidential helpline for people and family members of those facing substance misuse or mental health conditions. They’re available 24 hours a day at 1-800-662-HELP (4357).

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Is MDD the same as depression?

MDD is a type of depression. Other types include persistent depressive disorder and bipolar disorder.

Is MDD considered a serious mental illness?

MDD can be a serious mental health condition because it can significantly affect your ability to live your day-to-day life. For example, it can cause difficulties with eating and sleeping and may negatively affect your relationships with colleagues, family, and friends.

What is the most common depressive disorder?

MDD is the most common type of depression. About 21 million U.S. adults had at least one major depressive episode in 2021.

While someone with MDD can feel hopeless at times, it’s important to remember that the disorder can be treated successfully. There is hope.

Sticking with a treatment plan is a critical part of improving your outlook. Try not to miss therapy sessions or follow-up appointments with your mental health professional.

Similarly, it’s important not to stop taking your medications unless a mental health or healthcare professional advises you to.

On days when you feel particularly depressed despite treatment, it can be helpful to call a local crisis or mental health service. Resources are available.

A friendly, supportive voice could be just what you need to get you through a difficult time.

Read this article in Spanish.

Suicidal thoughts

If you start taking antidepressants and have suicidal thoughts, call your doctor or 911 or local emergency services right away. Although it’s a rare occurrence, some MDD medications can cause suicidal thoughts in people who have just started treatment.

Talk with a doctor about concerns you may have about taking medications that pose this risk.

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