Depression Specialist

If I had to define a major depression in a single sentence, I would describe it as a genetic/neurochemical disorder requiring a strong environmental trigger whose characteristic manifestation is an inability to appreciate sunsets.

• Robert M. Sapolsky, PhD – Stanford University

What is major depression?

Major depressive disorder is a biological and psychological condition in which the individual may suffer from low mood, an impaired ability to enjoy their activities of living, and a set of related symptoms, often including sleep difficulty, appetite changes, low energy, decreased libido, and distorted thinking such as a negative or pessimistic outlook on life. There is a strong relationship between symptoms of depression and anxiety, in that they commonly occur together. There may also be feelings of hopelessness, at times so severe that one may experience thoughts of suicide. Globally, the burden of major depression has massive economic and societal implications. Individually, the suffering can be profoundly impairing.

What causes a major depression?

Normal variations in mood are believed to have an evolutionary basis, in that they serve to communicate something about our internal state to others. However, pathological depression reflects a multifactorial state of illness following a complex interplay between one’s genetics, environment, and psychology. Genes have been identified in certain individuals that are clearly associated with a tendency to produce depressed states in response to stress. Recent research has also established a strong link between persistent Inflammatory states and depression. What we eat, how well we rest, who we associate with, and how we handle stress all play a major role in the development, or prevention, of major depression. Depression can also serve as a form of psychological defense, for example against less tolerable feeling states, such as anger. There are many paths to a depressed state, and the solution almost always requires a multifactorial approach to recovery from depression.

How is major depression treated?

The first step is an accurate diagnosis by a trained clinician. Are your symptoms getting in the way of you achieving your goals? Have friends or family members expressed their concerns to you about your mood? While it is important to take an inventory of symptoms, the assessment of depression includes much more than simply using a checklist. A full evaluation must lead to an understanding of your diet and state of physical fitness, lifestyle choices, relationships and experiences, and your psychological makeup. Once the diagnosis is established, a personalized treatment plan targeting each problem area that contributes to the persistence of a major depressive episode area should be implemented assertively. This might include lifestyle improvements, individual or group psychotherapy, and in certain instances, the use of anti-depressant medications under the supervision of a psychiatrist.