Major Depressive Disorder
Major depressive disorder (major depression) features one or more major depressive episodes, each of which lasts at least 2 weeks. The primary symptoms of major depressive disorder are depressed mood and loss of interest or pleasure. There are a wide range of additional symptoms (some of which are the opposite of others). For example, insomnia and weight loss are considered to be classic signs of depression, although some individuals with depression will gain weight and sleep excessively. Some symptoms commonly seen with Major Depressive Disorder, specifically oversleeping, overeating, and weight gain, may be more prevalent in women than men. Anxiety symptoms such as panic attacks, phobias, and obsessions also are not uncommon. Some individuals experiencing major depression will also experience symptoms of mania (see Bipolar Disorder) and psychoses (e.g., hallucinations).
When untreated, a major depressive episode may last, on average, about 9 months. Eighty to 90 percent of individuals will have their major depression remit within 2 years of the first episode. After that, at least 50 percent of depressions will recur, and after three or more episodes the odds of recurrence within 3 years increases to 70 to 80 percent if the patient has not had preventive treatment. Thus, for many, a first episode of major depression will evolve over time into the more recurrent illness sometimes referred to as unipolar major depression. Each new episode of major depression makes it more likely that the individual will consider suicide, that the depression will reappear, and that it will be disabling for the individual.
An excerpt from Mental Health: A Report of the Surgeon General, U.S. Department of Health & Human Services.
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