Like many aspects of the medical world, mental health treatment is not a one-size-fits-all situation. Under the umbrella of major mental illness diagnoses, there are many more specific conditions, which often describe individuals’ experiences in more detail and lead to more accurate treatment. Under the category of depression lies one such condition, major depressive disorder, a condition categorized by feelings of depression most of the time.

Symptoms of Major Depressive Disorder

So what is MDD or Major Depressive Disorder? Let’s break it down in a way that’s easy to understand. While many forms of depression, such as seasonal affective disorder and minor depression, are situational, short-term, or experienced few days of the week, a person with major depressive disorder may experience two or more of the following symptoms most days of the week for all or most of the day:

  • Fatigue
  • Emotions such as guilty or worthlessness
  • Sleeping too little or too much
  • Reduced pleasure in activities of all kinds
  • Difficulty concentrating and/or making decisions
  • Unusual issues with memory

Additional Symptoms Some People Experience

A person with major depressive disorder might experience the following, though not necessarily every day:

  • Restlessness
  • Thoughts of self-harm or suicide
  • A 5% or more change in body weight per month
These symptoms can also be used to define clinical depression. However, the key is to remember that the frequency at which they are experienced is what categorizes major depressive disorder.

Who Suffers from Major Depressive Disorder?

Nearly one out of every four people experiences a major depressive episode in their lifetimes. Whether brought on by grief, stress, finances, or a brain hormone imbalance, it’s expected that lots of people will have an experience with depression at some point. Depression is a common occurrence amongst our population, but only around 7% of the adult population is thought to suffer from major depressive disorder regularly. People who were assigned female at birth seem to suffer from depression at higher rates than people assigned male, with twice as many of these individuals diagnosed with the disease. This phenomenon is thought to be agitated by the female reproductive system, with menstruation, pregnancy, and menopause increasing a person’s risk of depressive episodes.

Who Suffers from Major Depressive Disorder?

Though adults make up the bulk of the population that suffers from major depressive disorder, it’s thought to affect other groups as well. Teenagers, older children, and the elderly often experience a major depressive disorder. Without the research and resources readily available to back up the stats, these cases often go undiagnosed. It’s also thought that persons who have undergone some medical trauma, such as a heart attack or miscarriage, are more prone to developing MDD.

Treatments Are Available for Severe Depression

Just like symptoms of depression itself, treatment for major depressive disorder varies from person to person. Treatment plans should always be formulated with a professional and monitored carefully. The basis for all mental health treatment includes taking exceptional care of one’s health in general. A doctor will often first suggest increasing fruits, vegetables, and omega-3 rich foods in your diet to help the brain combat depression. Your doctor may also help you formulate a fitness plan, as exercise has been shown to ease depression symptoms. Limiting or eliminating alcohol may also be called for, as alcohol acts as a depressant in the nervous system and may worsen symptoms.

Individual Therapy

Individual Therapy for Depression

A major option for combating mental illness is the use of psychotherapy. This treatment model involves talking to a licensed therapist or counselor regularly about your emotional state. Therapy has been shown to relieve major depressive disorder symptoms by working through the situations and thought patterns that may have your brain stuck in a depressed state.

A therapist is likely to do the following work with a patient experiencing depression:

  • Identify negative beliefs and challenge them
  • Encourage positive thinking
  • Analyze relationships and acknowledge ways in which others may be positively or negatively affecting your mental state
  • Develop healthy coping mechanisms
  • Aid in setting goals
  • Help gain a feeling of control over your mental state

Finding the right therapist and committing to doing the hard work of counseling are key to therapy’s efficacy in fighting against depression.



In many cases, lifestyle changes are not enough to fully combat major depressive disorder, and your doctor will suggest other options. When depression isn’t temporary or situational, it’s often a chemical imbalance in the brain that needs medical treatment. Antidepressants are suggested to help relieve the patient’s mental state and give them the energy to get back on their feet.

There are several main categories of antidepressants that your doctor may prescribe:

Selective serotonin reuptake inhibitors (SSRIs) ensure that the serotonin in your brain hops evenly from cell to cell instead of being reabsorbed into the same cells several times. These are often the first class of medication a doctor will prescribe, as their side effects are minimal, and they can be highly effective.
Selective serotonin reuptake inhibitors (SSRIs) ensure that the serotonin in your brain hops evenly from cell to cell instead of being reabsorbed into the same cells several times. These are often the first class of medication a doctor will prescribe, as their side effects are minimal, and they can be highly effective.
Tricyclic antidepressants help increase the availability of serotonin or norepinephrine in the brain. These are often prescribed after an SSRI or SNRI has failed to work, as in some cases preventing serotonin reuptake is useless if there isn’t a lot of serotonin in the brain to begin with.
Monoamine oxidase inhibitors block the work of monoamine oxidase, a stubborn enzyme that removes essential “happy” hormones from the brain. When this process is blocked, more serotonin, norepinephrine, and dopamine are available for your brain to use.

Not all antidepressants fit into these categories and depending on your situation, your doctor may prescribe something else to ease your symptoms.

Using Transcranial Magnetic Stimulation Therapy for Treatment-Resistant Depression

PET Scans

Image Source: Mark George, M.D. Biological Psychiatry Branch of Intramural Research Programs. NIMH1993

In some cases, medications, lifestyle changes, and therapy don’t significantly impact a person’s depression. These cases are often categorized as treatment-resistant depression. This diagnosis can be disheartening for some, as it implies that there is no solution for them. This, however, is not the case. Many treatment-resistant cases of major depressive disorder benefit from transcranial magnetic stimulation (TMS).

TMS is a Food and Drug Administration-approved depression treatment that involves sending magnetic signals to specific parts of the brain. Though the details of why this works aren’t completely understood, scientists believe that this therapy activates areas of the brain that major depressive disorder has caused significant stagnancy in. By waking these areas up, depression symptoms are reduced and improve with each session.

Watch this video to learn more about how Sage uses TMS to help individuals with treatment-resistant depression:

Remember, There is Help

If you feel like you have tried everything but are losing the battle against depression, don’t lose hope. Sage Neuroscience Center helps create a custom plan for depression treatment that can greatly impact your situation. For more information on how to feel better, contact us today. We’ll start where you are and help get you to where you’re going.