Major depressive disorder is called by several names, including major depression, clinical depression, or unipolar depression. Depression is a disorder of the brain that leads to constant feelings of sadness, hopelessness, and low energy that are so strong that you have trouble with daily life for weeks at a time. It is estimated that 6.7 percent of adults in America have major depressive disorder, with women twice as likely as men to have this disorder. Read more in our patient education guide.
In major depressive disorder, depression symptoms last for 2 weeks or more and are severe enough to interfere with the ability to work, sleep, study, eat, and enjoy life. Symptoms may include:
Doctors Who Treat Major Depressive Disorder
As your major depression is diagnosed, treated, and managed, you may encounter the following team of doctors and specialists listed in this patient education guide:
- Internist or family physician - A doctor who provides general medical care for adults and children; people with depression often see an internist or family physician first and may be monitored by one of these doctors and other specialists as needed.
- Pediatrician - A doctor who specializes in the medical care of children; children with depression often see a pediatrician first and are often monitored by a pediatrician and other specialists as needed.
- Psychiatrist - A doctor who specializes in mental illnesses; a psychiatrist diagnoses, treats, and monitors patients with depression, including prescribing antidepressant medications and providing psychotherapy.
- Psychologist - A therapist with an advanced degree in the study of the brain and behavior; a psychologist is involved in diagnosing depression and can provide psychotherapy or counseling.
- Child and adolescent psychiatrist - A psychiatrist who specializes in mental illnesses in children and adolescents; a child or adolescent psychiatrist diagnoses, treats, and monitors children and adolescents with depression, including prescribing antidepressant medications and providing psychotherapy.
- Child and adolescent psychologist - A psychologist who specializes in children’s mental health; a child or adolescent psychologist is involved in diagnosing depression and providing psychotherapy or counseling for children and adolescents.
How to Prepare for Your Doctor Visit for Major Depressive Disorder
Having made your appointment with a healthcare provider, there are certain actions you can take to maximize the benefit of your doctor visit for major depression, and are listed below in this patient education guide.
- Write down a list of all your symptoms, including any that may seem unrelated to depression such as stomach aches, headaches, trouble sleeping, or loss of appetite.
- Make a list of all medications, vitamins, and supplements that you’re taking. Include the dosage you are taking of each.
- Write down key personal information, including prior illnesses, chronic illnesses, diet and exercise habits, and any major stresses or recent life changes.
- Be prepared to talk about difficult topics such as troubles in your life or whether you have ever thought about suicide.
- Be prepared to answer many questions and to take an active role in managing your disease. Depression is a complex disease that requires ongoing medical care and active participation by patients.
Questions to Ask Your Doctor About Major Depressive Disorder
From your initial diagnosis throughout your treatment and care, you will have questions about your condition. This patient education guide list questions to discuss with your doctor so you can make informed decisions about your condition your major depression and your care.
Question About My Diagnosis
- How did I get major depression?
- What is the difference between major depression and milder forms of depression?
- What makes my condition major depression rather than mild depression?
- How long will my depression last?
Questions About My Treatment
- What type of medication is used to treat major depression? Are there side effects?
- Will I have to take medication for the rest of my life?
- How do you decide which medication or therapy is best for me?
- Should I see a therapist/counselor? Will insurance pay for therapy/counseling sessions?
- Will other medications I take interact with my depression medication?
- Are there vitamins or herbal supplements that treat depression?
Questions About My Lifestyle & Family
- Are there changes in my diet or daily activities that could help improve my mood?
- Is it true that exercise can cure depression?
- Can I take antidepressants if I am pregnant, nursing, or trying to become pregnant?
- Are there any groups for support or patient education in my area for people with depression?
Common Tests or Labs to Diagnose Depression
Making a proper diagnosis of major depression involves the doctor asking you many questions, performing a physical exam, and possibly running some tests.
The doctor will ask you questions about the history of your depression symptoms, including when they started, how long they have lasted, how severe they are, whether they have occurred before, and if so, how they were treated.
He or she will also ask about life stresses and whether any family members have been diagnosed with depression.
Doctors also use standardized depression questionnaires to gather information to help them make a diagnosis.
The doctor will review any medications you are taking to determine if a medication may be affecting your mood.
A physical examination and lab tests can be performed to rule out other conditions that cause symptoms similar to depression. For example, a blood test can show if you have a condition, such as thyroid disease, anemia, or kidney disease that may be causing your depression symptoms. Treating these conditions can often relieve the depression symptoms. Read more in this patient education guide.
Common Medications and Treatments for Major Depressive Disorder
Major depressive disorder is typically treated with antidepressant medications and/or psychotherapy (counseling). Antidepressant medications work by changing the balance of certain chemicals in the brain, which helps improve mood. The table below describes the common medications used to treat major depression. Psychotherapy and other therapies that may be included in depression treatment are described below in this patient education guide.
| Drug Category |
How it works |
| Selective serotonin reuptake inhibitors (SSRIs) |
These drugs work by blocking a receptor in the brain that absorbs serotonin, a brain chemical known to influence mood. |
| Serotonin and norepinephrine reuptake inhibitors (SNRIs) |
These drugs work by blocking the absorption of serotonin and norepinephrine (another brain chemical that affects mood) in the brain. |
| Bupropion |
This drug works by acting on the chemical dopamine in the brain.
It does not fit into any specific drug category. |
| Monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, and tetracyclic antidepressants |
These older classes of antidepressants are prescribed less often than SSRIs, SNRIs, and bupropion. They typically cause more side effects; however they do work well for some people. |
Psychotherapy (also called counseling or talk therapy) - This therapy involves talking about your depressive moods, attitudes, and life stresses or problems with a professional therapist. The therapist helps you develop new ways to think about and deal with difficult situations and helps you develop ways to cope with your feelings. Therapy gives people tools to help fight feelings of depression, low self-esteem, anger, fear, anxiety, shyness, or panic.
Electroconvulsive therapy (ECT) - This treatment may be recommended for severe depression that does not respond to medication or therapy. ECT involves delivering an electrical shock to the brain for 1-2 seconds in an attempt to alter the release of brain chemicals involved in depression.
Alternative therapies – Some studies suggest that St. John’s wort may relieve symptoms of milder depression, but it has NOT been shown effective for treating major depression. It is important to talk to your doctor before taking any herbal supplements, particularly St. John’s wort, because it can interact with some medications.
In addition to standard depression therapies, the following habits may help manage depression symptoms:
- Eating a nutritious diet
- Exercising on a regular basis
- Avoiding alcohol and illicit drugs
- Avoiding too much caffeine
