What is the History of Major Depressive Disorder?

Major Depressive Disorder is one of the four major mental illnesses. The other three are bipolar disorder (feelings of both depression and mania), schizophrenia, and schizoaffective (a combination of both bipolar and schizophrenia). Major Depressive Disorder is characterized by uncontrollable feelings of sadness. These feelings can lead to suicidal thoughts and suicide. Sufferers may even experience mania, hallucinations (both auditory and visual). The disorder lasts longer than six months and affects all aspects of the patient's life.

What is Major Depressive Disorder

• Perhaps the hardest aspect of having Major Depressive Disorder is that many feel those who have it simply need to "change their lives" or "face their realities. Unfortunately, it has been scientifically proven that the disorder is biological. It occurs in approximately 30 to 35 million Americans. This could be an even larger number since not all those who suffer from the disorder seek treatment, and thereby go unrecorded. Major Depression is not be confused with dysthymic depression, which is characterized by a bout of depression that lasts longer than five months but less than six (webmd.com).

History

• Those who suffered from major depression prior to 1980 thought they were simply depressed, physicians and psychologists fought long and hard to treat the consistent low mood, low self esteem, lack of interest in all aspects of their lives and suicidal thoughts. In 1980, the American Psychiatric Association added "Major Depressive Disorder" to their "Diagnostic and Statistical Manual of Mental Disorders," commonly referred to as the DSMIII. Although the disorder was not acknowledged as such by the psychiatric community, effective treatments were few and far between. During this time, electroconvulsive shock therapy was commonly used. A seemingly extreme treatment for patients who felt "sad."

New Medications Arrive for the Treatment of Major Depressive Disorder

• Since the acceptance of Major Depressive Disorder into the DSMIII, the need for more effective treatments were already underway. Perhaps the first and the one that offered the most promising results, was Pfizer's breakthrough drug, Prozac. The disorder is believed by many scientists to be a lack of one of the three major chemicals in our brain which are: serotonin, dopamine and norepinehrine. Most scientists believed that serotonin, which is the chemical believed to keep us at a stable, even mood, was clearly the cause of depression and therefore, held the key to treating it.

What are SSRI's?

• Selective Serotonin Reuptake Inhibitors, referred to as "SSRI's" are created to slowly build up the level of serotonin in the patient's brain. As it is believed that those who suffer from depression lack enough serotonin to keep their moods stable, the SSRI's served to "block" transmitters in the brain from pulling the serotonin back into the body. By "blocking" neurotransmitters, the SSRI's will slowly build the amount of the serotonin the brain has, thereby creating a more even mood in its users.

SSRI's and their Efficacy on Major Depressive Disorder

• When SSRI's arrived on the scene there efficacy was so promising that many banked on them saving their dark, sad lives. For many, the drugs did exactly that, Prozac helped thousands to finally be able to wake up and face their day. Soon many other SSRI's followed, Paxil, Luvox, the list goes on. These drugs, however, not only did very little for many patients, but had serious side effects that include but are not limited to: insomnia, anxiety, suicidal thought, and violent behaviors such as causing physical harm to themselves or others (mentalhealth.com). Another downside to these medications was that those it did work for experienced a lack of efficacy as they continued to stay on the drug. After prolonged use, the effectiveness fades, as the body becomes used to the drug and builds up a tolerance. Physicians often change SSRI's as although their activeness is similar, they are in fact, different drugs.

Major Depressive Disorder and its Future

• New drugs are being made and tested almost daily to treat depression. Perhaps the most promising of these drugs are similar to the SSRI's although they target the brain's pleasure causing chemical, dopamine (psychiatryonline.com). In tests, the SDRI's show great promise, but unfortunately, dopamine is directly related to addiction and the FDA seems resilient in not allowing them to be released for public use. In severe cases, shock therapy is still used to some degree. Carrie Fisher, of Princess Leia fame, swears by the procedure as all other forms of treatments have proved inept in treating her lifelong battle with depression. The future of the disorder is uncertain. We know very little about the brain and psychotropic medications prove this as each one works differently in each person. What works for some may not only prove ineffective for another but may actually harm them.

Major Depression and Exercise

• As mentioned above, medication is not a cure all for depression. Although difficult for many sufferers, the power of exercise and therapy cannot be underestimated. The releasing of endorphins from exercise and the cathartic aspects of routine therapy are an excellent combat against depression. If one relies on medication alone, they will quickly find that there is no "magical pill" to alleviate depression's relentless attack on one's happiness. Perhaps the most effective way to treat depression is surely the combination of medication and cognitive therapy. Positive thoughts, although difficult, are an excellent asset for anyone, especially those that suffer from Major Depressive Disorder.