Everyone feels sad, irritable, or tired at times. Many people experience difficulty sleeping when they’re under stress. These are normal reactions to life stressors that typically pass within a few days.

Major depressive disorder is different. Though insomnia and fatigue are often the presenting complaints, people with depression experience depressed mood or loss of interest in normal daily activities for weeks at a time.

The twelve-month prevalence of major depressive disorder is approximately 7%. Although women experience 1.5-3-fold higher rates of depression beginning in early adolescence, men do experience depression.

Symptoms of major depressive disorder

 The essential feature of major depressive disorder is a period of two weeks during which there is either depressed mood most of the day nearly every day or loss of interest or pleasure in nearly all activities. Other potential symptoms include:

  • Significant weight loss when not dieting or weight gain and changes in appetite
  • Insomnia or hypersomnia nearly every day
  • Psychomotor agitation or retardation nearly every day
  • Fatigue or loss of energy nearly every day
  • Feelings of worthlessness or excessive guilt
  • Impaired ability to think or concentrate, and/or indecisiveness
  • Recurrent thoughts of death, recurrent suicidal ideation without a plan, or a suicide attempt or suicide plan

The symptoms of major depressive disorder cause significant distress or impairment in social, occupational, or other areas of functioning.

Suicide risk

The possibility of suicidal behavior exists at all times during a major depressive episode. The most consistent risk factor is a past history of attempts or threats, but it’s important to remember that most completed suicides are not preceded by unsuccessful suicides. Although women with depression are more likely to attempt suicide, men are more likely to die by suicide

Symptoms of depression in men

Different people experience different symptoms of depression, and symptoms for men can differ from symptoms for women. Men or more likely to feel very tired and irritable, lose interest in work, family, and/or hobbies, and have difficulty sleeping.

Men are likely to exhibit some of the following symptoms of depression:

  • Feel sad or “empty”
  • Feeling irritable, angry, hopeless, or anxious
  • Loss of interest in work, family, or other hobbies or interests (including sex)
  • Feeling very tired
  • Difficulty concentrating
  • Sleep disturbance (unable to sleep or sleeping too much)
  • Changes in eating habits (overeating or not eating at all)
  • Thoughts of suicide, suicide attempts
  • Somatic complaints (aches or pains, headaches, digestive problems)
  • Inability to meet daily responsibilities.

Treatment

A combination of medication and psychotherapy is effective for most people with depression. Changes in lifestyle can also help.

Lifestyle

In mild cases of depression, daily exercise, improved eating habits, and a specific sleep routine can assist in alleviating some symptoms.

Psychotherapy

Psychotherapy, or “talk therapy,” is a general term that refers to treating depression by talking through your triggers and responses with a licensed mental health professional. There are different types of psychotherapy that can be effective in treating depression.

  • Cognitive Behavioral Therapy (CBT): This short-term therapy works to replace negative and unproductive thought patterns with more realistic and useful ones. This treatment focuses on taking specific steps to manage and reduce symptoms.
  • Interpersonal “talk” therapy: This attachment-focused therapy centers on resolving interpersonal problems and symptomatic recovery.
  • Problem solving therapy: This treatment helps people learn tools to effectively manage the negative effects of stressful life events.

Psychotherapy can help people with depression:

  • Cope with a crisis
  • Identify and replace negative beliefs
  • Explore relationships and experiences and build positive connections
  • Find adaptive ways to solve problems
  • Identify issues that contribute to depression
  • Set realistic goals
  • Develop the ability to tolerate stress and distress.

Medication management

Either a primary care physician or a psychiatrist can assist with medication management. Selective serotonin reuptake inhibitor (SSRI) and serotonin norepinephrine reuptake inhibitor (SNRI) medications are both effective treatments for depression. Other possible medications include norepinephrine dopamine reuptake inhibitors (NDRI), atypical antidepressants, tricyclic antidepressants, and monoamine oxidase inhibitors (MAOI).

Different people have different responses to medications. It’s important to work closely with your primary care physician or psychiatrist and report any side effects. Never stop taking antidepressant medication without consulting the prescribing doctor. Stopping treatment abruptly can produce withdrawal-like symptoms and cause a sudden worsening of depressive symptoms.

Hospitalization

Severe cases of depression can require hospitalization. Psychiatric care in a hospital setting helps patients stay safe until their mood improves, particularly in the case of suicidal thoughts or suicide attempts.

 

Last Updated: May 23, 2017