Major Depressive Disorder

by

Rick Ingram

• LAST REVIEWED: 19 December 2012
• LAST MODIFIED: 19 December 2012
• DOI: 10.1093/obo/9780195389678-0171

Introduction

Depression is a term that can describe a number of states or conditions. Depression can be described as a symptom, synonymous with feeling sad. It can also be described as a syndrome that is characterized by a collection of symptoms that tend to occur together. When such a syndrome occurs with enough symptoms that functioning is impaired, it is viewed as a psychiatric illness, or as a psychological disorder. When it reaches the level of a psychological disorder, it falls within a group of affective disorders that are described in the fourth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV), specifically as a category of mood disorders. Among these disorders is major depressive disorder, which is the focus of this article. Other major mood disorders described by the DSM are dysthymic disorders, which represent a low-grade depressive state that lasts for at least a two-year period. Bipolar disorders are also covered and include bipolar I disorder, which is characterized by manic symptoms, and bipolar II disorder, which is characterized by somewhat less severe manic symptoms known as hypomania. Depression is among the most common of all psychological disorders, with some estimates suggesting that between 15 and 20 percent of Americans will experience a clinically significant episode of depression at some point in their lives. Although depression is viewed as a disorder of mood, the effects of depression pervade the individual’s life and negatively affect social relationships and relationships with partners and children, as well as occupational and academic functioning. Depression can be highly recurrent in some individuals, and for many people, having one depressive disorder places them at risk for the development of future depressive disorders. However, many instances of depression are time limited, and symptoms usually disappear within six to nine months. When symptoms are absent or minimal for at least three consecutive weeks, the disorder is assumed to be in remission, and if there is no return of symptoms for at least four months following remission, the person is assumed to have recovered from the episode. Either naturally or through treatment, most individuals recover from their depressive episode, although a very small percentage of patients do not recover even with treatment.

Reference Works

These sources represent overviews of many contemporary theories and data on depression. Beck and Alford 2009 is a revision of an earlier book and is a landmark in conceptualizing depression. Gotlib and Hammen 2009 provides a number of chapters that examine a number of depression topics in general, while Ingram 2009, an encyclopedia, briefly covers a wide variety of depression topics. Stein, et al. 2006 also includes chapters on a number of topics but tends to cover the disorder from more of a medical-model perspective. Stone 2006, a chapter in Stein, et al. 2006, presents an important history of depression.

• Beck, A. T., and B. A. Alford. 2009. Depression: Causes and treatment. 2d ed. Philadelphia: Univ. of Pennsylvania Press.

  An updated version of the classic work that launched the contemporary psychological study of depression. This volume also introduced a cognitive model of depression that still represents the foundation of much contemporary research on depression.

• Gotlib, I. H., and C. L. Hammen, eds. 2009. Handbook of depression. 2d ed. New York: Guilford.

  This book provides chapters on a number of topics in depression and is a must for any student of depression.

• Ingram, R. E., ed. 2009. The international encyclopedia of depression. New York: Springer.

  The entries in this work are not as detailed as in either Gotlib and Hammen 2009 or Stein, et al. 2006, but the coverage is broader and examines depression from A to (almost) Z.

• Stein, D. J., D. J. Kupfer, and A. F. Schatzberg, eds. 2006. The American Psychiatric Publishing textbook of mood disorders. Washington, DC: American Psychiatric Publishing.

  Another book that provides chapters on a number of topics in depression. Because the editors are psychiatrists, the coverage of biologically based approaches is more heavily emphasized than in Gotlib and Hammen 2009.

• Stone, M. H. 2006. Historical aspects of mood disorders. In The American Psychiatric Publishing textbook of mood disorders. Edited by D. J. Stein, D. J. Kupfer, and A. F. Schatzberg, 3–16. Washington, DC: American Psychiatric Publishing.

  A nicely presented history of the idea of depression. Starts with the Bible and goes though developments in the 20th century.