Major Depressive Disorder: What you need to know

What is major depressive disorder?

Major depressive disorder (MDD) is part of a cluster called the depressive disorders. Depressive disorders are a group of conditions that include:

  • Major depressive disorder
  • Persistent depressive disorder (dysthymia)
  • Disruptive mood dysregulation disorder 

MDD goes far beyond the typical feelings of sadness. Individuals with MDD experience pervasive sadness or loss of interest (anhedonia) along with other symptoms for at least two weeks. It causes a child to experience sad or irritable mood persistently which affects their thinking and behavior at home, in school, and with peers.

Early onset of depressive disorders can predict future episodes of depression into adulthood. With early intervention the risk of recurrence and the severity of symptoms can be reduced while improving functioning and mental well-being.  

Causes and Risk Factors 

It could be caused by a combination of factors such as genetics, environmental, and psychological factors and biochemical disturbances.

  • Brain chemistry

    Imbalances in certain neurotransmitters might play a role in how the brain works, which can affect moods and emotions and increase the likelihood of experiencing depression. Reduced dopamine, serotonin and norepinephrine levels can contribute to depression in some people.
  • Environmental factors

    Stressful, chaotic, or unstable family relationships and home environment can also make children more prone to experiencing depression. Bullying, abuse or neglect may also be a contributing factor.
  • Family history

    Children with family members who have mood disorders are at a greater risk for being similarly affected or experiencing symptoms of depressive disorders.
  • Stress/trauma

    Sudden changes in life or traumatic events might also contribute to feelings of depression.

  • Other mental-illnesses

    Having any other major disorder or a chronic medical condition can also make children more likely to develop depression.

Signs and Symptoms of MDD 

For a diagnosis of MDD, a young person will experience a depressed or irritable mood or lose interest or pleasure in daily activities or both, for at least 2 weeks. In addition, the child might show a variety of the following signs: 

  • Loss of interest or pleasure in all or almost all activities once enjoyed
  • Feeling hopeless or helpless
  • Marked weight loss or gain
  • Having low self-esteem
  • Feeling inadequate
  • Excessive guilt
  • Decreased energy
  • Sleeping too much or too little
  • Restlessness 
  • Lethargy or fatigue
  • Feelings of worthlessness  
  • Cloudy or indecisive thinking
  • Preoccupation with death
  • Suicidal ideation or an actual suicide attempt
  • Increased sensitivity to failure or rejection

All other causes for these symptoms must be ruled out e.g., substance abuse, diabetes and hypothyroidism etc. 

Treatment for MDD 

The treatment for MDD might include psychotherapy (counselling), medication or a combination of the two depending on the severity of the symptoms and the age of the child. 

Mental-health Counselling

Counselling might help children learn to think more positively and control negative behaviours. It gives children the tools to manage and cope with depression in healthier ways.


Many medications have proven effective in combating depression. The most common antidepressant medication for children increases the level of serotonin in the brain. Serotonin is a chemical that can help increase feelings of happiness and well-being. 

It is recommended to be extra cautious when administering antidepressants to children. Some children might not show any improvement with the medications, or may even end up feeling more depressed. Medication should only be administered if prescribed by a qualified specialist. 

What can I do at home?

The following are some of the steps you can take to encourage healthy coping skills and support your child’s mental health:

  • Talk about how caring for the body also helps the mind. Explain how eating nutritious food and exercise is good for their mental health.
  • Make sure your child has a consistent sleep schedule. 
  • Help your child develop a rich social life 
  • Teach your child how to solve problems, manage their emotions in healthy ways, and develop strategies that will help them cope with failure and setbacks.
  • Talk about your mental health too and make staying healthy a priority in your family. 
  • Spend time with your child doing things you both can enjoy. Gradually encouraging positive emotions and moods can slowly help to overcome the depressive moods
  • Try to stay patient and understanding. 

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