Major Depressive Disorder

Major Depressive Disorder or MDD is a very common clinical condition that affects millions of people every year. According to the Agency for Health Care Policy & Research, " depression is under diagnosed & untreated by most medical doctors, despite the fact that it can almost always be treated successfully.

According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV); A person who suffers from this disorder must have a depressed mood, or have lost interest in things that would have normally brought them pleasure; for a minimum of two weeks. This must be different then the person's normal behaviors, and it may not be caused by a general medical condition. (American Psychiatric Association, 1994)

Depression is an illness within itself that affects the "whole body". (Staywell,1998) The body, feelings, thoughts, and behavior are all immensely altered when someone is depressed. It is not a sign of personal weakness, or a condition that can be wished or willed away. For some people depression is just temporary, but for others it can last for weeks, months and even years.

The exact causes of depression seem to differ immensely, but there are some who believe that it maybe caused by a chemical imbalance in the brain, or that it may even be hereditary. Still there are others who believe that it is a combination of social, biological, emotional, psychological, and economical influences that may cause someone who has no family history of depression to develop even a mild case of depression.

"Women are two times more likely to develop depressive symptoms then men"(Psychosocial and Behavioral Factors in Women's Health, 1990), and women who are among the child-bearing years tend to be more at risk. However this is not to say that men are not affected by depression. It is usually, because of negative social influences, such as economic instability, and/or the inability to handle stress in their lives.

Regardless of the person whether male or female who has developed the symptoms of depression, their lives have been invaded by a sickness that can have a devastating effect on their lives; depending on how severe their symptoms are. If left untreated the end result could have an even more devastating effect. Luckily, there are treatments available that are successful.

The first step to treatment should be a complete physical by a doctor, so that any medical condition is ruled out as the cause of depression. Then, the physician can start to focus on the causes and treatments available. The treatments for depression can be antidepressants, psychotherapy, or a combination of both.

Treatments using anti-depressants is well documented, but there are very few studies documenting only the use of psychotherapy. However, in one study done using the Cognitive-behavioral analysis system of psychotherapy (CBASP) as a maintenance treatment, the overall findings show that psychotherapy in itself can be successful. " There were 82 patients who were treated with CBASP long term. Patients were chosen at random to reduce their treatment to monthly or to an observational status. The patients, only treated monthly with CBASP, showed a smaller amount of reoccurring symptoms then the patients in the observational status. These findings support the use of only CBASP as a maintenance treatment for depression." (Klein, 2004)

Psychotherapy itself comes in many forms, and is based on many different psychological models. Adlerian therapy on the growth model, Gestalt therapy integrates the body and mind, psychoanalytic therapy focuses on the first six years of life, Reality therapy teaches people to control the world around them, and Rational and Cognitive therapy, deals with the cognitive and moral state of the patient. Any one of these could be chosen as a treatment option, but for the purpose of this paper, I will focus on a form of Humanistic Therapy.

Humanistic Therapy is a process by which an individual is influenced and gains their knowledge from within themselves; by changing the negative attitudes and thoughts to eventually produce a positive outcome. As stated in our text, "Humanistic Therapies place emphasis on the person's desire to achieve self-respect. Existential therapy emphasizes the need to confront basic questions of ones existence, such as: What is the meaning of my life?" (Sarason & Sarason, 1999) A combination of these two are known as Person-centered therapy or Client-centered therapy.

Carl Rogers founded person-centered/client-centered therapy in the 1940's. In this type of therapy it allows the client to take part more, and except responsibility for his or her own treatment. This type of treatment focuses on the person from the inside out. Starting with the inner turmoil, which the person is fighting inside. The therapist and the client both have certain goals