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Sometimes we have a tough day and that's okay. But if you find it hard to enjoy things you used to like for a long time, it's a good idea to seek help. Here we explain what major depression is and how you can get help.

What is major depression?

Major depression‘ is a mental illness characterized by a deep and persistent sense of sadness or loss of interest in activities that were previously enjoyable. It is more than just temporary feelings of sadness or low mood; it is a more serious condition that affects the person’s daily functioning and well-being.

To diagnose major depression, symptoms need to be present for at least two weeks and contribute to a change from the person’s previous level of functioning. Treatment for major depression may include psychotherapy, medication such as antidepressants, or a combination of both.

It is important to seek professional help if major depression is suspected, as it is a serious medical condition that can improve with proper treatment.

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What are the symptoms of major depression?

Major depression is characterised by mood changes such as prolonged sadness or hopelessness, loss of interest in previously valued activities, significant changes in appetite and weight, sleep problems, persistent fatigue or loss of energy, feelings of worthlessness or guilt, difficulty concentrating, psychomotor agitation or inhibition, and recurrent thoughts of death or suicide. These symptoms are persistent and are a change from the person’s previous functioning.

Why do people get depressed?

Depression is a complex illness that often results from a combination of genetic, biological, environmental and psychological factors. Family history suggests that genetics may play a role. Imbalances in brain neurotransmitters such as serotonin and dopamine, which affect mood and emotional stability, may be involved. Hormonal changes during pregnancy, the postpartum period, menopause or thyroid problems can trigger depression symptoms.

Certain personality traits such as low self-esteem and pessimism or increased sensitivity to stress can make individuals more likely to develop depression. Traumatic or stressful events such as the loss of a loved one, financial problems or major life changes can also trigger the illness.


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Long-term or serious illnesses such as heart disease or cancer can increase the risk. Substance abuse of alcohol, drugs and some medicines can contribute to or worsen depression. Social and environmental factors such as isolation, lack of social support and difficult life situations such as unemployment or domestic abuse can also contribute.

It is important to understand that depression is an illness and not a sign of weakness or lack of willpower. Effective treatments, including therapy, medication and lifestyle changes, are available to help people suffering from depression. If you feel less joy in life and more sadness, it may be wise to seek professional help for support and advice.

Criteria for major depression

Major depression, or major depressive disorder, is diagnosed according to DSM-5 when an individual experiences at least one depressive episode lasting at least two weeks and involving either a depressed mood or loss of interest or pleasure in activities. Diagnosis requires the presence of five or more specific symptoms such as significant weight changes, sleep problems, fatigue, feelings of worthlessness or guilt, impaired ability to think or concentrate, and recurrent thoughts of death or suicide.

These symptoms must cause clinically significant suffering or disability and cannot be explained by other medical conditions or substance use. In addition, the symptoms should not be better explained by other mental disorders such as schizophrenia. The diagnosis should be made by a qualified health professional.


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The difference between major depression and dysthymia

Major depression is characterised by intense and acute depressive symptoms such as deep sadness and loss of interest, and these symptoms usually last for at least two weeks. This type of depression is episodic, meaning that individuals may experience periods of normal mood between episodes.

Dysthymia is less intense but more chronic and long-lasting. Its symptoms, such as low energy and lack of happiness, extend over a longer period of time, usually for at least two years for adults. While major depression involves more severe symptoms for shorter periods, dysthymia is less intense but more persistent, often affecting the person’s daily functioning for longer periods of time. Both conditions require professional treatment.

Treatment for major depression

Treatment for major depression, also known as clinical depression or major depressive disorder, usually involves a combination of psychotherapy, medication and lifestyle changes. The treatment plan may vary depending on the individual’s specific symptoms, severity and other personal factors. Here are some of the most common treatment methods:

  1. Medication: Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, and other types, are often used to treat chemical imbalances in the brain that are associated with depression.
  2. Psychotherapy: Talk therapy, including cognitive behavioral therapy (CBT), interpersonal therapy (IPT), and psychodynamic therapy, can be effective in helping individuals manage their emotions, build coping strategies, and understand underlying causes of their depression.
  3. Lifestyle changes: Lifestyle changes, such as regular physical activity, healthy diet, adequate sleep and stress management techniques, can also play an important role in the treatment of depression.
  4. Electroconvulsive therapy (ECT): For severe cases of depression that do not respond to other treatments, ECT may be an option. This treatment involves electrical impulses sent to the brain under general anesthesia to trigger brief seizures.
  5. Mindfulness and relaxation techniques: Mindfulness meditation, yoga and other relaxation techniques can help reduce depression symptoms and improve mood.

It is important that treatment for depression is tailored to the individual’s needs and is supervised by a qualified health professional. Treatment may need to be adjusted over time to find the best treatment for the individual client.


12 frequently asked questions about major depression

What is major depression?

Major depression is a mental illness characterised by a deep and persistent sense of sadness or loss of interest in activities that were previously enjoyable.

What are the most common symptoms of major depression?

The most common symptoms include persistent sadness, lack of energy, sleep problems, fatigue and irritability.

How is major depression diagnosed?

Diagnosis of major depression is usually done through interviews and assessment forms by a health professional such as a psychologist or doctor. Blood tests are also often taken to rule out other medical causes.

What causes major depression?

Depression is a complex illness that is often caused by a combination of genetic, biological, environmental and psychological factors.

How is major depression treated?

Treatment options vary but often include therapy, medication and lifestyle changes. Cognitive behavioral therapy (CBT) is a common form of psychological treatment.

How long is the treatment for major depression?

The length of treatment can vary depending on the severity and individual needs. Some people can experience relief within a few weeks, while others need longer treatment.

Is major depression hereditary?

Genetics can play a role in depression, but it is usually a combination of several factors such as life events and personal circumstances that contribute to the illness.

Can exercise help with major depression?

Yes, regular physical activity can help but often more intervention is needed and physical activity should not replace professional care when needed.

What are the risk factors for major depression?

The risk factors for major depression are multiple and involve a combination of genetic, biological, environmental and psychological elements, so it can be difficult to predict.

What is the difference between major depression and dysthymia?

Major depression is episodic, meaning that individuals may experience periods of normal mood between episodes. Dysthymia is less intense but more chronic and long-lasting.

How does major depression affect relationships?

Depression can make it difficult to maintain healthy relationships and can lead to social withdrawal. You may have less interest in being social.

Where can I get help?

If you experience symptoms of depression, it is important to seek professional help. Our psychologists and therapists are available for online or face-to-face sessions and can help you make the difficult things easier. If you have thoughts of self-harm or suicidal thoughts, contact 112 or the nearest emergency psychiatric clinic.

How is major depression treated?

Treatment for major depression is often a combination of psychotherapy, medication and lifestyle changes, tailored to the individual’s specific needs and situation. Here are some common treatment methods:

  1. Medication: Antidepressants are often a central part of treatment. These include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants and others. The choice of medication depends on the patient’s symptoms, health status and response to previous treatments.
  2. Psychotherapy: Talking therapies such as cognitive behavioral therapy (CBT), interpersonal therapy (IPT) and psychodynamic therapy are effective for many patients. These therapies help individuals understand and manage their thoughts, feelings and behaviors that contribute to depression.
  3. Lifestyle changes and self-help strategies: Physical activity, healthy eating, good sleep hygiene and stress management can play an important role in the treatment of depression. Establishing a regular routine, participating in social activities and practicing relaxation techniques such as mindfulness and meditation can also be helpful.
  4. Electroconvulsive therapy (ECT): For severe depression or when other treatments have not been effective, ECT may be an option. This treatment involves electrical impulses to the brain under general anesthesia and is known to quickly reduce symptoms of severe depression.
  5. Psychotherapeutic and medical combination treatments: Often a combination of psychotherapy and medication is used to provide a more comprehensive treatment.
  6. Support groups and counseling: Participation in support groups and family counseling can provide additional support and help patients and their families better cope with the illness.

Importantly, treatment for major depression is individualised and may need to be adjusted over time. Regular follow-up with a health professional is important to monitor progress and make necessary adjustments to the treatment plan.

If you or someone close to you is seeking professional help for depression, do not hesitate to book a session with one of our qualified psychologists or therapists.

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Written by Ellen Lindgren

Licensed psychologist

Ellen is a licensed psychologist and has experience mainly in clinical psychology where she has worked with various conditions such as stress, anxiety, depression, insomnia, crises and trauma in primary care and psychiatry. She has also worked with research while studying in the US and with affective disorders and insomnia at Karolinska Institutet, Sweden.