Anxiety and Depression

Major Depressive Disorder

21 July 2020  |   3 min read

Major Depressive Disorder (MDD) is an illness that affects the mind, body and mood to a point of dysfunction. It is characterised by a combination of symptoms that interfere with a person’s ability to work, study, interact and enjoy activities like they once used to.

Signs and Symptoms

The following are some of the common symptoms of depression. A person who experiences five or more of these symptoms, with one of them being either persistent low mood or loss of interest, for more than two weeks may have a depressive illness:

  • Persistent sadness; or feeling down or gloomy
  • A loss of interest in activities previously enjoyed
  • Weight loss or weight gain; or decrease or increase in appetite
  • Difficulty falling asleep or staying asleep; or sleeping excessively
  • Feeling agitated or restless
  • Feeling tired and lacking the energy
  • Feelings of worthlessness or excessive guilt
  • Difficulty concentrating or having trouble thinking
  • Frequent thoughts of death or suicide

Causes of Major Depressive Disorder

The causes for MDD are multifactorial. Studies have shown that depression, to an extent, is associated with an imbalance of certain neurotransmitters (chemical messengers) in the brain, such as serotonin, norepinephrine, and dopamine. This imbalance could trigger a brain malfunction, causing one to feel depressed and out of sorts.

The presence of adverse life events or stressors and psychosocial factors such as childhood trauma, substance abuse, personality traits and family history of depression may also increase the risk of developing the condition.

Management of Major Depressive Disorder

The two main treatment methods for MDD are:

  • Psychotherapy
  • Medication

In mild to moderate depressive episodes, recovery is often possible with psychotherapy alone. However, in more severe cases, both types of treatment may be needed.

There are various types of psychotherapy which can be effective for major depressive episodes. However, the most frequently used method involves identifying the person’s negative thoughts, and developing strategies to challenge these, in addition to developing psychological methods of preventing further episodes.

If antidepressant medication is necessary, it is likely to take between one and three weeks before any improvement of the symptoms is noticed. For those who have had several bouts of depression, long-term treatment with medication is the most effective means of preventing more episodes.

Where to get help?

Depression is highly treatable. You may seek treatment from mental health professionals at the restructured hospitals, polyclinics, private clinics or from general practitioners. Various other organisations, such as the Singapore Association for Mental Health, Singapore Anglican Community Service, Club HEAL, and Caregivers Alliance also provide further support in the form of psychiatric rehabilitation programmes, psycho-education, employment support services or support to persons-in-recovery and their family members.

Here are some helplines you can call if you require emotional support

National CARE Hotline – Tel: 1800 202 6868

IMH (24-hour Helpline) – Tel: 6389 2222

Republished with permission from Institute of Mental Health (IMH)

Original source:

https://www.imh.com.sg/uploadedFiles/Publications/Educational_Resources/Depression%20Brochure.pdf