Depression Major Depressive Disorder (Mdd)

Depression

Major depressive disorder (MDD) is an illness that impairs the "mood, thoughts and behavioral patterns," according to an article in the Journal of the American Dental Association (Friedlander, et al., 2001). This paper reviews the article and points to what it presents and how that applies to knowledge of depression.

What are the symptoms? Many people use the phrase "I'm depressed" to indicate they are unhappy or upset about something that has happened in their lives. But it is not likely they are truly experiencing what healthcare professionals refer to as MDD -- "major depressive disorder" (Friedlander, p. 629). MDD is a "psychiatric illness" that lasts at least two weeks, Friedlander explains, and when a patient is suffering from MDD, he or she may experience the following symptoms: a) a feeling of being "helpless, hopeless, irritable… blue, sad" (called "dysphoria"); b) a loss of "interest or pleasure in previously enjoyed hobbies" or a lack of interest in social / sexual activities (called "anhedonia"); and c) a sense of being worthless, a sense of guilt, which can be associated with "past minor failings and thoughts of suicide" (Friedlander, p. 629).

Additionally, the person afflicted with MDD may be subject to severe mood changes, may have drastic changes in appetite (sudden weight gain or sudden weight loss), and may have trouble falling asleep, Friedlander explains. The person with MDD might also withdraw from social contact with peers and friends, and if not treated by professional medical personnel MDD can last "six months or longer," Friedlander continues.

What medications do dentists and doctors use to treat MDD? The article explains that typically patients with MDD are treated with antidepressant medications and with "brief psychotherapy (15 to 20 sessions)," Friedlander points out on page 630. The antidepressants used to treat MDD vary, depending on whether the patient is lethargic (in which case an "activating medication" is used) or "anxious" (a more "sedating" drug will be prescribed). On page 631 the article lists twenty-one antidepressant drugs that are used to treat MDD. One drug that is very commonly used for depression is Prozac (by Eli Lilly), which contains an "inhibitor" called fluoxetine; another inhibitor is called "phenelzine" and its commercial antidepressant drug is Nardil (by Parke-Davis drug company), which falls under the category of "Monoamine oxidase inhibitor" (MAOI) (Friedlander, p. 632).

The problem with some of these medications, like MAOI for example, is they may cause "dizziness… hypotension, insomnia, central nervous system stimulation, weight gain and edema" in some patients (Friedlander, p. 632). And those MDD patients that are taking a MAOI drug should avoid beer, cheese, red wine and "aged meats" because in some cases those foods and drinks mixed with an MAOI medication can cause "blood levels to rise, and, on occasion, bring about a fatal hypertensive crisis," Friedlander continues on page 632.

The authors suggest that along with antidepressants, patients with MDD should also undergo "Cognitive-behavioral therapy or interpersonal psychotherapy" (p. 632) in order to be sure they are doing all they can to become healthy again.