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What Is Primary Major Depressive Disorder?

What Is Primary Major Depressive Disorder

Major depressive disorder (MDD), also known as unipolar and clinical depression, is listed as serious mood disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The World Health Organization (WHO) explains that depression is “characterized by persistent sadness and a lack of interest or pleasure in previously rewarding or enjoyable activities,” resulting in significant impairment in one’s daily life. A young person who suffers from major depressive disorder has a chemical imbalance in his or her brain, resulting in an inability to return to an emotional equilibrium as quickly as others when experiencing an emotional low. Psycom asserts that “the unipolar connotes a difference between major depression and bipolar depression, which refers to an oscillating state between depression and mania.” Major depressive disorder is not uncommon, as the Centers for Disease Control and Prevention (CDC) estimates depression affects nearly 10% of the general population in America. 

Signs and Symptoms

Major depressive disorder can manifest in several different ways in teens. Some young people may experience a loss of interest in previously enjoyed pastimes such as sports, school, friendships, etc. Teens may experience significant weight fluctuations, changes in sleep habits (e.g., sleeping too much, or inability to fall asleep or stay asleep), and/ or low self-esteem. Some additional examples of symptoms that may be exhibited by a young person struggling with major depressive disorder include, provided by the Mayo Clinic:

  • Agitation
  • Irritability 
  • Random crying spells
  • Excessive feelings of guilt
  • Extreme self-criticism
  • Social isolation
  • Difficulty concentrating
  • Overly sensitive to failures or rejection
  • Body aches
  • Lack of proper hygiene 
  • Low self-esteem/ low self-worth
  • Self-harm (e.g., excessive piercing, cutting, burning, etc.)
  • Risky behavior

It is not uncommon for a teen to present with one or more of the above symptoms and not have MDD. However, if there is any concern that a teen may be struggling with major depressive disorder, it is essential to get help. MDD is a highly treatable disorder and the sooner a young person obtains help, the better. To receive the most effective treatment, a young person must be properly diagnosed, by a qualified mental health professional.  

DSM-5 Diagnostic Criteria

To be diagnosed with major depressive disorder, a young person’s symptoms must fit the criteria outlined in the DSM-5. An adolescent must be experiencing five or more of the following symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure:

  1. Depressed mood most of the day, nearly every day.
  2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
  3. Significant weight loss when not dieting or weight gain or decrease or increase in appetite nearly every day.
  4. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
  5. Fatigue or loss of energy nearly every day.
  6. Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
  7. Diminished ability to think or concentrate, or indecisiveness, nearly every day.
  8. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

These symptoms must cause the individual clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms must also not be a result of substance abuse or another medical condition.

For Information and Support

Every family in need of mental health treatment must select a program that will best suit the needs of their family. When one member of a family struggles, it impacts everyone in the family unit. To maximize the benefits of treatment we work closely with the entire family to ensure that everyone is receiving the support they need through these difficult times.

Seeking help is never easy, but you are not alone! If you or someone you know needs mental health treatment, we strongly encourage you to reach out for help as quickly as possible. It is not uncommon for many mental health difficulties to impact a person’s life, long term. Pursuing support at the beginning of one’s journey can put the individual in the best position to learn how to manage themselves in a healthy way so they can go on to live happy and fulfilling lives.


We are available to answer any questions you may have regarding mental health treatment and our residential program, anytime. Contact us today using the form to the right.

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