Christian Counselor Seattle
Receiving a mental health diagnosis may feel overwhelming or perhaps a bit intimidating—especially if you’ve never received a diagnosis before or are unfamiliar with mental illness. This article will provide suggestions for “next steps” after receiving a diagnosis of Major Depressive Disorder. But, before you read any further, I want to provide clarification on the purpose of a diagnosis.A diagnosis is used to describe the symptoms you’re experiencing. It validates the distress or impairment that you’re facing and can help inform treatment and facilitate communication between health professionals coordinating your care. A diagnosis does not have the power to take away your free will or determine your identity or personal worth. With or without a diagnosis, you are a valuable human being, created by God to live a life of purpose and meaning.
Life can feel hindered or burdened when you are depressed. But, it can be made much easier when you receive proper treatment and support. In order to pursue appropriate treatment and to care for yourself well, it’s important to understand your diagnosis of Major Depressive Disorder.
Understanding Major Depressive Disorder
“I’ve Been Diagnosed with Major Depressive Disorder”: Understanding the Diagnosis
A diagnosis of Major Depressive Disorder is typically made by medical or mental health professionals like primary care doctors, psychiatrists, nurse practitioners, clinical psychologists, mental health counselors, marriage and family therapists, and clinical social workers. All mental health diagnoses are determined based on particular sets of criteria found in the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-V; APA, 2013).
Major Depressive Disorder (i.e., “clinical depression”) is one of several “depressive disorders” listed in the DSM-V (APA, 2013). It is characterized by a two-week period in which at least five of the following symptoms are present. At least one of the symptoms must be either, 1) depressed mood (i.e., feels sad, empty, hopeless) most of the day, nearly everyday, or 2) decreased interest or pleasure in all or almost all activities most of the day, nearly everyday.
1. Depressed mood (i.e., feels sad, empty, hopeless) most of the day, nearly everyday.
2. Decreased interest or pleasure in all or almost all activities most of the day, nearly everyday.
3. Significant weight gain/loss or increase/decrease in appetite.
4. Difficulty falling sleeping (i.e., insomnia) or staying awake (i.e., hypersomnia) nearly everyday.
5. Being visibly restless or contrastingly, moving or speaking slower than usual nearly everyday.
6. Feeling tired or energy-zapped nearly everyday.
7. Feeling very poorly about oneself or excessively or inappropriately guilty nearly everyday.
8. Difficulty concentrating or making decisions nearly everyday.
9. Thoughts of death, not wanting to be alive, having a plan for suicide, or a suicide attempt.
(Major Depressive Disorder criteria from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition, 2013)These depressive symptoms must cause significant distress or impair ability to fulfill social, occupational, or other normal responsibilities. A diagnosis of Major Depressive Disorder assumes that other medical conditions or mental health disorders have already been ruled out as causes for these symptoms.
Some people may experience a single instance (or “episode”) of Major Depressive Disorder, while others may experience recurring Major Depressive Disorder (multiple depressive episodes). Major Depressive Disorder can manifest itself in various ways. For example, some people may feel on edge, anxious, and worried during the episode of depression, while others may just feel down and hopeless.
According to the National Institute of Mental Health (2017), Major Depressive Disorder is one of the most common mental disorders in the United States. In 2015, it was estimated that 16.1 million adults (6.7% of the American adult population) had experienced at least one depressive episode within the past year.
If you have questions or concerns about your given diagnosis of Major Depressive Disorder, you can ask the professional who provided the diagnosis for clarification. It’s okay to ask the professional how they concluded that Major Depressive Disorder best describes your symptoms. And, you’re welcome to provide feedback if you do not believe this diagnosis fits your experience.
Treatment for Major Depressive Disorder
“Now What Do I Do?”: How I Can Care for Myself
Research suggests that depressive disorders affect individuals irrespective of age, gender, race, or socioeconomic class. The causes of depressive disorders have yet to be determined. However, chemical or hormonal imbalances, significant stressors (e.g. relational issues, unemployment, financial difficulties, trauma, etc.), drug or alcohol use, and medical conditions (e.g. Parkinson’s disease, hypothyroidism) may contribute to the onset of depression (National Institute of Mental Health, 2015; American Psychiatric Association, 2013).
Seek Appropriate Treatment
One way that you can care for yourself is by seeking appropriate treatment. Although there is no “cure” for Major Depressive Disorder, it can be treated, meaning there are treatments available that can alleviate or lessen the effect of depressive symptoms. According to research, the most effective forms of treatment for Major Depressive Disorder are psychotherapy, medication, or a combination of psychotherapy and medication.
Psychotherapy (i.e., therapy, counseling) can help you develop tools to address behaviors, automatic thoughts, deep beliefs, and ways of relating to self and others that may be affecting your symptoms. For example, your therapist can help you to identify triggers that worsen your mood and coping skills that help to improve it. Your therapist can also help address negative beliefs about yourself that may be perpetuating your depression.
Depression leaves you in a vulnerable mental state—you might find that your usual abilities to reason and balance unhelpful beliefs is lacking. Old or deeply rooted insecurities may be “speaking louder” than is typical for you and negative beliefs about the self or others may feel more true than usual.
You may also find that disappointments or “bad things” seem to stand out more than the positives. Especially when you’re feeling depressed, it’s important to be mindful of what you think about. A therapist can help you to notice the negative thoughts that are surfacing and to instead intentionally engage with thoughts that are more helpful to you.Since isolation, loneliness, and fatigue tend to accompany depression, it can be extremely helpful to have a therapist or counselor partnering with you as you pursue health. A therapist can provide emotional support and tools for helping you to manage your symptoms without the expectation that you will reciprocate that care for him/her. Ideally, the relationship between therapist and client can be a source of safety and rest, a place to recuperate and grow.
Your mood is intricately connected to your brain and your body. According to the National Institute of Mental Health (2017), antidepressants “may help improve the way your brain uses certain chemicals that control mood or stress.” Although you cannot see it, your mood (and behavior) is affected by chemicals in the brain.
Medication in the form of antidepressants can help alleviate symptoms like depressed mood, concentration, appetite, sleep, and motivation—symptoms that can hinder daily functioning. Medical professionals like primary care physicians, psychiatrists (medical doctors who have a specialization in psychiatry), and psychiatric nurse practitioners can prescribe antidepressants.
There are multiple types of antidepressants and you may respond better to some medications than others. You may need to try multiple antidepressants before finding the right one for you. Please consult a medical professional that is trained to prescribe medication for information regarding medication treatment and side effects.
Combined Psychotherapy and Medication Treatment
A recent meta-analysis (a study that utilizes data from multiple studies) found that a combined treatment of psychotherapy and medication was more effective for treating Major Depressive Disorder than medication treatment alone (Cuijpers et al., 2014). So, if you choose to pursue medication treatment, it may be beneficial to consider adding psychotherapy to your treatment.
Enlist Your Social Network for Support
In addition to seeking appropriate treatment, you can care for yourself by reaching out to people in your social network. It may be helpful to share your diagnosis with trusted friends or family as it might help them to understand you better at this time. You can also ask them for support as you pursue treatment. Here are some practical ways friends and family might care for you:
- Help you search for therapists/counselors or medical prescribers
- Sit with you as you make a phone call to inquire about therapy/counseling or medication treatment
- Listen to you with the intention of conveying support and understanding rather than trying to “fix” the way you feel
- Go on a walk or hike with you
- Help you to plan something new to do together
- Pray with you
The symptoms of Major Depressive Disorder make it easy to be isolated, but isolation can perpetuate depression. Pervasive sadness or numbness, decreased pleasure in activities that used to be pleasurable, fatigue, feeling poorly about oneself, or feeling excessively or inappropriately guilty may leave you feeling hesitant to engage with others. Being with people may feel more taxing than usual.So, while it seems to make logical sense that interacting with others would be good for your health, it may not feel good initially to be with others. Even if you don’t feel good or motivated to spend time with others, give it a try. Getting out and doing something will be better than doing nothing. You may need to engage before you notice the benefits of it.
Of course, spend time or interact with those that you trust, who are supportive, and have historically made a positive impact on your life. And be clear and honest with others about what kinds of interaction would be helpful for you (e.g., going to a large party with a friend may feel less helpful than spending time with a few closer friends).
In addition to caring for yourself by seeking appropriate treatment and the support of your social network, exercising can also be beneficial to your mental health. The American Psychological Association and the National Institute of Mental Health have not listed exercise as an effective form of treatment for Major Depressive Disorder. However, Blumenthal et al. (2012) reviewed several studies involving exercise and depression and concluded that exercise is an “effective treatment” for depression and seems to decrease depressive symptoms. So, at the every least, exercise seems to support mental heath and is one way you can care for yourself.
Be Gracious with Yourself
One of the symptoms of Major Depressive Disorder is feeling badly about oneself, which can make it more difficult to find motivation to care for oneself. Typically, when we’re feeling discouraged or poorly about ourselves, we experience shame. And shame shuts us down, rather than builds us up. And when we’re shut down, it’s difficult to feel motivated. So please, be kind and patient with yourself–doing so may help facilitate healthy change in your life.
Being depressed can leave you feeling vulnerable and in need of others’ support more than usual. This may feel uncomfortable and unfamiliar for you—being in a position of need. But, to need help from others just means that you’re perfectly human. And there are people who will want to help you.
Major Depressive Disorder is a mental illness and it significantly impacts a person’s functioning. So, give yourself the same kind of grace that you would to someone who has a physical illness. Of course you would need more help than usual if you are not feeling well. It also takes time to recover from any illness. So, please be patient with yourself as you participate in treatment and make changes to improve your mood and symptoms.
Hopefully, this article provided you with some helpful suggestions for how to address a diagnosis of Major Depressive Disorder. You are valuable and created for a life of significance and purpose—a diagnosis does not change these truths. But, mental illness can affect your ability to engage with life fully. If you would like to pursue Christian psychotherapy or counseling to help you cope with your depression, the counselors at Seattle Christian Counseling would love to partner with you.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM–5. Washington, D.C: American Psychiatric Association.
Blumenthal, J. A., Smith, P. J., & Hoffman, B. M. (2012). Is Exercise a Viable Treatment for Depression? ACSM’s Health & Fitness Journal, 16(4), 14–21. http://doi.org/10.1249/01.FIT.0000416000.09526.eb
Cuijpers, P., Sijbrandij, M., Koole, S. L., Andersson, G., Beekman, A. T., & Reynolds, C. F. (2014). Adding psychotherapy to antidepressant medication in depression and anxiety disorders: a meta-analysis. World Psychiatry, 13(1), 56–67. http://doi.org/10.1002/wps.20089
National Institute of Mental Health. “Major Depression Among Adults.” https://www.nimh.nih.gov/health/statistics/prevalence/major-depression-among-adults.shtml. Recovered June 1, 2017.
National Institute of Mental Health. “Depression.” https://www.nimh.nih.gov/health/topics/depression/index.shtml#part_145399. Recovered June 1, 2017.
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