My chosen condition is Major Depressive Disorder ; (MDD) is a complex mental health condition characterized by persistent sadness, anhedonia, and cognitive impairment. The pathophysiology of MDD is multifactorial, involving neurotransmitter imbalances, structural brain changes, and dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. Dysfunction in serotonin, norepinephrine, and dopamine pathways contributes to mood disturbances, while neuroimaging studies reveal structural abnormalities in the prefrontal cortex, hippocampus, and amygdala (Malhi & Mann, 2018). Additionally, chronic stress and inflammation play a role, as elevated levels of cortisol and inflammatory markers such as C-reactive protein (CRP) have been linked to depressive symptoms (Kennis et al., 2020). Genetic predisposition and environmental factors, such as adverse childhood experiences (ACEs), also contribute to MDD development.
MDD presents with a range of symptoms, including persistent low mood, fatigue, sleep disturbances, appetite changes, psychomotor agitation or retardation, and suicidal ideation. The disorder can lead to severe complications, including an increased risk of suicide, social withdrawal, impaired occupational functioning, and co-occurring conditions such as anxiety disorders and substance abuse (American Psychiatric Association [APA], 2022). Risk factors for MDD include a family history of depression, exposure to chronic stress, low socioeconomic status, and coexisting medical conditions such as diabetes and cardiovascular disease (Cuijpers et al., 2021). Women are at a higher risk, particularly during pregnancy and postpartum, due to hormonal fluctuations and psychosocial stressors.
Diagnosis of MDD relies on clinical criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which requires the presence of at least five depressive symptoms for a minimum of two weeks, with significant impairment in daily functioning (APA, 2022). Standardized tools such as the Patient Health Questionnaire-9 (PHQ-9)and Hamilton Depression Rating Scale (HAM-D) are commonly used to assess symptom severity. Laboratory tests, including thyroid function tests and vitamin B12 levels, help rule out medical conditions that may mimic depressive symptoms (Goldstein-Piekarski et al., 2022). In cases of treatment-resistant depression, neuroimaging studies, such as magnetic resonance imaging (MRI), can assess structural abnormalities or coexisting neurological conditions.
MDD manifests differently across the lifespan, with variations in symptomatology and risk factors. In children and adolescents, irritability and behavioral issues may predominate over classic depressive symptoms, with increased academic difficulties and social withdrawal (Maughan et al., 2021). Among pregnant and postpartum women, MDD can contribute to negative maternal and fetal outcomes, including preterm birth and impaired mother-infant bonding (Woody et al., 2022). In older adults, MDD often presents with somatic symptoms, cognitive decline, and an increased risk of suicide, particularly in elderly men. Recognizing these variations is crucial for accurate diagnosis and appropriate treatment across different age groups.
Case Study: Major Depressive Disorder (MDD)
Patient Profile:
Presenting Symptoms:
Assessment Findings:
Diagnostic Workup:
Diagnosis:
Major Depressive Disorder (MDD), Moderate to Severe
Treatment Plan:
Initiate Selective Serotonin Reuptake Inhibitor (SSRI) (e.g., Sertraline 50 mg daily).
Cognitive Behavioral Therapy (CBT) for cognitive restructuring.
Supportive therapy for grief processing.
Encourage structured daily routines and social engagement.
Recommend mild exercise (walking, yoga).
Weekly follow-ups for the first month.
Safety plan for suicidal ideation.
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).American Psychiatric Publishing.
Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S. D., & van Straten, A. (2021). The effects of psychotherapies for major depression in adults on remission, recovery, and improvement: A meta-analysis. JAMA Psychiatry, 78(3), 294-302. https://doi.org/10.1001/jamapsychiatry.2020.3673
Goldstein-Piekarski, A. N., Williams, L. M., Humphreys, K. L., & Gotlib, I. H. (2022). Neurobiological markers of depression: Insights from neuroimaging and genetics. Molecular Psychiatry, 27(3), 1378-1394. https://doi.org/10.1038/s41380-021-01255-7
Kennis, M., Gerritsen, L., van Dalen, M., Williams, A., & Cuijpers, P. (2020). Prospective biomarkers of major depressive disorder: A systematic review and meta-analysis. Molecular Psychiatry, 25(2), 321-338. https://doi.org/10.1038/s41380-019-0585-z
Maughan, B., Collishaw, S., & Stringaris, A. (2021). Depression in childhood and adolescence. Journal of Child Psychology and Psychiatry, 62(5), 447-468. https://doi.org/10.1111/jcpp.13299
Woody, C. A., Ferrari, A. J., Siskind, D. J., Whiteford, H. A., & Harris, M. G. (2022). A systematic review and meta-regression of the prevalence and incidence of perinatal depression. Journal of Affective Disorders, 314, 1-11.
https://doi.org/10.1016/j.jad.2022.02.075Links to an external site.
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