This form of depression presents the most severe phase and category of depression. In a major depression more of the symptoms common to depression are present, and are usually more intensive and severe. It can result from a single traumatic event in somebody’s life, or may develop slowly as a consequence of a number of personal disappointments and problems occurring in an every day life.A certain people seem to develop the symptoms without any obvious life crisis being present at the centre of it, while others have had certain minor symptoms of depression for a long time (such as Dysthymic disorder), and a life crisis further results in increase in intensity of the already present symptoms.
Given the grave nature of this condition, it is never easy to pinpoint from the start the most appropriate treating method or therapy. Therefore, a therapist is the one that needs to rely on his experience with similar cases, in making the most appropriate first-step decision. This includes consideration over the need of the patient to be immediately hospitalized or not. Some of the most evident signs of a necessity of hospitalization are the presence of patient’s urge to commit a suicide or homicide and a complete loss of interest in food, clothing, “roof over one’s head” and alike. When a patient is treated for milder forms of depression then it is manageable to perform this kind of treatment in the office atmosphere, where a therapist will be able to conduct his spontaneous evaluation more often and thus be more at ease.
The next step would be a medication therapy. Most of the therapists opt for the therapy with the use of antidepressants, since this therapy has shown the potential to significantly diminishing both the hospitalization and suicide rates in patients with severe depression. However, it is not all that easy. The biggest difficulty perhaps is in the fact that a great majority of patients actually gives up on the antidepressants long before they can exhibit its potential and effectiveness. Recently conducted research showed that only 25% of patients who had started taking antidepressants managed to stick to it till the end. Before yielding any results, the therapy based on this medication should last at least 2-4 weeks.
Other therapy often employed is that of psychotherapy, and most psychiatrists agree on the fact that this technique works best when combined with antidepressants. They alleviate the symptoms common to depression rather rapidly, whereas psychotherapy aims in helping the patient handle his condition more easily and satisfactorily. This way the possibility of occurrence of stress, which can further intensify depression, is significantly diminished. Other effective methods of treating major depression include dynamic psychotherapy (one’s prior life experience essentially predetermines human behavior) and interpersonal therapy (disturbed social/personal relationships cause depression).