Major Depressive Disorder: A Five Year Prospective Study

In the United States, suicide is the third-leading cause of death for 10 to 14-year-olds (CDC, 2015) and for 15 to 19-year-olds (Friedman, 2008). In 2013, 17.0% of students grades 9 to 12 in the United States seriously thought about committing suicide; 13.6% made a suicide plan; 8.0% attempted suicide; and 2.7% attempted suicide in which required medical attention (CDC, 2015). These alarming statistics show that there is something wrong with the way suicide is handled in today’s society. In order to alleviate the devastating consequences of teenage suicide, it is important to get at the root of what causes it all: mental illness. According to the Centers for Disease Control and Protection (2013), mental illness is the imbalance of thinking, state of mind, and mood. Approximately 90% of all suicides are committed by people with mental illnesses (NAMI, n.d.). This shows that there is a correlation between mental illness and suicide. If mental illnesses are not treated, deadly consequences could occur. It would make sense that if there is a correlation between mental illness and suicide across all ages, the same should be thought for adolescents. Approximately 21% of all teenagers have a treatable mental illness (Friedman, 2008), although 60% do not receive the help that they need (Horowitz, Ballard, & Pao, 2009). If mental illnesses are not found and treated in teenagers, some of them may pay the ultimate price.

Cheung K, Aarts N, Noordam R, et al. Antidepressant use and the risk of suicide: A population-based cohort study. J Affect Disord. 2015;174:479-484. doi: 10.1016/j.jad.2014.12.032 [doi].

Depression is pervasive in both mental health and medical settings. In the US, the number of discharges with major depressive disorder as first-listed diagnosis was estimated 395,000 for 2010. The CDC also cites the percentage of persons 12 years of age and older with depression in any 2-week period at an estimated 8% between 2007-2010 (CDC, 2015). The American Psychiatric Associates guidelines on treatment of Major Depressive Disorder recommend the ongoing monitoring of symptoms among patients. Specifically, the APA recommends “systemically assessing symptoms of illness and the effects of treatment”. Consideration is given to matching clinical observations with clinician and/or patient administered rating scale measurements for initial and ongoing evaluation (American Psychiatric Association,

The National Institute of Mental Health (NIMH) has published a fact sheet of statistics on suicide in the United States. In 2007, it is reported that suicide was the tenth leading cause of death. Furthermore, for every suicide committed, eleven were attempted. A total of 34,598 deaths occurred from suicide with an overall rate of 11.3 suicide deaths per 100,000 people. (NIMH, 2010). Risk factors were also noted on this report and listed “depression and other mental disorders, or a substance abuse disorder (often in combination with other mental disorders). More than ninety percent of people who die by suicide have these risk factors (NIMH, 2010).”

Major depressive disorder, we all have probably heard of it, but do we really know what is it is ? Major depressive disorder is “a mood disorder that causes a persistent feeling of sadness and loss of interest… major depressive disorder or clinical depression, affects how you feel, think and behave and can lead to a variety of emotional and physical problems”(Mayo Clinic Staff). Having this disorder puts you in a very unstable position because you are constantly feeling depressed so it affects the way you think and feel and that can be very dangerous. Sometimes this happens to a person for one day, but put yourself in the shoes of someone who experiencing this for more than two weeks? When you have major depressive disorder, the signs of depression disorder can last for two weeks or more(myers646). This dis order must be treated immediately because “depression may make you feel as if life isn 't worth living”(Mayo Clinic Staff). Feeling this way can lead you to doing things that you can not take back such as committing suicide and sadly that can happen when you have major depressive disorder. Kiyohara and Yoshimasu conducted a research that showed that 90% of suicides have were dealing with major depressive disorder(qtd. in The World Health Organization). Throughout this paper I will be discussing the causes, symptoms and treatment when dealing with major depressive disorder.

(Kirmayer et al., 2007, p. 38) Not only do alcohol and CNS depressants affect a person’s behavior and mood it can also indicate pre-existing psychological factors and social problems that are related to suicidal behavior. (Kirmayer et al., 2007, p. 38)

Mental disorder is a common term to refer people’s mental health conditions in Canada and internationally. People who have studied Hamlet, a play that’s written by William Shakespeare, know that Ophelia is one of the characters who suffer from a mental disorder, which known as major depressive disorder. At the beginning of the play, Ophelia’s mental state is very healthy, she falls in love with her boyfriend Hamlet, yet their relationship is controlled by her father. During the play, Ophelia experiences a transformation of her mindset, which causes by Hamlet. As the play closer to the end, the death of Polonius, father of Ophelia, makes Ophelia’s mental becomes more unstable, which leads her to suicide at the end. Thus, due to all the unhappy events that happen to Ophelia’s life all at once, the psychological harms slowly turn Ophelia becomes insane and eventually brings her to death.

Although antidepressants can be used as an alternative treatment for depression, there are many concerns with regards to this type of treatment. One of the many concerns is that there is a risk of suicide when taking antidepressants. Study by Olfson et al, (2006) support this claim as their comparison between individuals treated with antidepressants and individuals not treated with those, has shown that there was a significant link between suicidal attempts and individuals taking antidepressants. However, this study presents only a link between those and this

“4. Compare the mean baseline and posttest depression scores of the control group. Do these scores strengthen or weaken the validity of the

3)Christina L. Boisseaua, Shirley Yen,John C. Markowitz,Carlos M.Grilo et al did a longitudinal study to identify characteristics that differentiate multiple suicide attempters from single attempters in people who suffered from personality disorders and depression.431 people participated from july 1996 to june 2008.Suicide attempts were assessed with a follow up evaluation at 6 and 12 months and then yearly through 10 years.21% of participants attempted

The mean baseline depression score of the experimental group is 14.00. The mean posttest depression score of the experimental group is 13.36. The posttest score is 0.64 lower than the baseline score. This was an expected finding because it was hypothesized that after the completion of

Suicide rates have skyrocketed in the last few years due in part to the lack of access to mental healthcare caused by the stigma that surrounds seeking treatment. An estimated 15% of people diagnosed with depression and approximately 20% of those diagnosed with bipolar disorder take their own life according to the Substance Abuse and Mental Health Administration (SAMHA) fact sheet. While these numbers are shocking, the statistics do not include the many suicide attempts among those with a mental illness or those that go unreported. SAMHA also claims that one-third of the 15.7 million adults who reported having a major depressive episode in the

Participants will visit the doctor every 3 months for 12 months (for a total of 5 visits). During the baseline visit, participants will be enrolled into the study, will get their first blood sample drawn and will be randomly assigned to one of the two groups (either receiving CBT or not receiving this type of intervention). All of the participants will also receive a blood glucose monitor at this visit. All of the participants will receive diabetes and depression medication and will be seen by a primary doctor for a clinical exam and by a psychiatrist. Patients will answer a Patient Health Questionnaire (PHQ9) which will measure the severity of depression and will fill out a survey that will ask about their demographic information such as age, height, weight, marital status, educational level, employment status, number of years living in the United Sates, language fluency levels, and number of children. Participants will also fill out a lifestyle questionnaire about alcohol use, illegal drug use, smoking and history of cardiovascular diseases. For the participants assigned to receive CBT, they will start receiving CBT session one week after becoming enrolled in the study. They will receive weekly 60 minute CBT sessions for 15 weeks (combining group and individual

A repeated measure mixed model ANOVA was conducted with depressive symptoms as the dependent variable and gender and diagnosis as the independent variables. Because no interaction between gender and diagnose was found, an independent sample t-test was done with diagnose as the independent variable (t(337)=-3.16 p=.002 d= -.37).

Suicide is a main source of death around the world and ranks among the three main causes of death among young adults aged between 15-45 years. Indeed, a response to this continuous worldwide issue, the World Health Organization called for the prevention of suicide (WHO, 2015). Several studies have evaluated some of the contributing factors, however, the connection between suicide and the evaluated factors is conclusively positive or negative.