​Major Depressive Disorder

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Major depressive disorder (also known as clinical depression, major depression, unipolar depression, or unipolar disorder) is a mental disorder characterized by persistent low mood as well as low self-esteem and a loss of interest in everyday, enjoyable activities. If you are experiencing major depression, it may become difficult for you to work, study, sleep, eat, and enjoy your time with friends. Depression affects how you feel, think and behave and can lead to a variety of emotional and physical problems. It may lead to a feeling as if your life isn't worth living.

Some people experience clinical depression once in their life, while others experience it several times. Depression in men often goes unreported. Men are less likely to seek help or talk about their experience. Repressing their feelings can result in violent behaviour directed both inwardly and outwardly. It can also result in an increase in illness, suicide, and homicide. Signs of depression in men may include: 

  • Irritability 

  • Anger 

  • Drug and alcohol abuse

Common triggers of depression include:

  • Grief over the loss of a loved one

  • Social isolation

  • Major life changes 

  • Personal conflicts 

  • Physical, sexual, or emotional abuse​​

If you believe you are suffering from major depressive disorder, you may report of the following symptoms:​

  • ​​Feelings of sadness, tearfulness or hopelessness​

  • Angry outbursts, irritability or frustration

  • Loss of interest in normal activities

  • Sleep disturbances

  • Tiredness and lack of energy

  • Changes in appetite

  • Anxiety, agitation or restlessness

  • Slowed responses

  • Trouble concentrating and making decisions

  • Suicidal thoughts​

If you are experiencing feelings of helplessness, loneliness or having suicidal thoughts, it is recommended that you see your doctor. You can obtain additional information and expert medical advice from the medical staff at the Mind and Brain Service Line​ at The Aga Khan University Hospital.​

You can also consult doctors from the Family Health Services for a preliminary examination. You can safely and privately discuss your symptoms, gain advice and receive personalized treatment and care.
Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here​ are some tips to help get you started.​

Your doctor will perform a number of tests and exams to determine what may be causing your symptoms, including:

  • Physical exam: your doctor may start by performing a thorough physical examination and ask detailed questions about your health. In some cases, depression has been known to be linked to an underlying physical health problem.

  • Lab tests: your doctor may order blood tests to test your thyroid to make sure it's functioning properly, as that has been known to have a role in depression.

  • Psychological evaluation: your doctor will ask about your symptoms, thoughts, feelings and behaviour. You may also have to fill out a detailed questionnaire to answer these questions.​​

Treatment choice for major depressive disorder depends on the outcome of the initial medical evaluation.

There are a number of antidepressant medications and psychotherapies that can be used to treat depressive disorders. These include: 

  • Selective serotonin reuptake inhibitors (SSRIs): doctors often start by prescribing an SSRI. These medications are safer and generally cause fewer side effects than other types of antidepressants. 

  • Serotonin-norepinephrine reuptake inhibitors (SNRIs): work in a manner similar to SSRIs

  • Norepinephrine-dopamine reuptake inhibitors (NDRIs): this is one of the few antidepressants not frequently associated with sexual side effects.

  • Atypical antidepressants: these don't fit into any other antidepressant categories and are thought to have a low risk of sexual side effects.

  • Tricyclic antidepressants: these antidepressants can be very effective, but tend to cause more severe side effects.

  • MAOI (Monoamine Oxidase Inhibitors): these may be prescribed when other medications haven't worked, because they can have serious side effects. ​

Sometimes your doctor will try a variety of antidepressants before finding the medication or combination of medications most effective for you. Sometimes the dosage must be increased to be effective. Antidepressant medications must be taken regularly for as many as eight weeks before the full therapeutic effect occurs. You must never stop taking antidepressants without talking to your doctor first. Stopping treatment abruptly or missing several doses can cause withdrawal symptoms, and quitting suddenly may cause a sudden worsening of depression. 

If you are experiencing a mild form of depression, you may benefit from psychotherapy alone. Psychotherapy helps you to:

  • Adjust to a crisis 

  • Develop positive interactions with others

  • Find better ways to cope and solve problems

  • Identify issues that contribute to your depression 

  • Regain control in your life and help ease depression symptoms

  • Develop the ability to tolerate and accept distress using healthier behaviour​

However, if your symptoms are moderate to severe, you will likely be prescribed antidepressants as well. It is not unusual to have a combination of both methods - medication to gain quick relief and psychotherapy to learn more effective ways to deal with bigger problems. Depending on the diagnosis and severity of your symptoms, your therapist may prescribe medication and/or one of the several forms of psychotherapy that have proven effective for depression.​​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.​

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.​

​The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.