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Major Depressive Disorder 101 – Signs, Symptoms, and Treatment

Major Depressive Disorder

Depression is feeling similar to sadness that many people feel they experience. Although there are various forms of sadness and depression, it is important to understand the difference between feeling sad, or situational depression, and having a clinical diagnoses of major depressive disorder. Major depressive disorder looks different for many people as individuals all experience unique situations through their lives. With that being said, there are key factors that most people show, making it possible to narrow down a specific diagnosis. In this article we will review what clinical depression looks like, how it is diagnosed, populations it effects, challenges from the disorder and more.

Man feeling sad at night lying in his bed

Common Characteristics

Characteristics of MDD can range from mild to severe and may look confusing to people not familiar with the disorder. Common characteristics include feeling hopeless, excessive sleep, insomnia, binge eating, persistent weight loss, lack of motivation, loss of interest in activities once enjoyed, and frequent discussion of death. To many, if one sleeps excessively or lacks motivation, it is assumed the individual is being lazy or manipulative. However, the individual may be experiencing a major depressive episode and may need to seek treatment. Similar to individual characteristics, various populations experience MDD different than other populations. For example, an individual experiencing homelessness has different biological, social, and environmental factors than a child who comes from a wealthy family. It is important to explore all aspects of clientele and to assess them individually in order to find the proper diagnoses or treatment process.


Clients with MDD tend to face difficulties when it comes to seeking treatment. A major factor to the difficulties relates directly to a major symptom of MDD: lack of motivation. It can be hard for a client with depression to feel motivated to attend group or individual therapy. It becomes increasingly more difficult if one has already attended treatment and felt that “nothing helped”. It can be difficult from the social workers point of view to resonate with the individual that sometimes you have to try various therapists, groups, or centers before one really starts to see and feel the effects. Another difficulty can be, if someone has not been formally diagnosed with MDD. Without a diagnosis, sometimes the number of services available to that person is reduced. A common relation to why someone may become depressed and not obtain services can relate to financial means. Many individuals seek treatment for their disorder but end up not getting them because they can’t afford therapy, medication, or other services necessary for treatment.

A woman alone crying in bed.


Throughout the last couple of years, negative stigma around mental health, specifically depression has decreased. In fact, 66%-71% felt more comfortable talking to people about their mental illness (HealthPartners, 2020). However, there is still great stigma associated around mental health disorders which effects one’s willingness to received treatment, self-esteem, employment opportunities and more. A study was performed by Roeloff et al, where stigma of depression was analyzed based on disclosure of disorder. Of the 1,150 participants, sixty-seven percent of participants expected negative consequences due to disclosure of depression on gaining employment, 59% for obtaining health insurance, and 24% on friendships (Roeloffs et al., 2003). Stigma can also effects people differently based on their environmental and cultural beliefs. Typically, Haitian individuals do not acknowledge the presence of mental illness. This can make it difficult to begin treatment due to stigma.  

Tools and Methods 

There are various forms of tools therapists or mental health workers can use in order to identify presence, severity, and persistence of MDD. One of the most common tools used to assess MDD is the Patient Health Questionnaire (PHQ-9). This is used to measure not only the presence, but also the severity, of MDD. Another common tool used by physicians, social workers and other mental health workers is the Columbia Suicide Severity Rating Scale (C-SSRS). This is used to measure severity of suicidal ideations by measuring thoughts, plan, intent, and means. These tools are very important as it gives the patient/client the opportunity to express their thoughts and feelings in a non-verbal format.

There are also a multitude of methods used to treat depression. The most known methods are therapy and medication. However, there are levels to both that make treatment more complex. Common types of medications used are antidepressants and anxiety management. More severe medications can be used through doctor’s discretion if needed. A very common and evidence-based therapy used for individuals with MDD is cognitive behavioral therapy (CBT). CBT analyzes one’s thoughts, behaviors and emotions while developing better ways to cope and react to situations that may have once had negative consequences. An example of this is if a client screams when they get put in a high stress environment, the screaming may cause difficulty with interpersonal relationships and employment. CBT evaluates why someone is reacting this way and helps a client better understand their feelings and reactions so they may eventually express their emotions in a more positive manner.

If you are depressed or think you have Major Depressive Disorder, it is important to seek help. Call Cape Coral/Fort Myers Therapists at (239) 565-6921. Get the support you need.

Cape Coral Office:
1404 Del Prado Blvd, Unit 135
Cape Coral, FLORIDA 33990

Sarasota Offices:
1487 2nd Street Suite C-4
Sarasota, FL 34236
(239) 565-6921

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