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What is major depressive disorder (MDD)?

What is major depressive disorder (MDD)?

If you feel extreme sadness over a prolonged period of time and it negatively impacts different areas of your life, you may be suffering from Major Depressive Disorder.

Reviewed by:
Sophia Monsour, DO
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January 4, 2024
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Key takeaways

Major depressive disorder (MDD), also known as depression or clinical depression, is characterized by a major depressive episode (MDE) and has two core symptoms: depressed mood OR a loss of interest or pleasure (also called anhedonia). Major Depressive Disorder affects almost 7% of the population, making it the most recognized depressive disorder and the second most common mental disorder in all of the US.

Experiencing sadness or grief during a period of emotional distress, such as when a loved one passes away or when going through a divorce, is a completely normal and healthy reaction. You are a human with emotions! However, if you feel extreme sadness over a prolonged period of time and it negatively impacts different areas of your life, you may be suffering from Major Depressive Disorder. In this situation, psychiatric treatment and medication might be helpful.

Major depressive disorder symptoms

Mental health professionals make diagnoses based on symptoms, behaviors, and conditions listed and defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). According to the DSM-5, in the same two-week period, a person with MDD would experience at least five of the following eight criteria:

  • Depressed mood most of the day, nearly every day.
  • Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
  • Significant weight loss when not dieting, weight gain, or a decrease or increase in appetite nearly every day.
  • A slowing down of thoughts and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
  • Fatigue or loss of energy nearly every day.
  • Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
  • Diminished ability to think or concentrate, or indecisiveness, nearly every day.
  • Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, a suicide attempt, or a specific plan for committing suicide.

This constellation of symptoms can significantly impair an individual’s life, including socially, professionally, and otherwise.

Causes of major depressive disorder

There is no known cause for MDD, as depression can be caused by a variety of factors. These factors include genetics, changes in hormonal states like pregnancy or menopause, trauma and other situational factors, seasonal patterns through Seasonal Affective Disorder (SAD), and more. It is worth noting, however, that data shows people of color, women, adults under the age of 25, and LGBTQ individuals have been reported more likely to be affected and suffer from MDD than any other demographics.

Feeling anxious, too? Check out: Anxiety vs. depression.

Treatment options for MDD

The good news is that there are ways to manage your symptoms and treat MDD. MDD is classified into 3 categories: mild, moderate, or severe. In most cases, a combination of psychotherapy and medication is effective and sufficient. However, if you have a severe MDE, are seeing and hearing things that are not there (hallucinations), believe in things that are not happening (delusions), and/or are having suicidal thoughts, you should seek psychiatric help immediately and call the National Suicide Prevention Lifeline at 1-800-273-8255.

How Talkiatry treats MDD

Medication management

Medication can be prescribed by a psychiatrist or nurse practitioner who specializes in psychiatry. Finding the right medication and dosage is a key part of our customized treatment solutions at Talkiatry. After a clinical diagnosis, our psychiatrists, who specialize in depressive disorders, will work with patients to prescribe medication and monitor progress to ensure optimal results while limiting unwanted side effects.

Read more about how our psychiatrists treat different types of depression.

The antidepressant medications most often prescribed for major depressive disorder are classified as selective serotonin reuptake inhibitors (SSRIs), but other types of antidepressants are available. This includes serotonin-norepinephrine reuptake inhibitors (SNRIs), atypical antidepressants, tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs). Your psychiatrist or nurse practitioner will work with you to determine the best type of medication for your treatment. There are also adjunct medications that may be recommended in combination with the above-mentioned antidepressants, especially if symptoms persist even with treatment.


In addition to medication management, Talkiatry uses psychotherapy (or talk therapy) to identify issues that are causing emotional distress in patients and develop individual solutions for coping with and managing MDD. Different types of psychotherapy that may be appropriate include cognitive behavioral therapy (CBT), supportive psychotherapy, and group therapy.

Many people respond well to treatment and can eventually reduce the frequency, or even stop treatment, of their medication and/or psychotherapy when both the doctor and patient feel symptoms have consistently improved, and it is safe to do so. This can be achieved when a provider works directly with the patient and sets a pace that limits relapses and side effects.

Take the next step with Talkiatry

Talkiatry is a psychiatric practice offering outpatient mental health services, including diagnosis, psychotherapy, and medication management to patients living with MDD.

We believe in providing accessible, affordable mental health management solutions, which is why we provide personalized in-network healthcare services that are focused on helping you feel better, faster. To match our therapeutic and modern approach to psychiatric care, we offer flexible telemedicine and in-office appointment options.

MDD is not something you need to struggle with. If you believe you have MDD or a variation of a depressive disorder, we highly recommend you start by taking our free and easy assessment to receive a preliminary diagnosis. Not only will you get a better understanding of your current symptoms, but we’ll also match you with the psychiatrists on staff that can provide you with the treatment you need to manage and treat MDD.

Take our short assessment today to get started.

Talkiatry is a national psychiatry practice that provides in-network, virtual care. Co-founded by a patient and a triple-board-certified psychiatrist, Talkiatry has over 300 doctors, 60 insurance partners, and first visits available in days. We treat patients with anxiety, depression, trauma, ADHD, and more.

The information in this article is for informational and educational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.

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Frequently asked questions

Does Talkiatry take my insurance?

We're in network with major insurers, including:

  • Aetna
  • Blue Cross Blue Shield
  • Cigna
  • Humana
  • Medicare
  • Oscar
  • United Healthcare
  • Optum
  • Compsych

Even if your insurer isn't on the list, we might still accept it. Use the insurance eligibility checker in our online assessment to learn more.

Can I get an estimate of my visit cost?

The best way to get a detailed estimate of your cost is to contact your insurance company directly, since your cost will depend on the details of your insurance.  

For some, it’s just a co-pay. If you have an unmet deductible it could be more.  

Call the number on your insurance card and ask about your plan’s coverage for outpatient psychiatric services.

How does Talkiatry compare to face-to-face treatment?

For most patients, Talkiatry treatment is just as effective as in-person psychiatry (American Psychiatric Association, 2021), and much more convenient. That said, we don’t currently provide treatment for schizophrenia, primary eating disorder treatment, or Medication Assisted Treatment for substance use disorders.

What kind of treatment does Talkiatry provide?

At Talkiatry, we specialize in psychiatry, meaning the diagnosis and treatment of mental health conditions. Your psychiatrist will meet with you virtually on a schedule you set together, devise a treatment plan tailored to your specific needs and preferences, and work with you to adjust your plan as you meet your goals.

If your treatment plan includes medication, your psychiatrist will prescribe and manage it. If needed, your psychiatrist can also refer you to a Talkiatry therapist.

What's the difference between a therapist and psychiatrist?

Psychiatrists are doctors who have specialized training in diagnosing and treating complex mental health conditions through medication management. If you are experiencing symptoms of a mental health condition such as depression, anxiety, bipolar disorder, PTSD, or similar, a psychiatrist may be a good place to start.  

Other signs that you should see a psychiatrist include:  

  • Your primary care doctor or another doctor thinks you may benefit from the services of a psychiatrist and provides a referral    
  • You are interested in taking medication to treat a mental health condition  
  • Your symptoms are severe enough to regularly interfere with your everyday life

The term “therapist” can apply to a range of professionals including social workers, mental health counselors, psychologists, professional counselors, marriage and family therapists, and psychoanalysts. Working with a therapist generally involves regular talk therapy sessions where you discuss your feelings, problem-solving strategies, and coping mechanisms to help with your condition.

Who can prescribe medication?

All our psychiatrists (and all psychiatrists in general) are medical doctors with additional training in mental health. They can prescribe any medication they think can help their patients. In order to find out which medications might be appropriate, they need to conduct a full evaluation. At Talkiatry, first visits are generally scheduled for 60 minutes or more to give your psychiatrist time to learn about you, work on a treatment plan, and discuss any medications that might be included.

Sophia Monsour, DO

Dr. Sophia Monsour holds the position of Chief Psychiatrist for Pennsylvania at Talkiatry. After completing residency in 2013 at Albany Medical Center, she has spent the past 9 years fulfilling her passion for integrated and specialty care for adults suffering from mental illness. Her years of experience has included working as an integrated care Psychiatrist at a community health center, a medical director of a Partial Hospital and Intensive Outpatient Program (PHP/IOP), and also working for an Assertive Community Treatment Team (ACT) specializing in the Serious Mentally Ill (SMI) population.

Most recently, she has been serving our veterans as the Outpatient Section Chief, Primary/Mental Health Integration Medical Director and Resident/Medical Student Coordinator at VA Pittsburgh. Dr. Monsour has an approachable style when treating individuals who suffer from various diagnoses, especially those with prior trauma. She provides supportive psychotherapy and at times uses psychodynamic therapy skills to address her patient’s current stressors and to identify the root cause of their ailment. She believes in a holistic approach and utilizes mindfulness as a technique along with medication management.

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