What Is Major Depressive Disorder?

What Is Major Depressive Disorder?

The Albany Clinic • June 3, 2022

Major depressive disorder, also known as “clinical depression” or simply “depression,” is a mental health condition characterized by depressed mood, loss of interest in things that used to be enjoyable, low energy levels, and other symptoms. 

Depression can cause significant problems in a person’s life and may even lead to suicide.

While anyone can experience a period of sadness or grief, major depressive disorder is more than just a temporary case of the blues. Clinical depression is a real medical condition that affects a person’s thoughts, feelings, behavior, and physical health. It can last for weeks, months, or years if left untreated.

In this article from The Albany Clinic, we’ll take an in-depth look at major depressive disorder, including the potential causes and triggers, common symptoms, and typical treatments used to help those with this condition. 

We’ll also explore the use of ketamine therapy in treating major depressive disorder.

What Is Major Depressive Disorder, and How Prevalent Is It?

Major depressive disorder is a common mental health condition that affects millions of adults in the United States each year. 

In fact, according to the National Institute of Mental Health , an estimated 21 million American adults experienced at least one major depressive episode in 2020.

As stated above, this condition is more than just feeling sad or going through a rough patch. Major depressive disorder is a serious medical condition that can have a profound impact on every aspect of a person’s life, from their personal relationships to their work performance.

Depression is one of the most common mental disorders in the world, and it can affect people of all ages, genders, and walks of life. However, this condition is most often diagnosed in adults aged 18-25 years old. 

Women are also more likely to be diagnosed with depression than men.

What Causes Major Depressive Disorder?

The cause of clinical depression is not fully understood, but it is thought to be a combination of biological, psychological, and social factors.

Biological Factors: Clinical depression may be caused by changes in the brain. Certain neurotransmitters (chemicals that transmit messages between nerve cells) are thought to play a role in mood regulation. An imbalance in these chemicals may lead to symptoms of depression.

Psychological Factors: Psychological factors that may contribute to depression include negative thinking patterns, low self-esteem, and feelings of hopelessness. People who have experienced trauma or stressful life events (such as the death of a loved one) are also at an increased risk for developing clinical depression.

Social Factors: Social factors that may contribute to depression include isolation, chronic stress, and exposure to violence.

What Are the Symptoms of Major Depressive Disorder?

The symptoms of major depressive disorder can vary from person to person. Some people experience only a few symptoms, while others may experience many. 

The severity of the symptoms also varies from mild to severe. The most common symptoms of clinical depression include:

  • Depressed Mood: A feeling of sadness or emptiness that lasts for more than two weeks.
  • Loss of Interest or Pleasure in Activities That Were Once Enjoyed: A loss of interest in hobbies, work, social activities, or sex.
  • Changes in Appetite: Weight gain or weight loss due to changes in appetite.
  • Sleep Problems: Insomnia (trouble falling or staying asleep) or hypersomnia (excessive sleeping).
  • Fatigue: Feeling tired all the time or having little energy.
  • Anxiety: Feeling restless, irritable, or on edge.
  • Difficulty Concentrating: Trouble focusing on tasks or making decisions.
  • Feelings of Worthlessness or Guilt: Negative thoughts about oneself.
  • Thoughts of Death or Suicide: Recurring thoughts of death or harming oneself.

If you are experiencing any of the above symptoms, it’s essential to see a mental health professional for an evaluation. Depression is a treatable condition, but it requires professional help.

What Are the Potential Treatments for Major Depressive Disorder?

The most common treatments for major depressive disorder are psychotherapy and medication. Psychotherapy, also known as “talk therapy,” is a type of counseling that can help people with depression understand and manage their condition. 

Types of psychotherapy used to treat depression include cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT).

Medication is another standard treatment for depression. Antidepressants are the most frequently prescribed medication and work by correcting chemical imbalances in the brain. 

Common types of antidepressants include selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs).

In some cases, a combination of psychotherapy and medication may be necessary to effectively treat clinical depression — though these methods and treatments may not work for everyone. Those who fail to find relief while undergoing these traditional treatments may have what’s known as “ treatment-resistant depression .”

In these cases, additional treatment options may be necessary, such as ketamine therapy.

Ketamine Therapy for Major Depressive Disorder

Ketamine is a medication that has been used for decades as an anesthetic for surgeries. In recent years, however, ketamine has shown promise as a treatment for major depressive disorder.

Ketamine works by binding to a receptor in the brain called the NMDA receptor. This interaction inhibits the release of glutamate, which leads to changes in brain activity.

Research suggests that ketamine may be effective in treating major depressive disorder because it can quickly reduce symptoms. In one study , ketamine significantly improved depression symptoms within two hours — with the slowest relief from symptoms found after four hours. 

It is thought that the rapid onset of action may be due to the fact that ketamine binds directly to the NMDA receptor, while other antidepressants work indirectly.

Another advantage of ketamine therapy is that it is not associated with the same side effects as other antidepressants. Common side effects of SSRIs and TCAs include weight gain, dry mouth, and sexual dysfunction. These side effects can often be so severe that people stop taking their medication.

Ketamine therapy is currently being studied as a potential treatment for major depressive disorder and other conditions. If you are interested in learning more about ketamine therapy, please don’t hesitate to reach out to the team at The Albany Clinic.

Find Relief From Major Depressive Disorder at The Albany Clinic

If you or someone you know is struggling with major depressive disorder, The Albany Clinic can help. We offer ketamine therapy, a treatment that has shown promise in quickly reducing symptoms of depression.

Our compassionate team of expert medical providers will work with you to create a personalized treatment plan that meets your needs. We understand the challenges associated with depression and are here to support you on your journey to recovery.

Contact us today to learn more about ketamine therapy and how we can help you find relief from depression.

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Stellate Ganglion Block (SGB) for Depression

By Kimberly Mercille • May 27, 2025
Stellate Ganglion Block (SGB) is an emerging mental health treatment that targets key mechanisms linked to depression. In this article, we’ll discuss the science behind SGB and its potential benefits. If you or someone you know is struggling with depression, this information can help you make an informed decision about whether SGB might be the right option. What is a Stellate Ganglion Block (SGB)? What is the Stellate Ganglion? The stellate ganglion is a cluster of sympathetic nerves located on each side of the neck near the first rib. These nerves are part of the autonomic nervous system, which controls automatic body functions like heart rate, blood pressure, and digestion. The term "stellate" means "star-shaped" because the ganglion often looks like a star under a microscope. It helps regulate the body's stress response by controlling norepinephrine, a chemical that triggers the fight-or-flight reaction. When this system becomes overactive, it can cause various physical and psychological problems, including depression. Stellate ganglion block (SGB) therapy may help by reducing the activity of the stellate ganglion, calming the fight-or-flight response, and lessening the damaging effects of prolonged nervous system stress. How Does Stellate Ganglion Block Work? Stellate Ganglion block (SGB) is when a local anesthetic is injected near the stellate ganglion. These drugs inhibit transmission between nerve cells, dampening activity in the ganglion. They typically include lidocaine, bupivacaine, or mepivacaine, which are sometimes combined with a steroid medication. Patients may also receive another medication to relax them before treatment. SGB is typically performed using ultrasound guidance . The injection process lasts no more than 10 minutes, but patients will motinoted for another 30-45 minutes after treatment to ensure their safety. How Does Stellate Ganglion Block Work for Depression? Chronic stress is a major contributor to depression and is often linked to an overactive sympathetic nervous system. People with depression commonly show high levels of cortisol, a hormone that plays a key role in the body's stress response, in their blood stream. Cortisol is helpful in small doses, but when chronically elevated, it can disrupt neural circuits in the brain. Excessive cortisol can lead to: Neurotoxicity - Cortisol can be toxic to nerve cells, especially in the hippocampus, which is crucial for memory and emotional regulation. Overinflammation - Cortisol increases the activity of the body’s natural defense system, resulting in the system causing damage to nerve cells. Impaired synaptic plasticity - Cortisol inhibits the capacity for the brain to “re-wire” itself. This makes it harder for people to adapt to stressful situations and learn new patterns of behaviour. Disrupted sleep - High cortisol can prevent people from sleeping well. During sleep, restorative biological processes occur in the brain, and excess cortisol can prevent these from happening. SGB decreases sympathetic nervous system activity, which can reduce cortisol levels. This can help restore function in brain areas and pathways associated with positive mood, emotional regulation, and stress resilience. Evidence Supporting SGB for Depression To date, there’s very limited evidence supporting the use of SGB for depression. One pilot study found that SGP significantly reduced depression symptoms in people with treatment-resistant depression (TRD) and was well-tolerated. However, there was no significant difference to the placebo group and the sample size was very small. Nonetheless, multiple lines of research show that SGB can alleviate symptoms of post-traumatic stress disorder (PTSD), which shares similarities with depression. In a trial of SGB for PTSD , participants reported significantly lower scores of depression following treatment. Who May Benefit from SGB for Depression? SGB is primarily utilized for treating PTSD, so individuals with PTSD who also experience depression may find SGB beneficial. Additionally, SGB has shown potential in alleviating anxiety symptoms, suggesting it may be advantageous for those dealing with both depression and anxiety. Because SGB isn’t approved by the FDA, it is typically only used when standard treatments like antidepressants and psychotherapy haven’t worked. SGB is an “off-label” treatment, much like ketamine therapy or brain stimulation therapies. Importantly, SGB may not be suitable for everyone because of medical reasons. Contraindications include: Recent myocardial infarction Coagulopathy or anticoagulant therapy Glaucoma Pre-existing contralateral phrenic nerve palsy Severe emphysema Cardiac conduction block Potential Risks and Side Effects of SGB Common Side Effects Most side effects of SGB are temporary and resolve as the anesthetic wears off. These may include: Hoarseness or Voice Changes: The proximity of the stellate ganglion to nerves controlling the voice box can lead to temporary hoarseness. Drooping Eyelid (Ptosis): Temporary drooping of the eyelid on the side of the injection may occur. Red or Bloodshot Eyes: Some individuals may notice redness in the eyes following the procedure. Watery Eyes and Nasal Congestion: Increased tearing and nasal stuffiness are possible but typically short-lived. Sensation of a Lump in the Throat and Difficulty Swallowing: Some individuals may experience a sensation of a lump in the throat and have difficulty swallowing after the procedure. Warmth or Tingling in the Arm or Hand: A warm or tingling sensation in the affected limb may be experienced temporarily. Although uncommon, some individuals may experience more serious complications, such as nerve damage, seizures, and allergic reactions. Given the potential risks, patients interested in SGB at the Albany Clinic will have an in-depth consultation with one of our qualified healthcare professionals before undergoing treatment. They can assess your medical history, current health status, and the potential benefits and risks of the procedure in your specific case. SGB for Depression in Illinois If you're in the Carbondale area and interested in the potential benefits of SGB for depression, the Albany Clinic is here to help. We specialize in innovative mental health treatments, including SGB, which has been shown to provide rapid relief from mental health symptoms, with effects lasting several weeks. Our experienced team offers personalized support, guiding you through every step—from determining if SGB is the right option for you to exploring alternative treatments and financial considerations. Contact us today to learn more about how we can support your mental health journey.

SGB for Long COVID: Can a Nerve Block Help Ease Symptoms?

By Matt Rodriguez • May 7, 2025
Long COVID is a condition in which symptoms–such as brain fog, fatigue, and shortness of breath—persist for months after a COVID-19 infection. Researchers are still working to understand why this happens and how to treat it. One potential therapy being explored is the stellate ganglion block (SGB) , a procedure that numbs a cluster of nerves in the neck. In the article, we’ll explore the science behind SGB and long COVID and the evidence supporting its use.

Insurance-Backed Options for Depression Treatment in Illinois

By Matt Rodriguez • April 1, 2025
Finding effective depression treatment can be challenging, especially when cost and insurance coverage add to the stress. Fortunately, for individuals in Illinois, several advanced, insurance-backed options are available beyond traditional antidepressants and therapy. This article explores innovative treatments for depression that are available at our Albany Clinic in Carbondale. Addressing the Need for Affordable Depression Relief in Illinois Depression remains a significant public health concern in Illinois. In 2023, data showed that 18.1% of all adults in the state had a doctor's diagnosis of a depressive disorder . Traditional first-line treatments for depression include medications such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). However, these are not universally effective; approximately one-third of patients are treatment-resistant. Even when these medications do work, they often take a long time to produce noticeable improvements, and unpleasant side effects can deter their use. Talk therapies , such as cognitive behavioral therapy (CBT) and psychodynamic therapy, are also strongly recommended. These treatments can have hugely beneficial effects, but it can require a lot of time commitment for results to show. Moreover, not all therapists accept insurance–especially for those practicing more specialized forms–making the treatment inaccessible for many. Spravato (Esketamine) for Depression What is Spravato, and how does it work? Spravato is an FDA-approved nasal spray that contains esketamine, a derivative of ketamine. Like ketamine, esketamine treats depression by interacting with NMDA receptors , proteins that play a key role in learning and memory. This interaction triggers several neurological processes, including neuroplasticity —the strengthening and forming of connections between nerve cells. Enhanced plasticity may improve the function of nerve circuits responsible for mood regulation, increasing overall well-being. A typical Spravato treatment involves sessions administered under medical supervision, starting with twice-weekly doses and then tapering as appropriate. Whereas antidepressants typically take around four weeks to show an effect, Spravato can have rapid action at alleviating symptoms. A study found that Spravato significantly reduced depression symptoms compared to a placebo drug within just 24 hours of administration. Does Insurance cover Spravato? Due to its FDA approval, Spravato is covered by most major insurance plans in Illinois, including Medicare and Medicaid. However, only patients with a formal diagnosis of treatment-resistant depression (TRD) or major depressive disorder with suicidal ideation (MDSI) are eligible for the treatment. While the medication is usually covered by insurance, patients may still have out-of-pocket costs , including copays , deductibles , and pre-treatment medical evaluations . Your exact expenses will depend on your specific insurance plan. At the Albany Clinic, we’re here to help you understand your costs and maximize your coverage. Transcranial Magnetic Stimulation (TMS) Therapy What is TMS, and how does it work? TMS therapy is a noninvasive procedure that uses magnetic fields to stimulate underactive regions of the brain associated with mood regulation. In depression, TMS targets the dorsolateral prefrontal cortex (DLPFC) , which is often less active in individuals with the condition. TMS therapy works by: Inducing electrical activity in neurons , prompting the release of neurotransmitters involved in mood and motivation. Increasing the activity of neural circuits responsible for mood regulation. Enhancing neuroplasticity , potentially “re-wiring” nerve circuits associated with unhealthy thinking and behavior. The treatment protocol typically consists of daily sessions over several weeks. Each session lasts about 20-40 minutes, during which patients remain awake and alert. Does insurance cover TMS? Since TMS therapy is FDA-approved, some major insurance providers in Illinois cover costs, but unfortunately, the state’s Medicaid does not. If you're considering TMS, check with your insurance provider to see if your plan includes coverage, as eligibility and benefits vary. At the Albany Clinic, we're here to help clarify details and explore options to make treatment more affordable. IV Ketamine Infusion Therapy What is an IV ketamine infusion and how does it work? IV ketamine infusion therapy involves administering ketamine intravenously at sub-anesthetic doses . This approach has shown rapid and robust antidepressant effects, especially in individuals with treatment-resistant depression. IV ketamine shares the same mechanism as Spravato but tends to have more rapid-acting effects. A standard course includes multiple infusions over a set period, with each session lasting approximately one hour. Does insurance cover IV ketamine? Unlike Spravato and TMS, IV ketamine infusion therapy is not FDA-approved for depression treatment and instead is used “ off-label .” This means most insurance plans don’t accept ketamine, and coverage is limited. However, some insurance companies may reimburse some of the treatment costs, such as the evaluation and management part. At the Albany Clinic, we’ll provide you with all the documentation to submit a claim to your insurance provider, but full payment is required before each procedure. Navigating Insurance for Depression Treatment Understanding insurance coverage for depression treatments can be complex. Here are steps to help streamline the process: Verify Coverage : Contact your insurance provider to inquire about treatment coverage specifics. Some insurers require a history of treatment failures with traditional antidepressants before approving coverage for these advanced therapies. Obtain Pre-Authorization : Many insurers require pre-authorization for certain treatments. Ensure all necessary approvals are secured before initiating therapy. The Albany Clinic's administrative team can assist in submitting pre-authorization requests. Understand Financial Responsibilities : Clarify any co-pays, deductibles, or out-of-pocket expenses associated with your treatment plan. Consult Our Team : The Albany Clinic's administrative staff is experienced in navigating insurance processes and can assist you in understanding and managing the financial aspects of your treatment. We also provide financial counseling to help patients explore payment plans and reimbursement options. Going Forward Navigating insurance for depression treatment can be complex, but you don’t have to do it alone. At The Albany Clinic , we’re dedicated to helping patients access effective, insurance-backed treatments while minimizing out-of-pocket costs. Contact us today to learn more about your options and take the next step toward relief.