A study conducted by Lewis Judd, M.D., chairman of the Department of Psychiatry at the University of California, found that major depressive disorder (MDD) is best seen as a long-term illness that is prone to recurrences. He studied 367 people who were diagnosed with MDD and followed them for up to 31 years after diagnosis. He found that 55% of the time, MDD patients had some depressive symptoms (sadness, crying, loss of interest in enjoyable activities, avoidance of friends and family, low self-esteem, low energy, sleeping/eating problems) whether they were mild, moderate or severe. During the course of illness, the experience of even mild symptoms not meeting the full criteria of the diagnosis were associated with difficulty in functioning – particularly in the areas of social and work functioning. Further, for patients who are recovering from a first major depressive episode, even the presence of non-clinical (mild) levels of depressive symptoms that were not addressed significantly increases the risk of a faster, more severe relapse. What does this mean if you have MDD? It means that you and your family need to know that MDD is a long-term illness that typically waxes and wanes. Long-term care is needed and early signs of even mild depressive symptoms need to be addressed. If you have been diagnosed with MDD, the experience of any depressive symptoms should instigate a consultation with a qualified mental health practitioner. Finally, it is important to follow through with the recommended treatment and medication for as long as necessary. Holly Houston, Ph.D. Licensed Clinical Psychologist