Major Depressive Disorder Treatment in Mississippi

Dr. Saurabh Bhardwaj

Dr. Bhardwaj, Medical Director is a Board-Certified Addiction Psychiatrist (ABPN) and currently the Medical Director of Defining Wellness Center in Brandon MS. He is also an Associate Professor of Psychiatry and Medical Director of Center for Innovation & Discovery in Addictions (CIDA) at the University of Mississippi Medical Center. He has been in Mississippi since 2018, building Addiction services for the state's only medical center and joined Defining Wellness Center in 2022 to provide specialized dual diagnostic services. He is a recipient of Ruth Fox scholarship from AAAP and trailblazer teaching award from UMMC. He is also a Fellow of the American Society of Addiction Medicine.

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A major depressive disorder can be a devastating mental illness that degrades a person’s quality of life, negatively impacts their relationships with loved ones, hurts their productivity in life, and can ultimately lead to an early death. These issues become even more problematic when they are linked to a substance use disorder.

Thankfully, there’s good news: Major depressive disorders are often highly respondent to treatment, and even the most depressed person can recover from their illness if it is treated properly.

What Is a Major Depressive Disorder?

major depressive disorder is more than just feeling sad: It comes with a set of criteria that can be diagnosed by a psychological professional. According to the Diagnostic & Statistics Manual V, the official diagnosis criteria involve having at least five or more major symptoms, every day or virtually every day, for at least two weeks. These symptoms include:

• Depressed mood
• Anhedonia, or a loss of pleasure or interest in things that were previously enjoyed
• Unexplained weight loss or weight gain
• Insomnia or increased sleeping
• Depressed movement or hyperactive movement and restlessness
• Fatigue
• Loss of the ability to concentrate
• Feelings of being worthless or guilty
• Thoughts of death or suicide

The above cannot be a result of another medical condition, such as a neurological disease or bipolar disorder. They must also cause significant impairment in many aspects of life, like disrupting one’s social life, the ability to maintain relationships, or your performance at work or school.

It is worth noting that depression can display itself differently in certain groups. In young children, the symptoms often manifest themselves as physical symptoms, such as an upset stomach or headache, or anxiety. Children may not want to go to school. For older adults, depression is also more likely to manifest itself as physical pain, but it may result in the individual having memory, concentration, and cognitive problems.

What Makes a Major Depressive Disorder Different From Other Forms of Depression?

A major depressive disorder should be viewed as distinct from other forms of depression. As noted above, the diagnosis of a major depressive disorder cannot come as a result of some other physical or emotional diagnosis, but it is certainly possible for a major depressive disorder to occur at the same time or as a result of other physical and emotional issues. Furthermore, a major depressive disorder should not be confused with grief that comes from a loss as that actually comes with a “bereavement exclusion” within the diagnosis criteria. However, grief can ultimately turn into a major depressive disorder.

Finally, there is a less severe form of depression known as dysthymia or a persistent depressive disorder. This is depression that changes in intensity over time and has many of the same symptoms as a major depressive disorder, but it is less severe and has a smaller impact on an individual’s life.

How Many People Suffer from a Major Depressive Disorder?

The numbers of people who suffer from a major depressive disorder in the United States are likely much higher than most people even realize. About one in five Americans is actively suffering from a mental illness, with a major depressive disorder being the most common form of mental illness. According to available statistics, 7.8% of all Americans, roughly 19.4 million people, have suffered from a major depressive disorder.

Unfortunately, a mere 44.8% of adults who suffered from a mental illness received the treatment that they needed. This means that there is a massive unmet need for treatment within the United States in terms of people who need help with their depression.

Furthermore, the trends on individuals who suffer from a major depressive disorder are all going in the wrong direction. As of September 2020, rates of depression in the United States had actually tripled, with more adults than ever reporting feelings of depression and anxiety. Much of this was attributed to life changes and stressors that came as a result of the COVID-19 pandemic and life events at the time. Studies in 2021 showed similar increases.

It is also worth noting that the trends show that some groups are being hit harder than others in terms of increases in major depressive disorder. Young adults and teenagers are showing the highest rates of increase in depression and anxiety with 9.7% of youth having a major depressive disorder in 2021, which was an increase from the 9.2% that reported a major depressive disorder in 2020. Suicidal ideation was increasing among all groups but even more so among young adults.

Generally speaking, some groups are more likely to suffer from depression than others. Women are statistically more likely to be diagnosed with depression than men, but this may be because of cultural differences in how women are more likely to admit they have a problem and seek treatment compared to men. The same statistics show that individuals who identify as more than one race are more likely to suffer from depression.

Depression is about more than just mental anguish. In addition to increasing the risk of an individual dying by suicide, people with depression are more likely to have a slew of physical problems, including heart disease, diabetes, stroke, pain disorders, Alzheimer’s, and more.

According to available statistics, adults in Mississippi are more likely than many other Americans to suffer from depression. This gap occurs in almost every possible demographic, but it is particularly acute among individuals ages 45-64. Just over 24% of Mississippi residents in this category have depression, compared to 19.4% of other Americans. The gap is also massive when it comes to Mississippi residents without a high school education: 29% of all Mississippi residents in this category have depression, compared to 20.9% of other American adults.

What Is the Connection Between a Major Depressive Disorder and a Substance Use Disorder?

The connections are frequently powerful; individuals who suffer from depression and substance use disorders are often intrinsically linked.

The relationship between a major depressive disorder and a substance use disorder is bidirectional. This means that individuals who suffer from one are more likely to suffer from the other. The two disorders often feed into each other: An individual who is suffering from a major depressive disorder may turn to a substance, like drugs or alcohol, in order to cope or escape from their illness. Furthermore, individuals who have developed a substance use disorder may become depressed as a result of their life circumstances.

This can complicate treatment because suffering from both disorders at the same time means that an individual has developed a co-occurring disorder. Both illnesses must be treated at the same time.

Thankfully, numerous studies have found good news too: By treating a major depressive disorder, an individual is more likely to be able to be successfully treated for a substance use disorder. As such, treating a major depressive disorder is absolutely critical to treatment for a substance use disorder.

How Can a Major Depressive Disorder Be Treated?

Despite its widespread prevalence in society, a major depressive disorder is highly treatable, even if someone is suffering from it and a substance use disorder at the same time. Multiple studies have found talk therapy to be an effective form of therapy for individuals who are suffering from a major depressive disorder. Fortunately, many forms of therapy have been developed that can help a person manage their depression, identify depressive episodes, and literally think their way out of the worst symptoms.

Cognitive-behavioral Therapy

Cognitive-behavioral therapy, or CBT, involves teaching individuals to identify their thoughts and evaluate how those thoughts produce feelings. Individuals can recognize bad or inappropriate thinking patterns that can deepen their depression, and then, they work to think in a more productive manner. Studies have found CBT to be among the most effective forms of treatment for depression, and almost every treatment center employs this in some way.

Dialectical-behavioral Therapy

Dialectical-behavioral therapy, or DBT, is very similar to CBT. However, instead of concentrating exclusively on thoughts and how those thoughts influence feelings, DBT helps individuals concentrate more on living in the moment, rather than ruminating, as well as cope with stress and improve relationships with others. DBT has been used to treat people suffering from eating disorders, substance use disorders, and borderline personality disorder.

Behavioral Activation

Behavioral activation is a skill taught within CBT. Instead of concentrating on thoughts, BA helps individuals identify what specific behaviors can lead to mood changes and depressive spikes. From there, individuals can be taught how to modify their behaviors in order to either avoid these triggers or change their moods.


In many cases, individuals with depression respond well to treatment that can be offered by an array of medications. These medications must be prescribed by a credentialed physician and usually work best when prescribed by a psychiatrist who is familiar with the patient in combination with appropriate therapy.

There are many types of medications that work for depression, but they usually fall into one of a few categories.

Selective Serotonin Reuptake Inhibitors

Selective serotonin reuptake inhibitors, or SSRIs, stop the reuptake of serotonin in the brain. Serotonin is a key neurotransmitter that has been shown to have an important role in the exhibition of depressive symptoms. People who have developed a substance use disorder are also often prescribed to SSRIs because psychotropic substances affect serotonin levels. SSRIs remain among the most popular types of anti-depressants. Examples include Lexapro, Paxil, Celexa and Zoloft.

Serotonin and Norepinephrine Reuptake Inhibitors

Serotonin and norepinephrine reuptake inhibitors, or SNRIs, are very similar to SSRIs but also work on the neurotransmitter norepinephrine. Examples include Effexor XR and Fetzima.

Tricyclic Antidepressants

These are older anti-depressants that also typically come with heavier side effects. They include drugs like amoxapine, doxepin, and Wellbutrin. They are used to treat disorders like obsessive-compulsive disorder and bipolar disorder.

Monoamine Oxidase Inhibitors

MAOIs, or monoamine oxidase inhibitors, impact the neurotransmitters in your brain. They are also among the first anti-depressants created. As such, they aren’t prescribed very often at this point. Examples include Marplan, Emsam, and Nardil, and they are commonly prescribed for people with social phobias.


If anxiety or panic is also present with depressive symptoms, an individual may also be prescribed a tranquilizer, such as Klonopin. These drugs can be addictive, much more so than any anti-depressant, and their use must be closely supervised. Given their addictive nature, it may be inappropriate to prescribe tranquilizers to an individual who is suffering from a substance use disorder.

Finding Major Depressive Disorder Treatment in Mississippi

If you or a loved one is suffering from a major depressive disorder and that disorder is linked to a substance use disorder, don’t wait another moment to get the help you need. Thankfully, there is an array of treatment options that can help you or your loved one lead a full, complete, and happy life. You or your loved one can find a way to get well at Defining Wellness Centers, located throughout Mississippi.

Our centers have trained clinicians with decades of experience and the resources that you need to make a full and complete recovery. For years, Defining Wellness Centers have helped Mississippi residents live the lives that they deserve.

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If you are ready to take the step towards a new life, call Defining Wellness today and learn more about how we can help you.