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Major Depressive Disorder: Pathophysiology and Clinical Management.

Netsanet Fekadu, Workineh Shibeshi and Ephrem Engidawork

Depression is a chronic mental disorder that causes changes in mood, thoughts, behavior and physical health. According to the World Health Organization (WHO) 350 people worldwide are said to suffer from this mental disorder. The lifetime prevalence for major depression is reported to be as high as 14-17% and the one-year prevalence is 4-8%. The lifetime prevalence rates of major depressive disorders among women are 10-25%, and for men 5-12%. There are various forms of depression that range from mild to extremely severe conditions like psychotic depression in which the patients show symptoms such as hallucinations and delusions. There are diverse theories on the pathogenesis of depression most based on measurement of indirect markers, post-mortem studies and neuro-imaging techniques. Furthermore, an array of treatment options has been developed to combat depression over the decades. The various approaches include pharmacotherapy, psychotherapy and somatic therapy often employed for treatment resistant depression. Medicinal plants around the world have been used to treat disorders of the body and the mind since antiquity. Herbal medicine has also been a reasonable alternative for the management of mental disorders such as anxiety, depression and dementia among plenty others. Medicinal plants most widely used to treatment depression around the world are Hypericum perforatum, Centella asiatica, Rhodiola rosea, Pfaffia paniculata, Rauwolfia serpentina, Rhododendron molle, Schizandra chin, Thea sinensis, Uncaria tome, Valeriana officinalis and Withania somnifera.