Depression Disorders – Types, Symptoms, And Treatments
Content warning: Please be advised, the below article mentions suicide and suicidal thoughts. If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The National Suicide Prevention Lifeline can be reached at 1-800-273-8255, and is available 24/7.
Depression is a severe condition that affects millions of people worldwide. In fact, according to the Centers for Disease Control (CDC), 16 million American adults are affected by depression each year. Yet, if two people who feel depressed compare their symptoms, they often find that they’re quite different from each other. One reason for that is that you may not have the same depressive disorder. You may be wondering if you have depression at all, or if so, what type you have. Learning about the various mental health conditions related to depression, as well as risk factors such as family history, may help you make sense of the subject and give you the confidence to get the treatment you need.
Although the various types of depression are different, much like any mood disorder, you might find it useful to start with a brief overview of the most common symptoms of depression. In making an accurate diagnosis, the doctor will consider all the symptoms you’ve had for two weeks or more. They might use the Diagnostic and Statistical Manual (DSM-5) to determine whether your condition meets the criteria for one of the types of depression.
- Low mood
- Sleep problems, such as sleeping too much or too little
- Decreased or increased appetite; weight loss or weight gain
- Less activity or more agitation
- Trouble concentrating
- Low energy
- Low self-esteem
- Feeling hopeless or guilty
- Loss of interest in normally enjoyed activities
- Mood swings
- Physical aches and pains without a clear physical cause
- Suicidal thoughts
According to the National Institute of Mental Health, there are a variety of factors that influence one’s risk of developing depression. The National Institute of Mental Health states that genetic, biological, environmental, and psychological factors all play a role in whether or not we experience depression, and how severely. Examples of these risk factors, per the National Institute’s website, include:
- Personal or family history of depression
- Major life changes, trauma, or stress
- Certain physical illnesses and medications
Types Of Depression
Although the above symptoms may appear in any type of depressive disorder, each type has a unique blend, triggers, and presentation of them. Here are brief descriptions of various kinds of depression medical conditions and what makes them each unique.
Major Depressive Disorder
Primary symptoms of the type of depression called major depressive disorder are loss of interest or pleasure in things once enjoyed and a sad or depressed mood. To receive this diagnosis, one or both must be present, as well as three or four of the others, for a total of five of the symptoms. The major depressive episode(s) must be severe enough to interfere with daily life. Also, they must not be due to grief, substance abuse, a medication or another medical condition, a psychotic disorder, or a schizophrenic disorder. Finally, if you’ve had a manic or hypomanic episode, the diagnosis probably won’t be major depressive disorder.
Persistent Depressive Disorder
Persistent depression, sometimes called dysthymia or persistent depressive disorder (PDD), is a type of clinical depression that lasts at least two years or longer. Within those two years, the PDD symptoms may get better or more severe, but they’re present at some level throughout that time.
Bipolar disorder, also known as manic depression or bipolar depression, is a condition in which depressive symptoms alternate with manic or hypomanic symptoms. During the depressive phases, you may have any of the general depression symptoms. While you’re in the manic phase, you might have other symptoms like rapid speech, grandiose ideas, elevated mood, and others. Hypomania is similar to mania, but it’s less extreme. If you have bipolar disorder, you may also have times when you are neither depressed nor manic or hypomanic.
Seasonal Affective Disorder (SAD)
Seasonal affective disorder is a depressive disorder that begins in the winter months and lifts in the spring. It may be related to the amount of natural light available during the day. Seasonal depression usually has symptoms like social isolation, weight gain, loss of interest in activities, and oversleeping. Symptoms occur most often in winter for most people. SAD comes back every winter, year after year, and is often categorized as a type of mild depression but can be more severe, as well.
Perinatal depression happens when a woman is pregnant. It can also occur after birth, in which case it is sometimes called postpartum depression or the “baby blues.” Perinatal and postpartum depression have the symptoms of major depression, and the most common for this disorder are anxiety, distress, sadness, and fatigue. The depressive symptoms may be severe enough to interfere with the mother’s ability to take care of her infant correctly.
Premenstrual Dysphoric Disorder (PMDD)
Some women experience cyclic depressions that correspond to their menstrual cycles. Premenstrual dysphoric disorder (PMDD) is a hormone-related mood disorder. It is a more severe form of this than PMS, and it typically interferes with life for several days before the woman’s period. This disorder has physical symptoms, along with the usual mental health symptoms of depression. Irritability is common.
Disruptive Mood Dysregulation Syndrome (DMDD)
Another recently identified type of depression is disruptive mood dysregulation syndrome. DMDD’s most common symptoms are irritability and temper outbursts. It’s primarily diagnosed in children. Unlike the episodes of irritability in bipolar depression, the irritability in DMDD is persistent and severe.
Atypical depression is a subtype of major depression characterized by specific symptoms such as oversleeping, overeating, and irritability. If you have this type, you may also feel extraordinarily sensitive to rejection, have a feeling of heaviness in your arms and legs, or have difficulty with your close relationships. It can sometimes be considered a type of treatment resistant depression, but not always.
Reactive depression goes by many names, the most common being situational depression. Reactive depression comes as a reaction to a traumatic event or major life change. Your symptoms might be similar to the general symptoms of depression, but they typically subside within a relatively short time as you adapt to a loss or change.
Major Depression With Psychotic Features
Also known as psychotic depression, this type of depression is severe enough that you begin to have psychotic symptoms in addition to the general depression symptoms. These symptoms might include disorganized thinking, delusions, and hallucinations. The psychotic depression symptoms might be sad or upsetting, corresponding with the depressed mood, or they might include grandiose ideas, feel exciting, and seem incongruent with the depressed mood.
Treatments For Depression
Treatment is important in managing depression. The most effective treatment depends on the type of depression, as well as factors that are unique to you as an individual. They often include talk therapy or other types of therapy, and/or medication, though common things that are also recommended can include a healthy diet, avoiding recreational drugs, and getting enough physical activity. The following are some of the treatments your doctor or therapist might recommend.
A wide assortment of medications is available for depression treatment. The first-line medications for many types of depression, particularly more severe cases of depression, are antidepressants. These include:
- Selective serotonin reuptake inhibitors (SSRIs) like Prozac, Paxil, or Lexapro
- Serotonin and norepinephrine reuptake inhibitors (SNRIs) like Cymbalta or Effexor XR
- Tricyclic antidepressants like Tofranil or Pamelor
- Monoamine oxidase inhibitors (MAOIs) such as Parnate or Nardil
- Atypical antidepressants, such as Wellbutrin SR
For those with manic depression, your doctor might prescribe a mood stabilizer, and possibly an antidepressant and other medications, too. For those with treatment-resistant depression, your doctor may try a combination of multiple medications, or try an SNRI or atypical antidepressant medication over the more widely used SSRIs.
Those with seasonal depression may improve with light therapy. Getting enough sunlight can be a great help for one’s mental health. However, there may not be enough light available during the winter months to lift your mood. So, some people with SAD choose light therapy, in which you sit near a special box that has very bright lights. The treatment lasts for a specific amount of time each day. The type of SAD light is also important, and narrow bandwidth blue light with a specific wavelength has been found the most helpful in alleviating symptoms of seasonal depression. Light therapy may also help those who experience depression of different types, as well.
Vagus Nerve Stimulation Implant
The vagus nerve is the longest of our 12 cranial nerves, and the one with the greatest amount of responsibility. It’s the primary operator of the parasympathetic nervous system, and is responsible for things like controlling our digestion, heart rate, immune system response, and even our moods. Vegas nerve stimulation (VNS) implants have the potential to help with all of these, but we’ll focus on the lattermost one for the sake of this article.
A VNS implant is typically used for treatment-resistant depression, or depression that hasn’t responded to more traditional forms of treatment like SSRIs or therapy. The implant itself is placed inside the chest cavity with a minor surgical procedure, while an electrode lead runs from the implant to wrap around the vagus nerve. Periodically, the implant will send a slight pulse of electricity to the node to your vagus nerve, directly stimulating a brain response. It has the potential to work on both emotional and physical problems, as it was originally developed to help treat epilepsy. Think of the VNS as sort of like a pacemaker for your brain.
Brain Stimulation Therapies
Because depression is a disorder of the brain, some therapies address the problem directly by stimulating the brain. One of these therapies is electroconvulsive therapy (ECT), which involves sending electrical stimulation through your brain in a very controlled way while you are under anesthesia. Another is transcranial magnetic stimulation (TMS), which is a noninvasive procedure that stimulates the brain’s nerve cells using a magnetic force. Both electroconvulsive therapy and transcranial magnetic stimulation therapy are usually reserved for people with severe or persistent depression, such as major depression, that doesn’t respond to other methods. This is also known as treatment resistant depression.
Psychotherapy can be helpful for nearly any mental health disorders you might have. The best therapy for you depends on factors like specific type and severity of your disorder as well as your personal preferences. Regardless of the type of therapy you choose, your counselor may adapt it to suit you as an individual. Both cognitive behavioral therapy and interpersonal therapy have been shown effective in many research studies and clinical practice for a variety of mental disorders, including clinical depression and other mental disorders.
Cognitive Behavioral Therapy (CBT)
Many psychologists recommend CBT to patients with various depression disorders. This type of therapy involves learning to recognize negative thoughts and behaviors. The next step is to change negative or inaccurate thoughts and behaviors that might be contributing to the depression or other mental health concerns. Your therapist acts as your guide and encourager during this process, while you are the one who learns and practices these techniques.
Interpersonal Therapy (IPT)
Interpersonal therapy is another suitable type of therapy for people with depression, including major depression, as well as other types of mental illness. During IPT, your therapist helps you learn how to express your feelings and solve problems in healthier ways. One of the goals is to build better relationships with others in your life. Also, this therapy is designed to teach you how to adapt to life’s problems, increase your social skills, and get support from those around you.
Seeking Help For Depression
If you experience depression, you are certainly not alone, and help is available. No matter what depressive disorder, mental illness, or personal concerns that you might have, a doctor or counselor can help you in your quest to relieve symptoms, improve mental health, and get back to a happier life. You can talk to a psychiatrist or doctor in your local community to get started with diagnosis and medications. Additionally, if you have depression, whether mild or severe, or bipolar disorder, the Depression and Bipolar Support Alliance has a plethora of resources and means to connect you with people who can help.
Or you might prefer to begin by talking to a therapist in your area or online. The most important thing is that you start somewhere – whether with a psychiatrist or a counselor – so you can feel better faster and build a better life.
Other Commonly Asked Questions
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