Depression Disorders

Depression can be a severe condition that affects millions of people worldwide. In fact, according to the Centers for Disease Control (CDC), 16 million American adults may be affected by depression each year. Yet, if two people who live with depression compare their symptoms, they may find that they’re quite different from each other. One reason for that may be that they do not have the same type of depressive disorder.

There are many types of mental disorders with depressive symptoms, including major depressive disorder, persistent depressive disorder, bipolar disorder, seasonal affective disorder, perinatal depression, premenstrual dysphoric disorder, and more. Treatments can include various types of therapy, medication, light therapy, vagus nerve implants, and brain stimulation therapies.

To begin your therapy journey, you can seek out a local therapist or connect with a mental health professional through an online therapy platform.

General symptoms of depression

Although the various types of depression can be different, you may find it useful to start with a brief overview of the most common symptoms of depression. In making an accurate diagnosis, a doctor will consider the symptoms you’ve had for two weeks or more. They will likely use the Diagnostic and Statistical Manual (DSM-5) to determine whether your condition meets the criteria for one of the types of depression.

Depression cases used to be defined as simply endogenous depression (i.e., caused by genetic or biological factors) or exogenous depression (i.e., caused by environmental factors). 

According to the National Institute of Mental Health, there may be a variety of factors that influence one’s risk of developing depression. Genetic, biological, environmental, and psychological factors can all play a role in whether and how severely a person experiences depression. 

Types of depression

Although the above symptoms may appear in any type of depressive disorder, each type usually has a unique blend of triggers and symptoms. Here are brief descriptions of various kinds of depression-related disorders so that you may be better able to recognize symptoms.

Major depressive disorder

The primary major depressive disorder symptoms may include loss of interest or pleasure in previously enjoyed activities and a prolonged sad or depressed mood. To receive this diagnosis, one or both of these symptoms must be present, as well as three or four of the others, for a total of five of the symptoms. 

To be classified as major depressive disorder, symptoms must be severe enough to interfere with daily life. In addition, they cannot typically be caused by grief, substance misuse, medication, or another medical condition.

If you’ve experienced a manic or hypomanic episode, the diagnosis probably won’t be major depressive disorder.

Persistent depressive disorder

Persistent depressive disorder (PDD), sometimes called dysthymia or persistent depression, is a type of clinical depression that lasts at least two years. Within those two years, PDD symptoms may intensify or subside, but they’re present at some level throughout that timeframe.

Bipolar disorder

Bipolar disorder, formerly known as “manic depression,” is characterized by alternating depressive and manic or hypomanic episodes with the potential for euthymic periods in between. Manic episodes include symptoms such as rapid speech, grandiose ideas, and an elevated mood; hypomanic episodes are similar but typically less severe. While bipolar depression is characterized by depressive symptoms that might mimic major depressive disorder, bipolar disorder is categorized as a mood disorder in the DSM-5.

Seasonal affective disorder (SAD)

Seasonal affective disorder can be defined as a depressive disorder that usually 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 tend to occur most frequently in winter for most people. SAD can come back every winter, year after year, and is often categorized as a type of mild depression, but it can also be severe in some cases.

Perinatal depression and postpartum depression

Perinatal depression generally happens during pregnancy or after birth, in which case it is sometimes called postpartum depression. Perinatal and postpartum depression usually have the symptoms of major depression, and the most common for this disorder tend to be anxiety, distress, sadness, and fatigue.

The depressive symptoms may be severe enough to interfere with a person’s ability to care for their infant.

Premenstrual dysphoric disorder (PMDD)

Some people experience cyclic depressions that correspond to their menstrual cycles. Premenstrual dysphoric disorder (PMDD) is generally a hormone-related mood disorder. It can be viewed as a more severe form of PMS, and it typically interferes with life for several days before a menstrual period starts.

This disorder often has physical symptoms, along with the usual mental health symptoms of depression. 

Disruptive mood dysregulation syndrome (DMDD)

Disruptive mood dysregulation syndrome (DMDD) is a relatively recently identified type of depression. DMDD’s most common symptoms are normally irritability and temper outbursts. It’s primarily diagnosed in children. Unlike the episodes of irritability in bipolar disorder, the irritability in DMDD is usually persistent and severe.

Atypical depression

Atypical depression can be viewed as a subtype of major depression characterized by specific symptoms, such as oversleeping, overeating, and irritability. If you have this type of depression, you may also be extraordinarily sensitive to rejection, have a sense 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.

Reactive depression

Reactive depression can go by many names, the most common typically being situational depression. Reactive depression can come 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 usually severe enough that you may 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 be exciting and seem incongruent with the depressed mood.

Treatments for depression

Treatment can be important in managing depression. The most effective treatment can depend on the type of depression, as well as factors that are unique to you as an individual. Treatment often includes talk therapy or other types of therapy or medication, though common lifestyle changes that may also be recommended can include a healthy diet, avoiding recreational substances, and getting enough physical activity.

The following are some of the treatments your doctor or therapist might recommend.

Medication

A wide assortment of medications may be available for depression treatment. However, it can be important to note that medication is often most effective when combined with talk therapy.

Please speak to your doctor or psychiatrist regarding any questions about medication, and never start or stop any form of medication without the guidance of a licensed medical professional.

Light therapy

Those with seasonal depression may experience symptom improvement with light therapy. Getting enough sunlight can greatly help one’s mental health. However, there may not be enough light available during the winter months to lift your mood. Some people with SAD choose light therapy, in which you sit near a special box that has very bright lights. The treatment typically lasts for a specific amount of time each day.

The type of SAD light can also be important, as narrow bandwidth blue light with a specific wavelength has generally been found to be the most helpful in alleviating symptoms of seasonal depression. Light therapy may also help those who experience depression of other types as well.

Vagus nerve stimulation implant

The vagus nerve is the longest of our 12 cranial nerves, and it may be the one with the greatest amount of responsibility. It’s the primary operator of the parasympathetic nervous system and can be responsible for things like controlling our digestion, heart rate, immune system response, and even our moods.

Vagus nerve stimulation (VNS) implants may have the potential to help with all these functions, but we’ll focus on the lattermost one for the sake of this article.

A VNS implant is sometimes used for treatment-resistant depression. The implant itself is generally 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 sends a slight pulse of electricity to the node of your vagus nerve, directly stimulating a brain response. This may have the potential to work on both emotional and physical concerns, as it was originally developed to treat epilepsy. 

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 may be electroconvulsive therapy (ECT), which normally involves sending electrical stimulation through your brain in a very controlled way while you are under anesthesia.

Another type of brain stimulation therapy is transcranial magnetic stimulation (TMS), which can be defined as 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, including depression that is unresponsive to more traditional forms of treatment like medication and therapy.
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Psychotherapy

Psychotherapy can be helpful for nearly any mental health disorder you might have. The best therapy for you may depend on factors like the specific type and severity of your disorder, as well as your personal preferences.

Regardless of the type of therapy you choose, your therapist may adapt it to suit you as an individual. Both cognitive behavioral therapy and interpersonal therapy have been shown to be effective in many research studies and clinical practice for a variety of mental health disorders, including clinical depression.

Cognitive behavioral therapy (CBT)

Many psychologists recommend CBT to patients with various depressive disorders. This type of therapy usually involves learning to recognize negative thoughts and behaviors. The next step may be to change negative or inaccurate thoughts and behaviors that might be contributing to depression or other mental health concerns.

Your therapist can act as your guide and encourage you during this process, while you are the one who will usually learn and practice these techniques.

Interpersonal therapy (IPT)

Interpersonal therapy may be another suitable type of therapy for people with depression, including major depression, as well as other types of mental illnesses. This therapy may be designed to teach you how to adapt to life’s problems, increase your social skills, and get support from those around you.

During IPT, your therapist generally helps you learn how to express your feelings and solve problems in healthier ways. One of the goals is usually to build better relationships with others in your life. 

Seeking help for depression

If you experience depression, you are not alone, and help is available. No matter what depressive disorder, mental illness, or personal concerns you may have, a doctor or therapist may help you in your quest to relieve symptoms, improve mental health, and enjoy a happier life. 

Benefits of online therapy

When you’re living with depression, the thought of attending therapy sessions in person can seem daunting. The ability to connect with a licensed mental health professional from anywhere with an internet connection—including the comfort of your own living room—can be appealing to many people with depression. Online therapy can eliminate many barriers to treatment, such as transportation, high costs, and scheduling difficulties.

Effectiveness of online therapy

A 2023 systematic review looking into the efficacy of virtual care for depressive disorders found that online therapy could be effective in treating many types of depression. In addition, online therapy was generally found to be similarly effective to in-person therapy.