What Are The 5 Types Of Depression And How Can You Determine Which You Have?
By: Darby Faubion
Updated September 17, 2020
Medically Reviewed By: Merlena James Leger, LPC
When a person says, "I've been feeling depressed," there is no way to gauge the severity of the depression-especially if we are on the outside looking in, as friends and family. Even if you have been feeling depressed lately, you may be unsure whether you're suffering from seasonal depression (many seem to get depressed in winter or summer), or from a family or employment-related situation, or a so-called "chemical imbalance" that makes a person feel blue, even if things are going well. There are clinical assessments that can do this, and the best way to determine if someone is depressed is for that person to see a licensed therapist.
What Exactly Is Depression?
When temporary grief or sadness becomes intense and includes feelings of being helpless, hopeless, or worthless, it's likely that sadness is turning into depression. Depression is a medical condition that is diagnosed based on a person's symptoms. In most cases, having five or more of the following symptoms for at least two weeks indicates the presence of depression:
- Feeling tired or lacking energy most days
- Feeling sadness or grief most of the day, especially in the morning
- Difficulty focusing, remembering details or making decisions
- Feeling guilty or unworthy almost daily
- Inability to sleep or sleeping too much most days
- Feeling restless or slowed down
- Persistent thoughts about death or suicide
- Lack of desire to participate in activities that you used to enjoy
- Frequent headaches or body aches and pain with no apparent cause
Please note that self-diagnosing depression based on these symptoms is not recommended. Although you may feel sad or depressed, it's best to seek the advice of your primary care provider because depression is a medical condition. Once you've seen your doctor, he/she may recommend medication and/or counseling. We'll discuss some counseling options later in this article.
What Causes Depression?
While it's often said that depression results from a chemical imbalance, research suggests that depression doesn't occur from simply having too much or too little of certain brain chemicals. Rather, there are many possible causes of depression, including faulty mood regulation by the brain, genetic vulnerability, stressful life events, medications, and medical problems. It's believed that several of these forces interact to bring on depression.
Types of Depression
Although there are many different diagnoses for depression, they can all be categorized into at least one of five different types of depression. Each type is characterized by certain contributing factors and symptoms.
Most people are familiar with Major Depression. Individuals who suffer from major depression tend to experience what many describe as an "all-consuming darkness." They lose interest in most activities, even ones that they may have previously enjoyed. Other symptoms include trouble sleeping, changes in appetite or weight, loss of energy, and feelings of worthlessness. In additions, thoughts of death or suicide may occur. Major depression is usually treated with antidepressant medication(s) and psychotherapy.
Persistent Depressive Disorder
Persistent Depressive Disorder was formerly referred to as "dysthymia." As the name suggests, someone with this type of depression exhibits symptoms that are persistent or ongoing, often lasting for at least two years. Although the symptoms linger, they do not reach the intensity of major depression.
Many people with persistent depressive disorder function well with day-to-day activities. However, they rarely show signs of joy or happiness. In addition, changes in appetite, energy, self-esteem, and sleep patterns will be present.
Persistent depressive disorder is often linked to changes in neurotransmitters in the brain or associated with disorders such as hypothyroidism or stroke. Stress and life changes may also contribute to persistent depressive disorder.
Bipolar Disorder is commonly referred to as "manic-depressive disorder." This type of depression is associated with mood changes and behavior that may be described as "polar opposites." Individuals who experience bipolar disorder experience periods of high energy and then feel very low and depressed.
The "manic" side of bipolar disorder is characterized by high energy, grandiose ideas, unrealistically high self-esteem, and a decreased need for sleep. During this stage, individuals experience racing thoughts and may engage in unsafe or erratic behavior. Some individuals may also become sexually promiscuous, overspend on unnecessary wants/needs, and take risks. Although the exaggerated feelings of energy and high self-esteem may feel good, the symptoms do not last.
When the manic phase ends, the depressive phase begins. During this time, the symptoms are similar to a major depressive disorder. The individual will feel extreme sadness or hopelessness, may sleep a lot, and will have no desire to participate in any activities. He/she may also have feelings of self-loathing or guilt.
Seasonal Affective Disorder (SAD)
As the name suggests, Seasonal Affective Disorder (SAD) is characterized by changes in mood as seasons change. The symptoms are generally more prevalent during fall and winter seasons. It's believed that SAD may result from changes in the body's natural schedule/rhythm or changes in the function of chemical messengers in the body, such as serotonin and melatonin.
Vitamin D, also known as the "sunshine vitamin" or the "happy vitamin" may be related as well. When skin is exposed to sunlight, it makes vitamin D from cholesterol in the skin's cells, but without adequate energy from sunlight, vitamin D synthesis cannot occur. Because people are less active and more likely to remain indoors during fall and winter seasons, less vitamin D synthesis occurs, hence the depressed mood. Many people refer to this as the "Winter-Time Blues."
The leading treatment for SAD is light therapy, which involves daily sessions sitting close to a particularly intense light source. In extreme cases, psychotherapy and medication therapy may be effective as well. To prevent this disorder, many physicians recommend taking a vitamin D supplement during the fall and winter months.
Postpartum depression is a mood disorder that can affect nearly one in seven mothers after childbirth. Mothers with postpartum depression experience feelings of extreme sadness, anxiety, and exhaustion that may make it difficult for them to complete daily care activities for themselves or others.
While there doesn't seem to be a single contributing factor to postpartum depression, it's considered to be the result of both physical and emotional factors. After childbirth, the levels of estrogen and progesterone in a woman's body drop quickly. This leads to chemical changes in the brain that may trigger mood swings. Additionally, lack of sleep means the body and the mind cannot recover from childbirth. This constant sleep deprivation can lead to physical discomfort and exhaustion, both of which affect mood and may lead to postpartum depression.
Some women appear to be at greater risk for developing postpartum depression due to previously existing risk factors, such as:
- Symptoms of depression during or after a previous pregnancy
- Previous experience with depression or bipolar disorder at another time in life
- A stressful life event during pregnancy or shortly after giving birth, such as job loss, death of a loved one, domestic violence, or personal illness
- Mixed feelings about the pregnancy, whether it was planned or unplanned
- A lack of strong emotional support from her spouse, partner, family, or friends
- Alcohol or other drug abuse problems.
Postpartum depression can affect any woman regardless of age, race, ethnicity, or economic status.
What Type of Depression Do I Have and What Can be Done?
While there are many resources for information about depression, including those found here, you can only receive a true diagnosis from a physician or a mental health professional. If you're experiencing symptoms that concern you, make an appointment with your primary care provider for an initial evaluation.
Depression evaluations may include a health history, a general physical exam to rule out underlying health issues, drawing blood to check for chemical or hormonal imbalances, and answering questionnaires that focus on mental health issues.
Many times, people are apprehensive about seeing a physician to diagnose depression. However, mental health is just as important as physical health. If there's an issue, it should be addressed by a medical professional.
Where to Find Help
In addition to talking to your primary care doctor, there are many places where you can learn about depression. For example, you may want to seek help from a counselor or a therapist. Speaking with a therapist can help you manage your depression symptoms and cope with depressive thoughts and behaviors. While many people are interested in counseling, the idea of seeing a stranger and sharing personal information can feel a bit intimidating. That's where online counseling comes in.
BetterHelp offers online counseling, providing a network of licensed professionals who are experts in mental health care. The platform is completely anonymous, and you may access it from the comfort and privacy of your own home (or wherever you have an internet connection). Read below for some reviews of BetterHelp counselors from people experiencing a range of issues related to depression.
"Tamera is straightforward and supportive. She's not afraid of pointing out what to work on and give you the right tools immediately. It is highly personalized just for your unique symptoms and situation! Tamera helped me manage my depression and anxiety and I became more empowered to have more control in my life. I feel a lot happier."
"Heidi has been a great help. I'm so very thankful. I was having a hard time getting my thoughts in order, and was at an all time low with my depression because I didn't know where to go or what to do. Heidi's guidance helped me tremendously and I am ever so grateful."
Feeling sadness or depression can seem overwhelming at times. However, there is help available. If you're experiencing symptoms of depression, make an appointment with your primary care provider or seek the help of a counselor who can help you learn coping mechanisms to deal with it. Take the first step to care for yourself today.