Types of depression and how to recognize them

It is quite natural to feel depressed sometimes, but if this condition persists for a long time and affects your quality of life, it may be clinical depression. It can be treated with various medications, talking to a therapist, and lifestyle changes.

Depression has many different types and some of them appear as a result of certain events that have occurred in life, and some are caused by chemical changes in the brain.

Regardless of the cause, you should immediately consult a doctor and report your feelings. He or she can refer you to a specialized specialist, such as a psychiatrist or psychologist, who can determine the type of depression you are experiencing, as well as make an appropriate diagnosis and prescribe the right treatment. Let's take a look at what types of depression exist.

Major depression

Some doctors call it “major depressive disorder ” or “clinical depression”. This type is diagnosed if a person feels depressed for more than two weeks. This type of depression is considered the most common and severe.

Symptoms:

• loss of interest or pleasure in work;
• weight loss or gain;
• loss or excessive appetite;
• constant feeling of sleepiness or problems falling asleep;
• Feeling anxious or agitated, lethargic, physically or mentally sluggish;
• constant feeling of fatigue and loss of energy;
• excessive self-criticism or feelings of guilt;
• loss of concentration or inability to make decisions;
• thoughts of suicide, suicide attempts, or suicide planning.

A doctor can diagnose severe depression if a person has 5 or more of the above symptoms that have not resolved for 2 weeks or more. One of them must be a depressed mood or loss of interest in work.

Major depression manifests itself differently in different people and depends on how they feel. It can be in the form of:

Anxiety disorder. A person feels tense and anxious most of the day. It's hard to concentrate because he or she is constantly thinking about something bad happening. He also feels that he cannot control himself.

Melancholy. The person is very sad and loses interest in the work they used to enjoy. They feel bad even when something good happens. He or she may also:

• Feel hopeless and sad, especially in the morning.
• Lose weight and appetite;
• Sleep poorly and wake up early.
• Think about suicide.

Mixed type. The person feels out of sorts most of the time as well:

• Talks a lot.
• Constantly moves, for example, jerks his arms or walks in circles around the room.
• Acts impulsively.

Psychotherapy by talking to a doctor can solve this problem. When you see a psychotherapist, he or she will ask you several questions and help you find ways to cope with depression. If necessary, he will prescribe antidepressants. Complex therapy with the help of talk and medications shows the best results.

If these methods do not work, a specialist can offer:

1. Electroconvulsive therapy (ECT).
2. Transcranial magnetic stimulation (TMS).
3. Vagus nerve stimulation (VNS).

ECT uses electrical impulses, TMS uses a special type of magnet, and VNS uses an implanted device. All of them stimulate certain areas of brain activity, helping to control mood and improve performance.

Sometimes, depression can be mistaken for stress and anxiety due to overlapping symptoms. Understanding the differences is crucial for choosing the right approach to treatment and support.

Persistent depressive disorder

If depression persists for 2 years or more, doctors diagnose persistent depressive disorder (PDD). This term describes two conditions known as dysthymia (mild persistent depression) and chronic major depression.

Symptoms:

• lack of or excessive appetite;
• poor or too good sleep;
• lack of energy and fatigue;
• excessive self-criticism and low self-esteem;
• problems with concentration or making important decisions;
• feelings of hopelessness.

Treatment may include psychotherapy, medication, or a combination of both.

Bipolar disorder

People with bipolar disorder (manic depression) often have mood swings, ranging from an excessively high degree of activity with good mood to a complete decline in the form of severe depression. It is during the decline phase that symptoms of severe depression appear.

Mood swings can be controlled with medication. Regardless of the current phase of bipolar disorder, whether it is a rise or a fall, a specialist may prescribe a mood stabilizing drug such as lithium.

The FDA has approved 3 drugs for the treatment of bipolar disorder:

• Latuda.
• A combination of olanzapine and fluoxetine.
• Seroquel.

Sometimes doctors recommend other medications, such as the anticonvulsant drug lamotrigine or the atypical antipsychotic Vrylar.

A specialist does not always recommend conventional types of antidepressants for the treatment of bipolar disorder because there is no definitive evidence that they are more beneficial than placebo. Also, in some people with this problem, antidepressants can increase the risk of a higher stage of the disease or accelerate the onset of more episodes in a short time. Psychotherapy can help you cope and provide support for your family.

Destructive mood regulation disorder

This condition is a depressive disorder in children aged 6 to 18 years and manifests itself in the form of frequent and severe outbursts of anger and constant irritability.

Very serious symptoms often become a problem for the family and school. It is difficult for these children to communicate with their peers. Usually, the signs begin to appear at the age of 6-10 years. However, if they do not go away for a year or more, the child is diagnosed with the disease.

Methods of treatment:

1. Psychotherapy or talk therapy. Methods include cognitive behavioral therapy and parental education. A specialist may recommend treating a child between the ages of 6 and 12 with psychotherapy and then, if necessary, with medication.
2. Antidepressants. Treatment for children aged 12 to 18 years is mainly a combination of antidepressants and psychotherapy.

Seasonal affective disorder

SAD or major depressive disorder with a seasonal pattern is a period of severe depression that occurs when the seasons change. Many people suffer from SAD in winter, when daylight hours become shorter and there is much less sunlight. Mostly, the condition improves with the arrival of spring and summer.

If a person lives far from the equator (in Alaska or New England), he or she has an increased risk of getting sick with HAE. Today, it is difficult to determine how many people suffer from this disorder because it is not always diagnosed and recorded.

Hormones such as serotonin and melatonin are chemicals that help the body regulate sleep and wakefulness. Experts believe that a lack of serotonin and an excess of melatonin causes seasonal disorder. The lack of sunlight in winter causes the body to produce these hormones unevenly, making it difficult for the body to adapt to shorter days, leading to problems with sleep, mood, and behavior.

Antidepressants and light therapy can help to cope with SAD. During light therapy sessions, the patient sits for about 15-30 minutes every day in front of a special light device. The doctor may also prescribe psychotherapy and vitamin D, which increases the amount of serotonin.

Psychotic depression

Psychotic depression or depressive psychosis is accompanied by symptoms of severe depression combined with signs of a “psychotic” disorder:

• Auditory and visual hallucinations.
• False beliefs.
• Paranoia (false belief that other people want to harm you).

Antidepressants in combination with antipsychotic medications help to combat this mental disorder. ECT may also be prescribed.

Prenatal depression

This type of depression is observed in pregnant women who experience a constant feeling of intense sadness. At this time, hormone levels change, which can cause mood swings and symptoms of depression that do not go away for several days. Special therapy is required to eliminate the symptoms. This problem is observed in people who:

• Suffer from mental disorders.
• Face stress in their lives during pregnancy.
• Do not receive support from a partner or have no partner.
• Have an unexpected or unplanned pregnancy.
• Health problems or special needs arose during pregnancy.
• A woman is expecting twins, triplets or more children.
• Infertility did not allow having children.

Symptoms:

• Lack of appetite and weight changes that are not related to pregnancy.
• Lack of interest in activities that used to bring pleasure.
• Constant feeling of irritability.
• Constant feelings of sadness or hopelessness.
• Feelings of anxiety.
• Physical condition that is not related to health problems (migraines, muscle pain, nausea).

Changing your lifestyle can help you cope with the problem. For example, moderate exercise, proper diet, and quality sleep. The doctor may also prescribe psychotherapy and medications.

Postpartum depression

In women who suffer from severe depression for several weeks or months after childbirth, doctors may diagnose postpartum depression (PPD), also called peripartum or postnatal depression.

PPD is much more serious than the usual postpartum blues, associated with feelings of anxiety and sadness, and lasting one or two days after delivery. If the sadness, hopelessness, and anxiety persist for two weeks after giving birth, then the woman is suffering from PPD. These feelings can be so strong that it is difficult for a woman to connect with her baby and lead a normal life. These symptoms should not be ignored. It is necessary to consult a doctor who will prescribe appropriate therapy.

PPD is a rare but very severe form of psychosis, so if you have visual or auditory hallucinations, delusions (believing in things that do not exist), suicidal thoughts, or thoughts of harming your child, consult a specialist immediately.

Today, 1 in 7 women suffer from this type of depression. A specialist may recommend a course of treatment, which may include counseling with a psychotherapist, attending support groups, and taking antidepressants. In some cases, hormone therapy is prescribed.

Premenstrual dysphoric disorder

Women who have been diagnosed with premenstrual dysphoric disorder (PMDD) are prone to depression and other disorders one or two weeks before the start of their menstrual cycle. This is a more serious problem than PMS (premenstrual syndrome) because it creates inconvenience in life. After the start of menstruation, the symptoms of PMDD go away. During this type of disorder, a woman may experience:

• Sudden mood swings.
• Signs of irritability.
• Feelings of anxiety.
• Lack of concentration.
• Excessive fatigue.
• Lack of or excessive appetite.
• Problems with sleep.

For PMDD, antidepressants or hormone therapy are prescribed, as well as diet, lifestyle changes, and regular exercise to help improve mood.

Situational depression

In psychiatry, situational depression is not an official term. With this type of disorder, people may be depressed and therefore unable to cope with stressful situations in life, such as the death of a loved one, divorce, or dismissal from work. Experts call this condition “stress reaction syndrome”. In most cases, a doctor prescribes psychotherapy sessions to help you cope with the problem.

Atypical depression

This type of disorder is not associated with feelings of sadness, as it is considered a specifier that describes a pattern of different symptoms. Atypical depression is distinguished by the fact that any positive event in life can improve a person's mood for a while. This condition is called “mood reactivity”.

Symptoms:

• Excessive appetite.
• Long night sleep.
• A feeling of heaviness in the limbs.
• Strong sensitivity to criticism from strangers.

The doctor mostly prescribes antidepressants, such as selective serotonin reuptake inhibitors (SSRIs). In some cases, he or she may recommend an older type of antidepressant, monoamine oxidase inhibitors (MAOIs), which have shown good results in the treatment of atypical depression.

Treatment-resistant depression

Approximately one-third of people who undergo treatment for depression do not get the desired results. This means they suffer from treatment-resistant depression. There can be many different reasons for this, such as other medical conditions that make it difficult to treat the disorder.

If a doctor has diagnosed treatment-resistant depression, he or she may recommend electroconvulsive therapy (ECT) and other not-so-traditional treatments.

ECT is a medical procedure during which electrical impulses are sent through the human brain using a special device, causing a short-term seizure and changes in the cerebral cortex that can improve mood.

This type of depression can be treated with special methods. The doctor, together with the patient, chooses various combinations of medications and therapeutic procedures, including ECT, and also recommends psychotherapy.

Conclusion

Depression is not just a temporary feeling of sadness, but a certain mental health condition that negatively affects the quality of life. If the disorder does not go away for more than two weeks, the doctor makes the appropriate diagnosis - severe, acute depression, bipolar disorder, etc. Since depression with psychotic features can have different types, depending on this, a specialist chooses different methods of treatment, for example, antidepressants, psychotherapy, or electroconvulsive therapy. Also, lifestyle changes, proper diet, and exercise can help improve your condition and mood. For more expert insights on mental health, visit our main page.