Depression is extremely common, with it being a leading cause of disability across the world and an estimated 5% of adults suffering from it globally. Depression is actually classified into several different types, with the Diagnostic and Statistical Manual of Mental Disorders (currently known as the DSM-5) being the standard that is used to classify mental disorders, such as depression. The DSM-5 breaks down the definition of depression and the different types to better help mental health professionals to be able to diagnose patients, treat those patients appropriately, and conduct further research.
What is Major Depression?
Major depressive disorder is known as a serious mood disorder that causes continuous bouts of sadness that can be extremely debilitating. Major depression is characterized by a loss of interest in regular activities and a variety of physical and behavioral symptoms. Also known as clinical depression, symptoms must be present for at least two consecutive weeks and there must be a noticeable change in the person’s level of functioning in their daily life. Common symptoms include changes in sleep (either sleeping too much or sleeping too little), changes in appetite, lower energy levels, trouble focusing, accompanying irritability and/or anxiety. It is also thought that women are affected more by depression than men, although this could be because men underreport and do not seek help due to social stigmas.
Depression is not merely the occasional feeling of sadness, which everyone experiences at times, and often requires treatment in order to overcome. Depression treatment can be long-term depending on the severity of symptoms and first-line treatment typically involves psychotherapy, consisting of talk therapy, and antidepressants.
What are the Other Types of Depression?
Different depression types are classified and diagnosed depending on the specific set of symptoms that people experience, as there is some overlap of symptoms but also key differences, and the way people are affected by their depression. These are the forms of depression that are currently listed in the DSM-5:
- Seasonal Affective Disorder (SAD): Also called seasonal depression, it predominantly affects people in the colder months of fall and winter. This is when the Earth is furthest away from the Sun and people are exposed to very little sunlight on a daily basis. SAD is associated with disruptions in the circadian rhythm and imbalances in the chemicals in the brain, leading to depression. Symptoms also generally start at the end of fall or the beginning of winter when the days start to become shorter. Common symptoms include having low energy, feeling listless, sleeping too much, overeating (craving carbohydrates) and weight gain, feeling worthless, and feeling listless. For it to be diagnosed, major depressive symptoms must be present for a specific season at least two years in a row, although not everyone will experience symptoms every year.
- Peripartum Depression: Also known as postpartum depression, it is a type of depression that starts during pregnancy (peripartum) or within four weeks after a person has given birth (postpartum). This is more than just the “baby blues,” as it is an actual form of mild depression that can be diagnosed, however it generally goes away on its own around one to two weeks after it starts. Postpartum depression is most often characterized by feelings of extreme sadness, fatigue, withdrawal from family and friends, loss of interest in things that were once enjoyable, loss of interest in the baby, or even thoughts of harming the baby. People are also highly likely to experience anxiety along with the depression symptoms. Postpartum depression is a serious mental health disorder and should be treated as such and anyone experiencing severe symptoms needs to seek medical attention for the appropriate treatment.
- Premenstrual Dysphoric Disorder (PMDD): Premenstrual dysphoric disorder is often thought to be PMS, or premenstrual syndrome, but they are two separate disorders. It is classified differently from PMS because it is a much more severe disorder and can be very debilitating. PMDD symptoms will begin one to two weeks before a person’s period starts and will end two to three days after their period starts. Symptoms of PMDD are mood swings, depressed mood, irritability, decreased interest in daily activities, sense of being out of control, problems with being able to sleep, lack of energy, changes in appetite, weight gain, bloating, and breast tenderness. The underlying cause of PMDD is not currently known, although it is thought that hormonal changes play a part.
- Persistent Depressive Disorder (Dysthymia): Previously referred to as dysthymic disorder, persistent depressive disorder is a chronic form of depression that is less severe than major depression. One of the key differences between persistent depressive disorder and major depression is the length of time people usually experience it. Those with persistent depressive disorder will have symptoms of depression for more days than not for at least two years, which is significantly longer than major depression. The symptoms also can’t be absent for more than two consecutive months for it to be considered persistent depressive disorder. Symptoms include depressed mood, poor appetite or overeating, insomnia, fatigue, low energy, and a general feeling of being “down in the dumps.” Persistent depressive disorder can greatly affect a person’s daily life, such as at school, work, or with relationships.
- Disruptive Mood Dysregulation Disorder (DMDD): This is a childhood condition that usually occurs between the ages of six and eighteen. Disruptive mood dysregulation disorder will appear in children as irritability, anger, and frequent temper outbursts that are significantly worse than normal child moodiness. For there to be a diagnosis of DMDD, these extreme temper outbursts must present themselves at least three times a week and symptoms must occur for at least one year, with the onset of symptoms before the age of ten. The temper tantrums will also interfere with a child's ability to function at home, in school, and interact with other children or adults.
- Bipolar Disorders: Bipolar disorders (there are three types) cause extreme mood swings and when people are experiencing low mood as part of the cycle of bipolar disorder it actually meets the criteria of major depression, which is also referred to as bipolar depression. When someone with bipolar disorder, usually either bipolar disorder I or bipolar disorder II, experiences the depression side they will display classic symptoms of depression such as feeling sad, having low energy levels, changes in sleep (either sleeping too much or too little), changes in appetite (either eating too much or too little), having difficulty with concentration, and a loss of interest in activities. Symptoms usually last about 2 weeks and episodes of depression can happen rarely or several times a year.
How Depression is Treated
Depression is most commonly treated with either psychotherapy or medication, known as antidepressants. The most effective treatment utilizes both. Cognitive behavioral therapy is one of the types of psychotherapy that is widely used to treat depression, along with others like dialectical behavior therapy and psychodynamic therapy. CBT is a form of talk therapy that helps people identify negative thought patterns and behaviors and change those patterns/behaviors.
Antidepressants are also prescribed as a means to change a person’s mood by altering the chemicals in the brain, called neurotransmitters (ex. Serotonin and Dopamine). Some of the common categories of antidepressants are SSRIs (Selective Serotonin Reuptake Inhibitors), SNRIs (Serotonin Noradrenaline Reuptake Inhibitors), TCAs (Tricyclic antidepressants), MAOIs (Monoamine Oxidase Inhibitors), and NASSAs (Noradrenaline and Specific Serotonergic Antidepressants). They generally will start working within 2-4 weeks but may take a few months to show whether they are actually effective or not.
Those with treatment resistant depression may need to seek services, such as transcranial magnetic therapy (TMS) in order to finally overcome their depression. TMS therapy is a non-invasive procedure that is usually referred to when traditional methods have failed.
Want to See a Therapist?
If you are interested in seeking help for a mental health disorder or any mental health issues you may be experiencing then reach out to Gemini Health for the appropriate treatment. Our healthcare professionals are highly skilled and experienced to provide you with quality health services. They offer both individual and group therapy, as well as access to psychiatrists for all patients. Plus there are no wait times to join groups. Call (301) 363-1063 and speak to our staff to schedule your appointment today!