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What are the types and sub-types of depression?



Depression doesn’t come in one form, in fact it is possible to be diagnosed with more than one type. E.g. major depressive disorder and seasonal affective disorder (SAD). Many people report feeling different intensities of depression and wonder what type of depression they are suffering from. A doctor is the best person to diagnose the kind of depression being experienced.

These types of depression range in duration and differ in causes. A normally healthy woman may be excited about her pregnancy and be surprised by feeling blue because of postpartum depression. In another major change of life, women may experience depression during the stages of menopause; many women dismiss the symptoms of depression as being a normal part of aging.

Life changes that are painful and traumatic can cause situational depression; this type lasts for a limited time. Clinical depression differs and is also known as major depressive disorder (MDD). There is further study required to determine what exactly causes MDD, but certain factors contribute to the illness including genetics and a chemical imbalance in the brain. It is so common that it is the leading cause of disability in the world.


Persistent depressive disorder (dysthymia) has the marks of clinical depression but the symptoms aren’t as intense, yet it is just as serious as major depressive disorder. People with bipolar disorder suffer periods of depression and states of extremely elevated mood.  Psychotic depression has the symptoms of major depressive disorder and sufferers experience delusions and hallucinations.

Atypical depression is a different type of major depression and dysthymia and is marked by persons starting to experience the depressive symptoms during the teenage years. Premenstrual dysphoric disorder affects girls and women just before menstruation begins.


Differences in the types of depression

While the differing types of depression have similar characteristics, there are marked differences that determine how each is treated. There are many people who suffer from depression and are left untreated, in fact this is true for the majority of sufferers. People are either unaware of what is happening to them and don’t understand it is a condition that can be treated, or they are afraid of the stigma of having a mental illness, so they deal with the illness on their own.

Major depressive disorder (MDD)

Call it MDD, clinical depression or unipolar depression the symptoms are serious and left untreated can cause death due to suicide. The average age for the first episode of the illness occurring is 32. Women are diagnosed with MDD at a higher rate than men. It is thought that hormonal changes during major life stages are responsible for more women suffering from depression. Symptoms include:

  • thoughts of suicide
  • helplessness
  • hopelessness
  • fatigue
  • lack of motivation and interest in normally enjoyable activities
  • insomnia
  • restlessness
  • anger and irritability
  • social isolation
  • weight gain/loss

Treatments include drug therapy, psychotherapy, electroconvulsive therapy (ECT) and alternative medicine therapies. Some of these treatments may be used together for ultimate results in improvement.

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Seasonal Affective Disorder

Persons suffering from seasonal affective disorder (SAD) commonly suffer symptoms in the fall and winter though some may even experience the illness in the spring and summer. The symptoms are like MDD, but the duration is usually predictable depending on the seasons.

  • loss of interest in previously enjoyed activities
  • social isolation
  • fatigue
  • cognitive difficulties
  • feelings of excessive guilt
  • low self-esteem
  • suicidal ideation
  • over sleeping
  • change in appetite
  • anxiety

Treatments include antidepressants, psychotherapy, alternative medicine and light therapy; some of these may be used in combination with each other.

Postpartum depression

Postpartum depression occurs before and after the birth of a child for up to a year. Symptoms last for longer that two weeks and are like MDD. Also known as the “baby blues”, the mother may not bond well with the child and feel guilty for being a bad parent. Symptoms include:

  • despair
  • hopelessness
  • helplessness
  • excessive guilt
  • anxiety
  • suicidal thinking
  • difficulty making decisions
  • cognitive impairment (lacking concentration)
  • fatigue
  • loss of interests in once enjoyable activities

Treatments include psychotherapy, antidepressants, and help from a support group. It is important to receive help for this condition for the health of the mother and the child; help from loved ones to care for the child and mother may become necessary.

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Menopausal depression

When this change of life is progressing, depressive symptoms may appear and must be treated and not dismissed as being normal symptoms of menopause. Researchers have found a link in families and the stressful changes of life during middle age. The decrease in estrogen during perimenopause is believed to contribute the onset of depression before menopause. Symptoms include:

  • lack of pleasure in regular activities
  • fatigue
  • suicidal thinking
  • concentration difficulties
  • hopelessness
  • helplessness
  • change in appetite
  • excessive guilt

Not getting treatment for depression during this time can lead to increased risk for heart attack and bone fractures. Self care in combination with medical care contribute to better health and well-being. Medical treatments include antidepressants, talk therapy and herbal remedies.


Situational depression

There are times in life where a painful situation can bring on an episode of depression within 90 days of the event occurring. The symptoms may seem the same as MDD in the beginning two weeks but the difference is that MDD runs in families and the cause is a chemical imbalance, not an overwhelming situation. Symptoms include:

  • despair that lasts over two weeks
  • fatigue
  • suicidal thoughts
  • lack of motivation
  • change in appetite
  • crying
  • anxiety
  • social withdrawal
  • concentration difficulties

Treatment involves self care including exercise, eating a healthy diet, and support from friends and family. Medical treatment includes talk therapy and antidepressants. More severe symptoms may require a stay in the hospital.

 


 

Persistent depressive disorder (Dysthymia)

Persistent depressive disorder otherwise known as dysthymia is a chronic condition affecting more women than men. Diagnosing the condition requires that the person suffer depressive symptoms for over two years; it is a milder form of MDD, but it is disabling nevertheless. Most sufferers of dysthymia will experience MDD as well called double depression. Symptoms include:

  • poor appetite
  • overeating
  • fatigue
  • helplessness
  • hopelessness
  • suicidal thoughts
  • poor self esteem
  • insomnia
  • low mood

Treatment for dysthymia includes regular visits with a doctor, antidepressants, and talk therapy. Some family doctors don’t recognize the symptoms therefore, it is important to know the signs to discuss with your health practitioner. It is all too easy to dismiss the symptoms being caused by getting older.

Bipolar disorder

Bipolar disorder involves extreme highs and lows. The lows present as depression causing the same symptoms of MDD. It is a lifelong condition that can be managed with treatment and self care; episodes may happen a few times per year or less. There is more than one type of bipolar disorder.

  • Bipolar I– one or more manic episodes and depressive episodes. Mania may cause psychosis
  • Bipolar II– lacking a manic episode but including hypomania and depressive episodes
  • Cyclothymic disorder– children and teenagers experience one year of alternating depressive and hypomania while adults suffer for two years or more

Symptoms of hypomania

  • Reckless behaviour
  • Fast paced thoughts
  • Talkativeness that is extreme
  • Plenty of energy
  • Upbeat
  • Easily distracted

Treatments for bipolar disorder includes long-term treatment with medication, hospitalization, talk therapy and electroconvulsive therapy. It is important to continue with maintenance treatment(s) even when the person with bipolar disorder feels better.

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Psychotic depression

Psychotic depression is also known as major depressive disorder with psychotic features suffered by 20% of sufferers of MDD. The causes aren’t known but seems to run in families; hormonal changes and stress both alter the chemicals in the brain and contribute to psychotic depression. Symptoms include:

  • Hallucinations
  • Delusional thinking
  • Psychomotor retardation
  • Excessive guilt
  • Insomnia
  • Suicidal thoughts
  • Changes in appetite
  • Low energy
  • Cognitive impairment

A person being treated for psychotic depression benefits from visits with a psychiatrist, medication and talk therapy. If the sufferer is in immediate danger of hurting themselves, they may be hospitalized for a brief period.

Atypical depression

Persons suffering from atypical depression have several symptoms that can be debilitating. It is a subtype of major depressive disorder and dysthymia and is first experienced in the younger years. The condition may make people sensitive to their environment and prone to feel rejection. Symptoms include:

  • Excessive sleeping pattern
  • Weight gain
  • Fatigue
  • Weakness
  • Increase in appetite
  • Restlessness
  • Insomnia
  • Thoughts of suicide

Treatment for atypical depression includes talk therapy, medication and frequent visits with a medical doctor. It is a treatable condition that is like major depressive disorder.

Premenstrual dysphoric disorder

Teens and young women are prone to suffering depression just before commencing menstruation. It is part of premenstrual dysphoric disorder and causes the suffer to experience symptoms of varying intensities. Though they sound the same, PMS is different that this condition; it is more severe. Symptoms include:

  • Anxiety
  • Depression
  • Fatigue
  • Feeling overwhelmed
  • Change in appetite
  • Cognitive difficulties
  • Irritability
  • Mood swings
  • Low self esteem

These symptoms will subside when menstruation begins; it is a good idea to see a doctor for treatment to alleviate the symptoms which can affect the day to day life of the sufferer.

All these types are treatable, and the sufferers can find relief in the form of many available treatments that include talk therapy, medication and the inclusion of regular self care activities. For more information, talk to your doctor.

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Depression: Focus on what you CAN do and not on what you can’t

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Today, I woke up at 5:00 pm. I have never slept this late before, but in all fairness, I was up until dawn as a listener on 7 Cups. I have to say this is not me at my ultimate best, but it is out of my control sometimes when I cannot sleep. I kind of dread being awake now in the midnight hours, but I put my time to good use listening to those who need a kind and compassionate ear.

I sometimes let what I cannot do affect my self-esteem and I think I have reached a point where I have had enough; I am fed up with feeling not good enough. It is time to appreciate what I can do rather than what I can’t do. It is disappointing to not be able to do the things I would like because of suffering from major depressive disorder but I must continually adjust and adapt to each day not knowing what to expect.

Two of the people I listened two left ratings and I now have 5 out of 5 stars. I like to excel at what I do and sometimes the depression makes me feel inadequate on the days where it is even difficult to get out of bed. A frustrating battle of thoughts ensues, and I need to show the same compassion to myself that I show to others experiencing debilitating symptoms of depression.

Too much time has been spent in disappointment about what I cannot do now. What does this mean? It means I carry around shame and a feeling of disgrace because I am not functioning like healthier people can. I know I have tried my best on the road to recovery and must keep this in mind.

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Suffering from depression is not my fault and I must keep this in mind. It is unfortunate, but something that is manageable though there have been days when it has felt grueling to face the day. I’m not sure what to say when people ask what I do. I have found writing work at home, but some people don’t consider this to be a real job; I have also tried my hand at selling crafts online, but I could not keep up with what my mind had planned for the small business. It is time for some motivation!

Motivation for easing the self-doubt from depression

What is motivation? Why does it seem to work better on some days? I’m not sure. Not all of what is intended to be good advice or motivation is helpful, sometimes it can feel harmful due to expectations to kind of just snap out of the depression at will. Of course, it is better to think positively but the illness cannot be battled alone with positive thoughts. What kind of motivation is helpful? How can I include radical acceptance? What does this mean for me and most likely others? I need to accept myself at my best when the symptoms aren’t as debilitating, and at my worst. There is no need for self condemnation for being a person with depression. It runs in my family and why should I expect to be any different?

I have been learning mindfulness techniques lately; spending time in the past and worrying about the future is overwhelming. Of course, I appreciate good memories, but having depression has tempted me to ruminate over the negative and relive the pain every time I think of a painful experience.

Am I doing something that makes my depression worse? Yes. The non-stop critical thoughts are painful and sometimes it takes me a while to snap out of it and stop the negative thoughts. I hate struggling, it is wearisome. It is counterproductive when I really am trying hard to feel my best.

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Today’s motivation is the thought that I am working hard to be the best that I can. It’s okay to be me and it doesn’t matter if someone else wants to judge me harshly for having a mental illness. I have worked hard to be self-sufficient and strong; although I haven’t gotten to where I want to go in the way I thought I would get there, I am convinced that I will get there eventually even if it doesn’t look like I thought it would. Trying to act healthy when I need to be treated for depression doesn’t work, it doesn’t make me function any better.

Some days I have lost track of my goals and because of my fatigue it feels like I will never accomplish them and then I will l have days when I am full of energy and in control and well on my way to accomplishing the steps necessary reach my set goal. I feel best when life feels exciting; it can be difficult to remember that the weighing despair is not permanent though it feels like it will never go away.

It is hard to describe to others out of embarrassment and the need to be accepted as being a regular human being without prejudice and dislike. I have confided to a few people that I have depression, and some seem okay with it though they don’t know too much about it. I have to say I have accomplished my goals though I have had to adapt around the depression and have been set back by the symptoms and trying to find the right medication that makes me feel better. I am a writer and have had the opportunity to be paid for writing about issues that I learned in college. Listening on 7 Cups is a community service worker activity. So, my hard work did pay off, I am doing what I went to school for even though it isn’t where I thought it would be. I can do it even thought I am not moving as quickly as I hoped I would.

Do not let what you cannot do interfere with what you can do.

— John Wooden

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How to know when you should see a doctor for depression

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The symptoms of depression can start off subtly and if they last for longer than two weeks you would be wise to see a doctor. It can be tempting to think that the symptoms will go away on their own, but this may lead to a worsening of the symptoms you are experiencing. If you had a broken arm you would go to the doctor, right? The same is true for depression even though it is an invisible illness. It is the leading cause of disability in the world and should be taken seriously.

You may not want to go to see a physician for several reasons including facing rejection from others because of the stigma with mental illness, you feel it isn’t that serious, and maybe you are feeling to tired and unmotivated to go. The longer you wait for help, the longer it will take for you to feel better. You are the best judge of what kind of therapy is best for you; the doctor can recommend treatments that work well alone or together for your ultimate well-being.

To do an online check of your possible depression symptoms click on the image below.


Symptoms to look for before seeing a doctor

There are a few types of depression but many of the symptoms are the same. To start if you just aren’t feeling quite like your normal self it may be a clue that it is time to see a doctor. Depression is despair, overwhelming tiredness, irritability and sleep disturbances. These are a few of the obvious symptoms that debilitate and cause a person to be confused.

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It is confusing to be used to functioning and then be rendered incapable of even the simplest tasks. You may try harder yet feel like a failure. You may try to think positively which is good, but it won’t cure the depression. It is a daily battle and at its worst can lead to suicide. Yes, it is a serious condition.

Symptoms:

  • Fatigue
  • Over or under eating
  • anger
  • Lack of interest in once enjoyable activities
  • insomnia
  • Oversleeping
  • Thoughts of suicide
  • hopelessness
  • helplessness
  • Weight loss or gain
  • Feelings of despair
  • Body feels heavy
  • Movements are slower
  • Negative thinking
  • Isolating oneself

You may feel some or all these symptoms in varying intensities. There is help in dealing with these symptoms usually in the form of a combination of talk therapy and drug therapy. It may be hard to admit at first that what you are possibly experiencing is depression, but once you get a diagnosis from your doctor you’ll understand that it is real, serious and treatable.



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How to handle discrimination against depression

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The pain of discrimination and stigmas

Being discriminated against based on an attribute you possess is painful and humiliating. People discriminate against colour, age, race, socioeconomic status and people with disabilities. Some people view a person with a mental health issue with disregard and lack of respect. The problem is not with the person with the mental illness, rather it is with the person who is discriminating.

The pain of depression is difficult to bear without being discriminated against. Fortunately, there are many people who are understanding and take great offence at the mistreatment of others. There are many stereotypes about people diagnosed with depression and it is important to get the facts straight.

What is discrimination? What is a stigma?

Discrimination is an action towards another that excludes, isolates and judges and is meant to cause harm to the target person. In many countries it is against the charter of human rights or equivalent law to mistreat people based on personal biases. Discrimination is faced by many:

  • In the workplace
  • In school
  • Public institutions

It is somewhat surprising that so many people continue to discriminate when much progress has been made for the fair treatment of all by different groups of people whose message is the same; it is wrong to discriminate.

A stigma is similar and leads to negative actions towards a person based on stereotypes, that is a one size fits all character description, based on erroneous information. People with depression suffer from the stigma attached to it. In general, because of negative exposure in the media, the term mental illness is sometimes used when someone commits a crime. The vast majority of people who have a mental illness are more likely to be a victim of violent crime rather than be the perpetrator.

Yes, mental illness can be scary but so much more for the sufferer than anyone else. It is not a character flaw or a lack of good morals that cause someone to have a mental illness. It is the same as any other illness and people should be honoured for the strength it takes to make it day to day when suffering from an episode of major depressive disorder.

How to handle being discriminated against

It takes courage to defend against the hurtful actions of others and while it may be tempting to retaliate, it is best to be the bigger person and not make the situation worse. Insult for insult will not accomplish any good. There are sayings akin to retaliating with kindness and sometimes this will shame the other person for being so rude. Some people however will seemingly never change their ways, so it is best to avoid them if you can.

If you are discriminated against at work, you may have legal rights to protect you from any further harm. Make sure before you make a complaint that there isn’t a valid reason for the behaviour of your superior or coworkers. E.g. not getting a promotion. Was the decision made with prejudice?

In many countries the person filing the complaint should not fear retaliation for speaking up for themselves because they are legally protected by company policies. You may be able to make a complaint against a person without them knowing about it.

It is up to you to use your best judgement when responding to ignorance. Yes, it is hurtful, but remember it is ignorance on the part of the other person who is discriminating, and it is not your fault. You may not be able to change someone from mistreating you, but you can hold your head up high and not carry the shame and disgrace that was attempted to be put on you.

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