health and wellness, major depressive disorder family and friends, Treatment for depression

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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