Types of depression

Depression can be broken into categories depending on the severity of

symptoms. Some people experience mild and temporary episodes, while others
experience severe and ongoing depressive episodes.

There are two main types: major depressive disorder and persistent depressive
disorder.

Major depressive disorder

Major depressive disorder is the more severe form of depression. It’s

characterized by persistent feelings of sadness, hopelessness, and
worthlessness that don’t go away on their own.

In order to be diagnosed with clinical depression, you must experience 5 or more

of the following symptoms over a 2-week period:

 feeling depressed most of the day

 loss of interest in most regular activities
 significant weight loss or gain
 sleeping a lot or not being able to sleep
 slowed thinking or movement
 fatigue or low energy most days
 feelings of worthlessness or guilt
 loss of concentration or indecisiveness
 recurring thoughts of death or suicide
There are different subtypes of major depressive disorder, which the American
Psychiatric Association refers to as “specifiers.”

These include:

1 atypical features

Atypical depression is a form of depression in which the symptoms differ from the
usual symptoms of depression.

Doctors do not understand this form of depression as well as they do other types.
They may diagnose it as “major depressive disorder with atypical features.”

One key feature of atypical depression is that the person’s mood temporarily lifts
when something positive happens. Doctors call this “mood reactivity.”

Researchers state that a person must have two or more of the following

symptoms in addition to mood reactivity to receive a diagnosis of atypical
depression:

 significant weight gain

 increase in appetite
 hypersomnia, or sleeping too much
 leaden paralysis, or a feeling of heaviness in the limbs and body
 sensitivity to rejection from others that results in significant social problems
or issues at work

Older research indicates that atypical depression typically has a high prevalence

rate, starts when a person is younger, and lasts longer than other types of
depression. It is more common in those with bipolar disorder and anxiety
disorders.
  2 anxious distress
 3 mixed features

4 Postpartum and perinatal depression

Postpartum depression refers to depression that develops within the first year of

giving birth. It differs from the “baby blues,” which is a phenomenon that
affects up to 80% of mothers after giving birth.

People with the baby blues experience relatively mild anxiety, fatigue, and
sadness that typically persist for a few days before going away without treatment.
Postpartum depression, on the other hand, causes more extreme symptoms of
depression.

Postpartum depression affects almost 15% of births, with symptoms most

commonly appearing within 1 week to 1 month of the delivery. Treatment is
usually necessary for those with postpartum depression.

People can also experience depression throughout pregnancy. Doctors use the
revised term perinatal depression to describe depression that occurs both during
pregnancy and after the birth of the baby.

 r right after giving birth


 5 seasonal pattern

Previously known as seasonal affective disorder (SAD), major depressive

disorder with seasonal pattern is a type of depression that occurs in the winter
months. It is more common in areas that are farther away from the equator.

SAD causes symptoms similar to those of other forms of depression, including

anxiety, fatigue, and weight gain.
The American Psychiatric Association report that SAD affects
approximately 5% of people in the U.S.

Experts believe that SAD occurs in some people due to the lack of natural light.
However, they do not know why it affects some people and not others.
Symptoms typically last from early winter to spring.

A less common form of SAD, which is called summer-onset seasonal affective

disorder, occurs in the spring and summer months.

6 Melancholic Depression
 Melancholic depression is a form of major depressive disorder (MDD)
which presents with melancholic features. MDD is a significant mental
health condition characterized by persistent and intense feelings of
sadness and hopelessness. The disorder can affect many areas of life,
including work, school, and relationships. It may also impact mood and
behavior as well as various physical functions, such as appetite and sleep.
People with MDD often lose interest in activities they once enjoyed and
have trouble getting through the day. Occasionally, they may also feel as if
life isn’t worth living. The severity and type of MDD symptoms vary greatly
from person to person.

People with melancholic depression may experience symptoms of MDD, such

as:

 persistent feelings of extreme sadness for a long period of time

 loss of interest in activities that were once enjoyable
 having a lack of energy or feeling fatigued
 feeling anxious or irritable
 eating too much or too little
  sleeping too much or too little
 experiencing changes in body movement (for example, jiggling your leg
when you didn’t before)
 difficulty concentrating, making decisions, and remembering things
 thinking or talking about death or suicide
 suicide attempt

 7 psychotic features
 Psychotic depression occurs when an individual has severe depression
alongside psychosis. The revisions to the Diagnostic and Statistical
Manual of Mental Disorders (DSM-5) have changed the name of this
condition to “major depressive disorder” with the specifier “with psychotic
features.”
 People with psychosis may have false beliefs (delusions) or hear or see
things that are not happening (hallucinations).
 The symptoms of psychotic depression usually have a “theme,” such as
delusions of guilt, illness, or poverty.
 The findings of a 2018 study suggest that the lifetime prevalence of
psychotic depression ranges from 0.35–1%, with higher rates in older
adults

8 Catatonic Depression
 Catatonic depression is a type of depression that causes someone to
remain speechless and motionless for an extended period.

Catatonia is characterized by an inability to move normally. The symptoms of catatonia

can include:

 staying still
  a lack of speech
 fast movements
 abnormal movements

Symptoms of catatonic depression

If you have catatonic depression, you may experience the symptoms of depression, such
as:

 feelings of sadness, which can occur nearly every day

 a loss of interest in most activities
 sudden weight gain or loss
 a change in appetite
 trouble falling asleep
 trouble getting out of bed
 feelings of restlessness
 irritability
 feelings of worthlessness
 feelings of guilt
 fatigue
 difficulty concentrating
 difficulty thinking
 difficulty making decisions
 thoughts of suicide or death
 a suicide attempt
You may also experience symptoms of catatonia, including:

 extreme negativism, which means a lack of response to stimuli or an opposition to

stimuli
 agitation
 an inability to move
 difficulty speaking due to extreme anxiety
 unusual movements
 imitating another person’s speech or movements
 a refusal to eat or drink

People with severe catatonia may have difficulty completing daily tasks. For example, the
simple act of sitting up in bed may take hours.

Persistent depressive disorder

Persistent depressive disorder (PDD) used to be called dysthymia. It’s a milder,

but chronic, form of depression.

In order for the diagnosis to be made, symptoms must last for at least 2 years.
PDD can affect your life more than major depression because it lasts for a longer
period.

It’s common for people with PDD to:

 lose interest in normal daily activities

 feel hopeless
 lack productivity
  have low self-esteem

Depression can be treated successfully, but it’s important to stick to your

treatment plan.

Situational depression

Situational depression, or adjustment disorder, occurs in some people who

experience a traumatic or life-altering event. Doctors diagnose it more often in
children and adolescents.

Examples of such events include:

 divorce
 being the victim of a violent crime
 job loss
 bereavement
 chronic illness

In children, stressful events may also include a family move, the birth of a sibling,
and the separation of parents.

To receive a diagnosis of situational depression, the person must show

symptoms of depression that a mental health professional would
consider unhealthy or excessive, given the situation.

While symptoms may resolve on their own, treatment is sometimes necessary to

prevent the depression from getting worse or becoming chronic.
Diagnosis
To diagnose any form of depression, a doctor will likely carry out one or more of
the following:

 a physical examination
 blood tests to check for physical conditions that may be causing symptoms
 a psychiatric evaluation, which includes checking a person’s symptoms
against the DSM-5

Treatment
Medication, therapy, and a combination of both are the most common treatments
for most types of depression.

However, some types of depression may respond well to other forms of

treatment. For example, light therapy can be effective for those with SAD.

Medication

Several types of antidepressant medications are available. People vary in their

response to different drugs, and there is often a period of trial and error before
they find the right medication or combination of medications.

Types of antidepressants include:

 selective serotonin reuptake inhibitors (SSRIs)

 serotonin-norepinephrine reuptake inhibitors (SNRIs)
 tricyclic antidepressants
 monoamine oxidase inhibitors (MAOIs)
  atypical antidepressants

Other medications that can be helpful include anti-anxiety drugs, antipsychotics,

and mood stabilizers.

Individuals should discuss the benefits and potential risks of antidepressant use
with their doctor.

Psychotherapy

Psychotherapy, or talk therapy, can be an effective treatment for depression.

One form of psychotherapy that may be helpful for those with depression
is cognitive behavioral therapy (CBT). Other forms may also be beneficial.

Therapy is most effective when people find the most suitable style of therapy and
the right therapist for them.

Psychotherapy can help people adjust to their life circumstances, challenge

negative thoughts, and learn healthy ways to deal with stress.

It can also give people the awareness to identify issues that contribute to their
depression and the space to set life goals.

Other treatments

In severe cases of depression, a doctor may recommend a form of brain

stimulation therapy, such as electroconvulsive therapy or transcranial magnetic
stimulation.

Light therapy can help people with SAD.

A doctor can recommend lifestyle changes to support depression treatment.

These can include:
  eating a healthful diet
 exercising regularly
 developing stress-management techniques

They may also provide people with information about local or online depression
support groups.

When to see a doctor

Individuals should see a doctor if they feel depressed, particularly if a low mood
persists for 2 weeks or more or if it happens regularly.

People should seek urgent help if they have thoughts of suicide or self-harm.

Anyone who thinks that they have postpartum depression should see a doctor
right away, especially if their symptoms make it difficult to care for the baby or if
they have thoughts of hurting themselves or the baby.

A doctor can support the person to care for the baby and themselves.

Summary
Depression is a very common mental health condition. There are several types of
depression, each of which has different symptoms.

Depression is treatable with medications and psychotherapy. Other treatments

may also be beneficial for some people.
Anyone who has concerns that they or a loved one may have depression should
see a doctor. The sooner a person receives treatment, the sooner they can start
to feel better.