DIFFERENT TYPES OF DEPRESSION REQUIRE DIFFERENT TREATMENT.
These categories might give you an indication of the types of depression but this information doesn’t replace the need to have a clinical diagnosis and treatment from a medical practitioner.
MAJOR DEPRESSION
This is the most common form of depression affecting approximately 7% of the adult American population at any given time (National Institute of Mental Health).
- Symptoms typically include extreme sadness, hopelessness, irritability, lack of energy, difficulty concentrating, feelings of guilt, physical pain, and thoughts of death or suicide. Sleep patterns can also be affected, either sleeping too much or sleeping too little. A person may struggle to get too sleep or else wake up in the early hours of the morning and not be able to fall asleep again. I’ve heard 3 a.m referred to as ‘the dark hour of the soul’. Not surprising as this can be the worst time for someone with depression. All around is darkness and silence as others sleep on. This is the time when thoughts seem to go out of ‘control’. Eating patterns can also change. A depressed person may be unable to eat or else they might overeat. Things that used to interest a person, no longer have any appeal, including sex. For an official diagnosis of depression, these symptoms need to last for more than two weeks.
- Treatment: Don’t try and go it alone. Major depression is also a physical illness. The brain chemical serotonin has been depleted and this is what is causing the negative thinking. The chemical needs to be replaced so the thinking can return to normal. The best treatment is antidepressant medication combined with cognitive therapy. Compliance with a doctor is essential and anyone threatening suicide needs to get to a hospital.
DYSTHYMIA
This is a less severe form of depression than major depression, affecting about 2% of the American population. It causes a low mood over a period of time (about a year). The person is able to function but just seems sad and melancholic. They don’t enjoy their lives and don’t function to their best ability. The person goes through life feeling unimportant, dissatisfied and frightened.
- Symptoms can include tiredness, sadness, trouble concentrating, and changes in appetite and sleep patterns.
- Treatment A combination of antidepressants and cognitive therapy can give the greatest improvement. Antidepressants normalize the brain chemicals.
POSTPARTUM DEPRESSION
About 13% of women are diagnosed with postpartum depression. It can occur anywhere from weeks to months after childbirth but will always develop within a year after giving birth.
- Symptoms include feelings of extreme sadness, fatigue, loneliness, hopelessness, suicidal thoughts, fears about hurting the baby, and feelings of being disconnected from the child.
- Treatment needs to be prompt and the depression needs to be taken seriously. One woman told me that on seeking medical help she was told that she had nothing to be depressed about as she had such a beautiful baby! My only advice would be to change your doctor. Treatment will need a combination of cognitive and drug therapy.
SEASONAL AFFECTIVE DISORDER
This form of depression typically occurs in winter climate and is connected to the lessening of natural sunlight. It could be described as wanting to go into winter hibernation and typically affects 4-6 % of the American population.
- Symptoms include a tendency to gain weight, feeling ‘blue’, having anxiety, irritability and daytime fatigue. The person also becomes socially withdrawn, not wanting to venture out.
- Treatment: This type of depression can be treated with artificial light treatment. Starting in early winter it usually lifts in spring.
ATYPICAL DEPRESSION
This form of depression is one of the most common types of depression and is probably under diagnosed. Atypical depression is slightly different from major depression in that the sufferer is sometimes able to experience happiness and moments of elation.
- Symptoms of atypical depression include irritability, fatigue, oversleeping, overeating and weight gain. Oversleeping and overeating are the two most important symptoms for making a diagnosis of atypical depression. People who suffer from atypical depression believe that outside events such as success, or getting attention and praise, control their mood. They have an external locus of control. Relationship difficulties are also common. Episodes of atypical depression can last for months or a sufferer may live with it forever. A common sign of atypical depression is a sense of heaviness in the arms and legs which feels like a form of paralysis.
- Treatment: Talk therapy seems to have success.
PSYCHOTIC DEPRESSION
Psychosis is a mental state characterized by delusions (false beliefs) or hallucinations (imagined sights or sounds). These are more commonly found in a person suffering from schizophrenia. Psychotic depression affects about 10-15% of depressed people.
- Symptoms: In addition to the ‘normal’ symptoms of depression, the person imagines frightening and negative sounds and images.
- Treatment is usually started with antidepressant medication and if necessary anti-psychotic medication can be added. Hospital treatment is often necessary to stabilize the patient.
BIPOLAR DISORDER
This used to be called manic depression as symptoms alternate between extreme lows and extreme highs. Bipolar depression has a genetic base and affects 2-3% of the population.
- Symptoms of mania include high energy, excitement, racing thoughts, and poor judgment. A feeling of being able to conquer the world is also typical. Poor judgment can include sexual promiscuity, overspending, alcohol and drug abuse. Untreated the highs can lead to psychosis.
- Treatment will usually include mood stabilizers to level off the extreme moods. Treatment is extremely important as without treatment, the highs get higher and the lows get lower. There is a high risk of suicide so medical compliance is extremely important.
PREMENSTRUAL DYSPHORIC DISORDER (PMDD)
PMDD, is a type of depression that affects about 5% of women during the second half of their menstrual cycles. The woman’s relationships, as well as her ability to function normally, can be badly affected during this time.
- Symptoms include depression, anxiety, and mood swings. It is more severe than the commonly known Premenstrual Syndrome or PMS which affects about 75 % of women. The symptoms of PMS are far milder.
- Treatment usually includes a combination of antidepressants, talk and nutrition therapies.
SITUATIONAL DEPRESSION
As the name implies Situational Depression is triggered by a stressful or life-changing event such as a trauma, losing a job, losing a loved one to death or a bad break-up. Situational Depression is also known as Adjustment Disorder and is fairly common.
- Symptoms may include sadness, worry, or nervousness. These are normal responses to a loss but if they don’t go away or if they worsen, a major depression could be indicated and medical treatment should be sought.
- Treatment: Medication is rarely needed unless a major depression develops. The person should be given the opportunity to talk about their loss so that they can work through their feelings of loss.