Depressive disorders, or mood disorders, are the second most common type of mental health diagnosis after anxiety disorders, affecting an estimated 8.4 percent of adults and 17 percent of adolescents. But what exactly defines depression? What are the types of depression? And how does it develop in people?
For starters, depression has grown in prevalence over time, as widespread recognition of the condition and its effects in daily life have helped millions seek help instead of suffering quietly.
Yet despite growing awareness, only about a fifth of people who need treatment have access to it, and while public knowledge of depression has grown as of late, people are still unaware of the many forms a depressive illness can take and their major differences.
What is Depression?
Depression is a condition characterized by a consistently low mood. It is not just a prolonged state of sadness, but a shift downward in a person’s emotional baseline. When someone is depressed, it is as though their normal state is to feel low.
Depression can come and go but may also be chronic, meaning it lasts for six months or longer. Some forms of depression are stronger around a certain period – such as seasonal depression or premenstrual depression – while other forms are not tied to any specific time and are consistent.
Depression can range in severity, from a generalized low feeling to thoughts of suicide, self-harm, self-hatred, and unexplained feelings of guilt.
While most mood disorders share certain risk factors and treatment programs, there are differences in the ways certain forms of depression are diagnosed, recognized, and treated.
Seasonal affective disorder may be treated with phototherapy, for example, while peripartum depression and premenstrual dysphoric disorder (PMDD) treatment may include the use of allopregnanolone and other forms of hormone therapy. Some people respond well to modern antidepressants, while others respond better to older drugs such as MAOIs or tricyclic antidepressants or need an alternative treatment.
What are the Types of Depression?
Let’s explore some of the ways depression can develop in people.
Major Depressive Disorder
Major depressive disorder is the most common form of depression. It characterizes cases of depression that are not otherwise described by more specific mood disorders, where depression is the primary symptom (meaning it is not the result of a different physical or mental health issue). Major depressive disorder often co-occurs with an anxiety disorder, such as social anxiety disorder or generalized anxiety disorder, and may co-occur with a substance use disorder. Some of the symptoms of major depressive disorder include:
- Two or more episodes of depressive thinking and a consistently low mood over a period of multiple weeks.
- Self-depreciating thoughts.
- Low energy or constant fatigue.
- Slurred speed and slowing down of physical activity, without drinking or other causes.
- Sudden change in appetite and weight (gain/loss).
- Loss of interest in hobbies.
Premenstrual Dysphoric Disorder (PMDD)
Premenstrual dysphoric disorder, or PMDD, is a more severe form of PMS. It is a powerful and debilitating mood disorder that affects women around the luteal phase of their cycle, after ovulation, and before their next period.
Women with PMDD experience stronger, more negative shifts in mood than other forms of PMS and tend not to experience episodes of depression outside of their period. PMDD is a lifelong condition and may be hormonal in nature. For some clients, hormone treatment – including birth control – can be an effective treatment plan. In other cases, it can make symptoms worse. Antidepressants and therapy are also used to help teens and adults cope with PMDD symptoms.
Seasonal Affective Disorder
Seasonal affective disorder is a form of depression that centers around a certain time of year. Most forms of seasonal depression center around the winter holidays, but seasonal affective disorder can also affect people during summer, especially in late summer before school starts again or during peak summer due to inordinate heat.
Treatments for seasonal affective disorder depend on when a person’s depression is at its strongest. For clients who experience the most depression around the winter solstice, light therapy or phototherapy, in addition to vitamin D supplementation, can help reduce symptoms.
In many cases, talk therapy can also help clients who feel depressed due to the stressors of the holidays, being alone around the holidays, or are stressed about their return to school or work.
Bipolar disorder, previously known as manic depression, is a mood disorder that includes episodes of depression and mania. Mania is a form of mood disorder that involves an extraordinarily high mood rather than a consistently low mood.
While manic symptoms can be synonymous with productivity and joy, they usually also include negative aspects such as restlessness, insomnia, delusions of grandeur, irritability, aggression, and anxiety or panic.
Clients with bipolar disorder usually experience a major shift towards depression or mania several times per year, but no more than three or four. More frequent shifting is also known as rapid-cycling bipolar disorder. Treatments for bipolar disorder include mood-stabilizing medication, such as lithium.
Persistent Depressive Disorder
Where major depressive disorder is used to describe generalized depressive symptoms, long-term or chronic depression (lasting more than a year) is known as persistent depressive disorder.
Most cases of persistent depressive disorder are less severe than major depressive disorder but may be a lifelong condition.
Peripartum depression occurs in women during and after pregnancy. It is usually caused by a confluence of factors, including stressors before and after birth, work-related anxieties, and hormonal changes after birth. While peripartum depression is commonly known as postpartum depression, symptoms can also begin before birth.
Not all forms of depression are effectively treated through first-line therapies, such as antidepressant medication and cognitive behavioral therapy. About a fifth of clients who seek treatment for depression do not find these therapies to be effective and are thus diagnosed with treatment-resistant depression.
Certain treatment methods are particularly effective in cases of treatment-resistant depression, including ketamine therapy, repetitive transcranial magnetic stimulation, and vagus nerve stimulation. If you have been working with a psychiatrist and haven’t found an effective treatment for your depression yet, ask them about treatment-resistant depression and related therapies.
Depressive disorders can be debilitating, but they are also often treatable. Getting help as early as possible can result in better outcomes and a better chance at a higher quality of life.