Depression is one of the most common ailments affecting human beings and is the leading cause of disability in the United States among people between the ages of 15 and 24. Majority (80%) of individuals who get treatment for depression show an improvement within 4-6 weeks. However, it is unfortunate that two thirds of the people suffering from depression neither seek nor receive any treatment.
Depression is typically characterized by a pervasive feeling of sadness and loss of interest in activities previously enjoyed. However, symptoms of depression vary significantly among individuals. For instance, many people with depression get very little sleep while others tend to oversleep and the same situation is with eating; most have decrease in appetite while some eat more and gain weight.
Several distinct types of depression have been identified. Seven common types of depression are:
Clinical Depression (Major depressive disorder)
This is the most common and classic form of depression diagnosed in most individuals suffering from depressive symptoms. Main symptoms are persisting sadness/tearfulness/emptiness/hopelessnessand loss of interest in previously enjoyed activities. Other symptoms can include: lack of energy or feelings of tiredness and fatigue, irritability or angry outbursts, sleep disturbance in the form of insomnia or sleeping too much, decrease in appetite with weight loss or increased eating with weight gain, difficulty focusing and concentrating, feelings of worthlessness or excessive guilt, frequent or recurrent thoughts of death/dying or suicidal thoughts or behavior and unexplained physical symptoms such as headaches or back pain.
According to the National Institute of Mental Health (NIMH), more than 17 million adults in the United States suffered from this type of depression in 2017.
This type of depression appears to be more common in woman than men and in young individuals between the ages of 18 and 25 years.
Chronic Depression (Persistent Depressive Disorder; Dysthymia; Dysthymic Disorder)
Individuals with this type of depression have symptoms of depression lasting more than 2 years. Although the symptoms are not as severe as in major depression but they are chronic lasting over a much longer period of time. Many individuals with this type of depression can function in their day to day lives but they often feel unhappy and unable to enjoy life. In addition to sadness, symptoms can include disturbance in sleep, appetite, level of energy and low self-esteem.
Chronic depression is also more common in woman than in men and affects between 1-2% of adults in the United States.
Pregnancy related depression (PostpartumDepression , Perinatal Depression, “Baby Blues”)
Postpartum depression is the onset of depressive symptoms within one year of childbirth. In this depression, the symptoms are very similar to major depression and it affects approximately 15% of new mothers. The symptoms typically appear within a month after childbirth and professional treatment is usually needed to get rid of the symptoms.
Some pregnant woman experience symptoms of depression throughout the course of their pregnancy and for this the term perinatal depression is often used which covers depressive symptoms occurring both during pregnancy and after childbirth.
Postpartum and perinatal depression should not be confused with much milder and more common phenomenon called “baby blues”. This usually occurs within the first 3 days after childbirth and lasts for a couple of weeks and then gets better on its own. It affects 60-80% of new mothers and the symptoms may include being worried or nervous about being a good mother, feeling sad or crying over little things, feeling moodier or cranky, having trouble sleeping, eating or making decisions and feeling overwhelmed or trapped.
Seasonal Depression (Major depressive disorder with seasonal pattern; Seasonal Affective Disorder)
This is the type of depression which occurs seasonally, the same time every year. Typically, the symptoms start in the fall and persist throughout the winter. It is more common in geographical areas which are farther away from the equator. However, there is a less common form of seasonal depression which starts in the spring and lasts through summer and is called summer onset seasonal depression. Common symptoms of seasonal depression are sadness, fatigue, social withdrawal and isolation and feelings of hopelessness. The treatment includes light therapy, psychotherapy and antidepressant medications or a combination of any of these 3 modalities.
It is estimated that more than 3 million cases of seasonal depression occur every year in the United States.
Situational Depression (Adjustment Disorder with depressed mood; Reactive Depression)
This type of depression occurs due to a stressful event in a person’s life such as breakup in a relationship (divorce), death of a loved one, having problems at work or losing job, or experiencing some other adverse or traumatic event in life. In young children and adolescents, this type of depression can happen even after the family’s move or birth of a younger sibling. Sometimes, this type of depression is also called reactive depression. This type of depression is diagnosed when a person develops depressive symptoms within 3 months of a stressful life event, feels more stressed than one normally would after such an event, and the symptoms interfere in the person’s relationships or his/her work or school. Although symptoms of situational depression can improve on their own, often treatment is needed to prevent the symptoms from getting worse or becoming chronic.
Depression due to other illnesses (Depressive Disorder Due to Another Medical Condition)
Depressive symptoms such as sadness, loss of interest in previously enjoyed activities, social isolation and withdrawal and feelings of hopelessness can be caused by underlying medical problems or use of certain drugs/medications. The medical conditions most often causing symptoms of depression include stroke and heart disease, chronic pain due to any cause, hypothyroidism and other hormonal imbalances, brain disorders such as multiple sclerosis, Parkinson’s disease and Alzheimer’s, HIV infection and the use of some medications (anti-seizure medications such as Zarontin, beta blockers such as Atenolol &Metoprolol, benzodiazepines such as Ativan & Xanax, Interferon, statins such as Lipitor & Zocor, and many other types) as well as alcohol and illicit/recreational drugs. As such, it is always prudent to rule out any possible medical cause in a person suffering from symptoms of depression. This is important because undiagnosed and untreated medical conditions can make traditional treatments of depression ineffective and untreated depression can make recovery from the medical condition moredifficult.
Atypical Depression (Major Depressive Disorder with atypical features)
Depression isn’t always the same for everyone. In atypical depression, the symptoms are quite different from typical symptoms of depression. In typical depression, the person continues to feel depressed regardless of the situation and circumstances but in atypical depression the person’s mood gets better when something good happens. Also, people with atypical depression can be very sensitive to rejection from others. Other features of atypical depression include increased appetite with weight gain, increased sleep, and a feeling of heaviness in the arms or legs (called leaden paralysis). This type of depression seems to be more common in young people and those who have anxiety and bipolar disorder. The treatment for atypical depression is pretty much the same as that of other forms of depression including medications and psychotherapy