Over 280 million people around the world suffer from some type of depression, making it one of the most common mental illnesses in the world. [1]
Most people have at least a vague awareness of what depression is. To define it in the most basic sense, depression is a diagnosable mental illness that makes people feel sad, apathetic, or down. What you may not have known is there are many different types of depressive disorders.
The different types of depression have many symptoms in common, but vary in important ways. It’s critical to know the differences between the types, because they’re often treated in different ways. What works for one may not work for another.
Here’s your comprehensive guide to the 10 most common types of depression. Remember: The only true way to know which depressive disorder you have is to see a mental health professional for a diagnosis.
Major Depressive Disorder
Often, when people talk about having “clinical depression,” they’re referring to major depressive disorder.
Major depressive disorder is one of the most common, and most serious, types of depression. To be diagnosed with major depression, you must experience the following symptoms almost every day:
- Sad or depressed mood
- Loss of interest in activities you used to enjoy
- Feelings of worthlessness, hopelessness, or guilt
- Fatigue
- Being so sluggish or agitated that people start noticing
- Having trouble focusing
- Changes in sleep habits; either sleeping too much or too little
- Weight loss or gain, usually caused by changes in eating habits
- Thoughts about death or suicide
When you go through a period of two or more weeks with the above symptoms, you may be diagnosed with a major depressive episode. Some people just go through one depressive episode in their lifetime. Others experience depressive episodes more frequently, or very rarely experience days without these symptoms.
Some other signs you’re going through a major depressive episode include:
- Withdrawing from your friends and family
- Being unable to feel joy, even during happy events
- Not having an appetite
- Increased drug or alcohol use
- Low self-esteem
- Reduced sex drive
In 2019, almost 8% of all U.S. adults suffered from at least one major depressive episode. Many more women suffer from major depression than men. Young adults, between the ages of 18 and 25, have the highest rate of major depression. Up to 1 in 4 people will go through at least one depressive episode at some point in their lives. [2]
If any of the above symptoms sound familiar to you, it’s important that you get mental health support as soon as possible. Major depressive disorder is a serious, and debilitating, mental health condition—and it’s unlikely that it will improve without treatment.
Treatment for major depressive disorder
The most highly recommended treatment for major depressive disorder is a combination of psychotherapy and medication.
Psychotherapy can help people with clinical depression learn how to manage their symptoms. A type of therapy called cognitive behavioral therapy is one of the most effective ways to treat depression.
Antidepressant medication is also effective. There are several types of antidepressants, including:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin norepinephrine reuptake inhibitors (SNRIs)
Bipolar Depression
Bipolar disorder is a serious mood disorder that causes people to swing between two extreme moods: depression and mania (or hypomania). This is in contrast to major depressive disorder, or unipolar depression, which does not cause mania. People are not diagnosed with bipolar disorder if they only experience depressive episodes. They must experience both types of moods to meet the diagnostic criteria.
Signs of a manic episode include:
- Intense feelings of elation, restlessness, or agitation
- Racing thoughts
- A decreased need for sleep
- High energy levels
- Impulsive or risky behaviors
- Loss of appetite
- Talking very fast and changing subjects
The symptoms of a depressive episode that are part of bipolar disorder are the same as the symptoms of a major, or unipolar, depressive episode.
People with bipolar disorder can experience a depressive episode either before or after having a manic episode. Some people with bipolar disorder have only one manic episode in their lives, but experience several, or chronic, depressive episodes. Others experience mania far more often than they do depression.
Bipolar disorder is far less common than major depressive disorder, but it is still more common than you might think. Around 2.8% of the U.S. adult population suffer from bipolar disorder. [3]
Both the manic and depressive “poles” of this disorder can be debilitating and even life-threatening. In fact, bipolar disorder is one of the most fatal mental illnesses that exists. The suicide rate (both attempts and deaths) for bipolar disorder is twice as high as the rate for major depressive disorder. The only other mental illness that has a higher death rate than bipolar disorder is schizophrenia.
Treatment for bipolar depression
Depression as part of bipolar disorder needs to be treated differently than unipolar depression, especially when it comes to medication. Antidepressants, which are so commonly used in the treatment of major depressive disorder, carry the risk of pushing someone with bipolar disorder into a manic episode.
Bipolar disorder is usually treated with a combination of therapy and medication (mood stabilizers or atypical antipsychotics). If depression symptoms don’t go away even after the mania is managed, a person with bipolar disorder might be prescribed antidepressants (under a doctor’s supervision).
Persistent Depressive Disorder (Dysthymia)
Persistent depressive disorder is diagnosed when depression just won’t go away. It’s a relatively new diagnosis that is a combination of two earlier diagnoses: dysthymic disorder and chronic major depression.
In comparison to major depressive episodes, when symptoms are severe and acute, the symptoms of persistent depressive disorder can sometimes be less intense overall (although not always). But major depressive episodes sometimes last as little as two weeks; to meet the diagnostic criteria for persistent depressive disorder, you must have symptoms of depression for more than two years.
The symptoms of persistent depressive disorder are similar to those of major depression. They include:
- Depressed mood, almost all day every day, for two years (one year for children and teens)
- Changes in eating and/or sleeping habits
- Fatigue
- Loss of interest in previously enjoyable activities
- Trouble with concentration
If you’ve battled against these symptoms for many years, then you may have persistent depressive disorder.
Treatment for persistent depressive disorder
Although living with persistent depressive disorder may feel like it will never go away, that doesn’t have to be the case. There are effective treatments for this condition. The treatments for major depressive disorder, including antidepressant medication and psychotherapy, are also used for persistent depressive disorder.
Perinatal Depressive Disorder (Postpartum Depression)
Many women who give birth suffer from perinatal depressive disorder, more commonly known as postpartum depression. Although there’s still a serious stigma against talking about postpartum depression, it’s extremely common: up to 1 in 9 women suffer from it. [4]
It’s normal to feel down or stressed after having a baby. Taking care of a newborn is incredibly challenging, especially when you’re recovering from pregnancy and childbirth. Many women don’t feel that new-mother bliss they expected to feel after the arrival of their little one, a phenomenon that’s colloquially called the “baby blues.”
But if you’ve noticed your feelings of sadness or anxiety after having a baby are intense, or don’t start going away with time, then you may be experiencing something that’s more serious than the baby blues. It might be postpartum depression.
Men and women can both experience peripartum depression, with higher incidents in women who have given birth.
Postpartum depression can come on during pregnancy or after childbirth. Some signs of postpartum depression include:
- Experiencing the symptoms of a major depressive episode
- Having a hard time bonding with your baby
- Having thoughts of hurting yourself or your baby
- Feeling intense anxiety or fear about parenting; feeling like you’re not a good parent
- Intense irritability or anger
- Overwhelming fatigue or tiredness
Many different factors can contribute to postpartum depression, including:
- Hormonal changes that come along with pregnancy and childbirth
- A lack of time for regular self-care practices
- Being sleep-deprived
- Body changes leading to lower self-esteem
Other things, like having a personal history of depression before your pregnancy, can put you at higher risk for developing peripartum depression.
Treatment for postpartum depression
If you’ve experienced any of these signs, especially if they haven’t gone away for over two weeks, it may be time to seek help. Postpartum depression can be treated successfully with a combination of psychotherapy and antidepressant medication. Talk to your doctor about which medications are safe to take while pregnant or breastfeeding. With the right treatment, you can overcome this potentially terrifying disorder and start feeling better about being a new parent.
Silent Depression in Relationships
Break free from silent depression. In this podcast, Dr. Jantz explores the hidden reality of silent depression. Listen to the episode to understand how this depression can manifest within relationships and its impact on emotional well-being. Discover the path to recognition and healing, particularly in long-term marriages, and reclaim emotional vitality by breaking free from the isolation of silent suffering.
Listen to PodcastPremenstrual Dysphoric Disorder
Many people experience mood swings as part of premenstrual syndrome (PMS). But for some people, problems with mood and mental health at certain times in their menstrual cycles become more severe. When someone experiences symptoms of depression only at some points during their monthly menstrual cycle, they may be diagnosed with premenstrual dysphoric disorder, or PMDD.
Although PMS and PMDD have many symptoms in common, PMDD is a much more severe and debilitating condition. The depression that people with PMDD face seriously disrupts their lives.
The symptoms of PMDD usually come on a week or two before you get your period, and go away within a few days after your period starts. Signs and symptoms of PMDD include:
- Intense irritability or anger
- Sadness and despair
- Anxiety, worrying, or panic attacks
- Trouble sleeping
- Changes in appetite; specific food cravings and binge eating
- Severe mood swings, which may lead to frequent crying
- Feeling out of control
- Lack of concentration
- Fatigue
- Physical symptoms of PMS, such as breast tenderness, bloating, and cramps
Up to 5% of women of childbearing age experience PMDD.
Treatment for premenstrual dysphoric disorder
Luckily, there is treatment available. Your doctor may guide you to take birth control pills to prevent hormone changes that may be leading to symptoms of PMDD. You can also receive treatment to address the depression itself, including medication and psychotherapy.
Seasonal Affective Disorder
People with seasonal affective disorder, or SAD, also only experience depression symptoms at some times during a cycle. But in contrast to people with PMDD, whose moods fluctuate depending on the body’s menstrual cycle, people with SAD experience depression according to seasonal cycles during the year.
The symptoms of SAD are the same as those of major depressive disorder. The difference between them is that SAD symptoms are triggered by seasonal changes. Additional signs of SAD (in the winter) include:
- Hypersomnia, or sleeping too much
- Overeating or an increased appetite
- Weight gain
- “Hibernating,” or withdrawing from social connections
Most often, people with SAD get depressed during the darker winter months. But this isn’t always the case — some people get symptoms during the summer. On top of the symptoms of depression, other signs of summer-pattern SAD include:
- Insomnia, or not being able to sleep
- Lack of appetite
- Weight loss
- Restlessness, agitation, and anxiety
It’s also important to note that SAD is more serious than just the “winter blues.” Many people feel down-in-the-dumps in the cold, dark winter. But if you live with SAD, these feelings can become overwhelming and debilitating.
Millions of people suffer from SAD around the world, although the exact number is unknown. Unsurprisingly, it is more common in Northern areas, where the days get much shorter during the winter months.
Treatment for seasonal affective disorder
If seasonal affective disorder is triggered by the dark winter months, it may be treated with phototherapy, or light therapy. Light therapy uses simulated sunlight (created by a very bright device called a “light box”) to make up for the lack of daylight during the winter.
Like most other depressive disorders, psychotherapy and antidepressant medication are also effective forms of treatment for SAD.
Depression with Psychotic Features
Usually, depression only consists of the symptoms (like a low mood and fatigue) that we’ve already talked about here. Sometimes, however, depression can take on features of other mental illnesses — including psychotic disorders.
Psychosis is a mental health condition that causes people to lose touch with reality. The two main symptoms of psychosis are:
- Hallucinations
- Delusions
Hallucinations are seeing, hearing, or feeling things that aren’t actually there. This could look like a person hearing someone whispering their name (when no one is there) or seeing figures or things around them that aren’t really there.
Delusions are thoughts that are out of touch with reality. For example, someone may think that aliens are looking for them or that their television is speaking directly to them.
Major depressive disorder with psychotic features is diagnosed when someone meets the diagnostic criteria of MDD, but also experiences psychosis as part of their condition. [5]
Depression with psychotic features is a lot more common than you might think. Up to 1 in 5 people with depression are thought to also suffer from psychosis.
Treatment for depression with psychotic features
Currently, there is no FDA-approved treatment for major depression with psychotic features. However, both antidepressants and antipsychotic medication (which are used in the treatment for psychotic disorders like schizophrenia) can be effective in helping people manage their symptoms. Electroconvulsive therapy (ECT), a brain stimulation therapy, is also sometimes used.
Adjustment Disorder with Depressed Mood (Situational Depression)
Depression can be caused by a variety of different factors, including genetics, biology, and environment. Sometimes, a specific situation in your life causes you to feel depressed. For example, maybe you moved to a new city, or are going through a difficult break-up. It’s not hard to see how these types of situations might cause symptoms of depression.
If depression is caused by a stressful life event, then you may get diagnosed with “adjustment disorder with depressed mood,” or what is colloquially known as situational depression. Adjustment disorder is a diagnosis that is used when someone doesn’t have a chronic mental illness, but feels overwhelmed and stressed because of something going on in their lives.
To be diagnosed with an adjustment disorder, you must:
- Experience emotional or behavioral hardship no later than three months after a stressful event in your life
- Feel emotional distress that is disproportionate to the nature of the event (for example, grieving after the loss of a close family member is normal, and wouldn’t meet the diagnostic criteria for adjustment disorder)
- Experience these symptoms for no longer than six months after the stressful event.
Treatment for adjustment disorder with depressed mood
Usually, adjustment disorder is treated with psychotherapy. Therapy can help people process the stressful event and learn how to manage their temporary symptoms of depression. Because adjustment disorder is, by definition, a temporary condition, short-term, focused therapy methods are often used.
Atypical Depression
Major depression with atypical features, or atypical depression, is a diagnosis that’s used when the symptoms of depression don’t line up with what you would expect to see. As we’ve already reviewed, depression usually causes people to feel low,, fatigued, or apathetic. Sometimes, however, depression can present differently.
The unique symptoms of atypical depression include:
- Mood reactivity, or when your symptoms of depression go away or lift when there’s a happy event in your life
- Increased appetite and weight gain
- Hypersomnia, or sleeping too much
- Feeling a heaviness in your arms and legs
- Feeling extra-sensitive to rejection
Despite its name, atypical depression is actually not rare at all. In fact, it is the most common type of depression that is seen in outpatient clinics.
Treatment for atypical depression
Atypical depression is usually treated with psychotherapy. Antidepressant medications are also helpful. Although SSRIs are the most common, and generally safest, type of antidepressants prescribed, some studies show that monoamine oxidase inhibitors (MAOIs) might also be helpful for this subtype of depression.
Treatment-Resistant Depression
Treatment-resistant depression is not an official clinical diagnosis. Rather, it is a term used to describe situations in which a person with depression doesn’t feel better, even after going through all of the first line treatments (including medication and psychotherapy). Unfortunately, treatment-resistant depression is all-too-common; around 30% of people with depression don’t respond to initial treatment. [6]
Having treatment-resistant depression is especially challenging. It is easy for people with treatment-resistant depression to start feeling hopeless about recovery; like no treatment will ever be able to help them.
But even if your depression hasn’t responded to traditional treatments, there is hope. New, innovative treatments are being created all the time, and many of them have been found to be effective for even the most stubborn depression symptoms.
Treatment for treatment-resistant depression
If you’ve been told you have treatment-resistant depression, that means that, by definition, traditional treatment methods for depression (like psychotherapy and medication) haven’t helped you.
Don’t give up hope. Some other, more innovative treatments you can try next include:
- Transcranial magnetic stimulation (TMS)
- Electroconvulsive therapy (ECT)
- Ketamine
All of these treatments have accounts of being effective for treatment-resistant depression. You may also consider a new medication or a higher dose.
Depression Treatment at The Center • A Place for HOPE
No matter what type of depression you’re suffering from, we can help. At The Center, you will find a safe and respectful environment where you can focus on overcoming even the most stubborn of depression symptoms.
Our unique Whole Person Care approach ensures your depression treatment will address the physical, emotional, intellectual, relational, and spiritual elements of your life. In this way, you can start healing from all of the different ways that depression has affected you.
Contact us today to learn more about how we can help you overcome depression and start living the life you deserve.
[1] https://www.who.int/news-room/fact-sheets/detail/depression
[2] https://www.nimh.nih.gov/health/statistics/major-depression
[3] https://www.nimh.nih.gov/health/statistics/bipolar-disorder
[4] https://www.womenshealth.gov/mental-health/mental-health-conditions/postpartum-depression
[5] https://www.nhs.uk/mental-health/conditions/psychotic-depression/
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6982454/
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