Reading up on depression can be extremely confusing when all you want to know is:
Why do I feel like this?
What’s wrong with me?
Where can I get some help?
There are so many different types of depression, theories and facts that it’s hard to make sense of it all.
This article organizes the most common facts into bite size pieces to better understand the three main types of depression together with their respective symptoms and, help you decide if you’re having a bad few days or, you really do have depression.
Read on to find out exactly what depression is.
Depression is known as a ‘mood disorder’
This is probably the best description of depression because it is a disorder, which affects our mood.
This description is a lot more wholesome and directive than the commonly used ‘mental health disorder’ or ‘mental health illness’. Both of these titles lean in to the idea that it’s our brain that’s messed up and that can illicit fear in those of us who suffer from depression.
Mood disorder, on the other hand, better describes what depression is because it really is a mess up of the mood, emotions and resultant distorted thinking. The brain chemical imbalance then comes as a result of the depression, not the other way round as some medics may have us believe.
So what are the more common mood disorders and how can I find out which one I have?
In the latest version of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5)[i], which is used by clinicians to diagnose mood disorders, the authors address three core categories of depression: major depression, dysthymia and bi-polar.
Here’s an explanation of each of them:
1. Major Depression
Major depression refers to the depression that comes in bursts and then dissipates after a relatively short time.
During this time we can feel heavy, sad, burdened and experience a loss of interest in things that once were enjoyable. Our appetite changes, we might feel exhausted but suffer insomnia and have trouble concentrating.
We may suffer from guilt, shame and feelings of worthlessness. We may even consider suicide because we feel worthless and that life isn’t worth living.
This type of depression can be frightening because it seemingly springs out of nowhere.
Once you’ve experienced major depression, untreated, it often comes back after a certain amount of time. It can seem to return out of the blue with no rhyme nor reason as to why.
Do I have the classic symptoms of major depression?
Here’s a checklist to see exactly what a doctor will ask you to establish whether or not you have major depression according to the National Institute of Mental Health[ii].
If you have been experiencing some of the following signs and symptoms most of the day, nearly every day, for at least two weeks, you may be suffering from depression:
Persistent sad, anxious, or “empty” mood
Feelings of hopelessness or pessimism
Feelings of guilt, worthlessness, or helplessness
Loss of interest or pleasure in hobbies and activities
Decreased energy or fatigue
Moving or talking more slowly
Feeling restless or having trouble sitting still
Difficulty concentrating, remembering, or making decisions
Difficulty sleeping, early-morning awakening, or oversleeping
Appetite and/or weight changes
Thoughts of death or suicide, or suicide attempts
Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment
Not everyone who is depressed experiences every symptom. Some people experience only a few symptoms while others may experience many.
Several persistent symptoms in addition to low mood are required for a diagnosis of major depression.
However, people with only a few – but distressing – symptoms may benefit from treatment of their “subsyndromal” depression indicating that a person's depressive symptoms don't quite meet the criteria for a diagnosis of a major depressive episode.
This is quite common and tends to relate to those who have two or more symptoms of depression of the same intensity as in major depression.
The severity and frequency of symptoms and how long they last will vary depending on the individual and his or her particular illness. Symptoms may also vary depending on the stage of the illness.
Dysthymia is a type of depression that is much longer lasting but not as intense. If major depression is the dark, foreboding black cloud, then dysthymia is the light grey cloud that’s less menacing but stays put for a long time.
According to the American Psychiatric Association’s Diagnostic
Manual, Dysthymia lasts for at least two years with an average of five years.
It’s also known as Persistent Depressive Disorder or PDD. This type of depression presents the same emotional and physical problems as major depression but although they are less severe they last much longer.
Do I have Symptoms of Persistent Depressive Disorder or Dysthymia? Here’s a checklist to establish whether or not you have Dysthymia according to the National Institute of Mental Health[iii].
The symptoms of dysthymia are very similar to those of major depression but for the key difference that dysthymia symptoms are chronic and usually occur every day for at least two years.
These symptoms include:
Persistent feelings of sadness and hopelessness
A change in appetite
A lack of interest in daily activities
A negative attitude
Avoidance of social activities
The symptoms of dysthymia are often rooted in childhood and begin to appear in adolescence.
Children and teens with dysthymia may come across as irritable, moody, or pessimistic over an extended period. They may also display behavioural problems, show poor performance at school, and have difficulty interacting with their peers in social situations.
The symptoms may spike and fade over several years and the severity will vary over time.
Commonly known as ‘manic-depressive’ mood disorder, bipolar causes fairly extreme and unusual changes in behavior, mood, energy levels, activity and the ability to carry out day-to-day tasks.
What universally indicates bipolar is the extreme mood swings from high to low, or manic to depressive.
Do I have symptoms of bipolar? Here’s a checklist to establish whether or not you have bipolar according to the National Institute of Mental Health[iv].
Bipolar manic symptoms:
Increased Energy levels
Increased activity levels
Needing little sleep
Mind is spinning round like a washing machine
Have no concern about taking risks like spending money or having sex with strangers
Bipolar depressive symptoms:
Feel generally depressed
Eating to much or too little
Feeling sad and hopeless
Have thoughts about suicide
Crying a lot
It is possible for someone with bipolar to experience both manic and depressive symptoms at the same time. This has a special name: episode with mixed features. It is possible to feel energised as well as feeling hopeless.
Of course these are general classifications according to the American Psychiatric Association. Everyone’s unique and often cannot be put in a tick box scenario.
I don’t recognize any of those types of depression. Can I be suffering from something else? Here’s a list of other types of depression or mood disorders.
It’s important to recognise other types of depression that are less prevalent and discussed but just as devastating.
Postpartum depression (PPD) also known, as postnatal depression is a type of depression associated with low mood after a child is born. It can affect both sexes and the symptoms include sadness, low energy, anxiety, crying episodes, irritability, and changes in sleeping or eating patterns.
Seasonal Affective Disorder is a depression in which people who have normal mental health throughout most of the year exhibit depressive symptoms in winter.
Atypical Depression is now seen as a sub type of major depression and is identified by responding with a lifting of the mood in response to positive events.
Psychotic Depression describes an episode of psychotic symptoms where people experience the usual symptoms of depression, plus delusions and hallucinations.
Premenstrual Dysphoric Disorder is a more severe version of premenstrual tension where severe depression symptoms, irritability, and tension happen up to two weeks before menstruation.
Am I The Only One Who Feels Like This? Take Heart, Depression is much more common than you may think.
If you are depressed, don’t worry, you are not alone. The World Health Organization (WHO) states that by 2030 depression will be the leading cause of ill health worldwide.
Depression is called the ‘silent killer’ because the shame that surrounds sufferers often prevents them from getting help.
However, things are changing and the WHO also states that depression is no longer thought of as a ‘self indulgence’, with sufferers who should ‘pull their socks up’, but is recognized as a real threat to emotional, mental and physical health. Those of us who’ve suffered know exactly what that means.
Here are the current annual figures according to the NIMH[v]:
According to statistics and research, in a given year, these three moods disorders affect over twenty five million Americans or more than 10% of the population at any one time.
The findings also reveal that major depression is the leading cause of disability, the average age for the onset of major depression is 32 years old and it’s most prevalent in women.
My depression just comes out of the blue. Is this normal? A final note on how depression can take you by surprise.
Some of us suffer from depression that comes out of nowhere, has no identity and simply jumps on us, hijacking us, then leaving us asking: where the hell did that come from???
To try and work out the analytics of this type of depression is a waste of energy. It’s better to simply accept it, and roll with the black clouds. For that is what depression is, a series of black clouds that descend upon us and no matter how much we swing your arms around like a windmill, it makes no difference.
The best thing we can do to beat depression is to simply accept it because allowing the depression to be - as it is - is the fastest way to dissolve it.
This article isn’t a substitute for medical treatment or professional therapies. It’s information to work alongside other forms of help. If you want to stop any medical treatment, please see your doctor.