Depression, though one of the most common forms of mental illness in the world, is still vastly misunderstood. In part, this is because it’s difficult to differentiate between the intermittent episodes of sadness everyone experiences at some point and the deeper, more serious feelings of sadness that arise in clinical depression — something only those who experience it can really comprehend.
Researchers aren’t always sure what causes depressive disorders, but genetics, abuse, medications, and major life events all have the potential to contribute to an episode of depression. That said, the illness also appears in many forms, each with its own symptoms and different levels of severity, which can make it even more difficult for doctors to study and patients to deal with.
6 Different Types of Depression
The most well-known kind of depression, major depressive disorder affects almost 7 percent of American adults in a given year. A doctor may diagnose you with this kind of depression if you experience symptoms on most days, or the majority of the time. Symptoms usually include a loss of interest in things you used to enjoy, heavy feelings of sadness, guilt, or worthlessness, and trouble concentrating. If left untreated, major depression can spiral into thoughts of suicide, and even suicide attempts.
The hallmark of major depression is its all-consuming quality — even though you may only experience one bout of major depression in your life, that episode will include symptoms that affect you at every time of the day, nearly every day. Some patients have described the feeling as being on “autopilot,” or as if there was something heavy on their chest that they couldn’t move.
Persistent Depressive Disorder
Historically known as dysthymia, this form of depression occurs when depressive symptoms become chronic. Though the symptoms can be very similar to major depressive disorder, those with the persistent variation may have less severe symptoms, but for a more extended period — sometimes defined as two years or longer.
Doctors have not identified an exact cause of the disorder, but it does sometimes run in families. Some medications work for persistent depressive patients, but they may take longer to work or be less effective than in major depressive patients because of how entrenched the symptoms are.
Bipolar disorder is frequently misdiagnosed as major depression. This illness consists of two distinct mood episodes: one very similar to major depression, in which the patient feels sluggish, hazy, and unmotivated; and one described as “manic,” marked by high energy and feelings of euphoria. These moods can last for only a couple hours, or extend for months at a time — every patient experiences mood swings differently.
Oftentimes, patients first notice their symptoms when a depressive episode occurs. For this reason, doctors who don’t get a full history of their patient’s behavior and moods through an interview can misdiagnose the person as only depressive. Medications like lithium, a common mood stabilizer, can help patients control their moods.
Psychotic depression is a unique form of depression that is accompanied by psychosis — a mental break with reality. Of those diagnosed with some form of depression, anywhere from 14 to 50 percent may experience psychotic symptoms, which include hallucinations, paranoia, or delusions.
Unlike other mental illnesses that present with psychosis,like schizophrenia, psychotic depression specifically causes psychosis with depressive themes. For example, a person may exclusively hear voices telling them that they’re useless or worthless, whereas someone with psychosis related to other illnesses might feel like they’re being watched by a doppelganger or that someone they know has been replaced by an impostor.
A clinician may prescribe a combination of antidepressants and antipsychotic medications to get the illness under control, along with using talk therapy to work through feelings of shame or humiliation over the patient’s symptoms.
Postpartum depression affects about 15 percent of women who give birth, saddling them with a severe form of depression that manifests within four weeks after delivery. This form of depression can cause classic symptoms, but tearfulness and trouble sleeping are especially common.
Postpartum depression can occur in both mild — a slight blue feeling after giving birth — and severe forms. In the most serious cases, women may feel incapable of taking care of their child, or have thoughts of harming the baby. In these cases, immediate professional help is essential: your Ob/Gyn or primary care doctor will know where to start.
Seasonal Affective Disorder
Seasonal affective disorder is more than feeling glum because the weather is nasty. Those with this form of depression usually notice their symptoms around the same time every year: beginning in the fall and continuing through the winter. Patients may feel irritable, sleepy, or generally low on energy during this time, in addition to other common symptoms of depression.
This depressive haze will then lift, however, as the season changes back to warmer, lighter weather. Seasonal affective disorder can manifest in anyone, but it is more common in those living in areas that have very few hours of sunlight during the winter. For this reason, light therapy is a popular treatment for the illness — it can help regulate the body’s biological clock and the release of serotonin.