Depression is more than just feeling sad. Everyone feels low, upset, or unmotivated from time to time, but depression is much more than simply being down in the dumps. Depressive disorder is a mood disorder that affects how a person thinks, feels and behaves. Signs and symptoms of depression can range from hopelessness and fatigue, to a loss of interest in life, physical pain, and even suicidal thoughts. The DSM-5 definition of depression states that should a person present with these symptoms for a period of two weeks, the individual is experiencing a depressive episode.

There are many different types of depression, some of which are caused by events in your life, and others by chemical changes in the brain. Depression can be thought of as an umbrella term for a variety of disorders, some of which are caused by certain life events or situations, and others by chemical changes in the brain. What’s more, while some of the symptoms associated with the various depressive disorders overlap, there are also some key differences.

With the term ‘depression’ encompassing so many types of depression, if you think you might be depressed, you may be asking yourself: what kind of depression do I have?

Gaining a deeper understanding of the different types of depression can help to begin the journey to diagnosis and recovery. Taking some time to consider the root of where your depression comes from will assist you greatly when you feel ready to talk to a doctor or other mental health professional about depressive disorder. Remember, it is vital that you seek help from a doctor to get an accurate depression diagnosis and receive the treatment and support you need.

Major Depression (Clinical Depression)

Major depressive disorder, also known as unipolar or clinical depression, is characterized by a persistent feeling of sadness or a lack of interest in outside stimuli. You might have this type of depression if you have five or more of the following symptoms on most days for 2 weeks of longer. At least one of the symptoms must be a depressed mood or loss of interest in activities.

  • Loss of interest or pleasure in your activities
  • Feelings of worthlessness or guilt
  • Negative thinking with inability to see positive solutions
  • Feeling restless or agitated
  • Inability to focus
  • Lashing out at loved ones
  • Irritability
  • Withdrawing from loved ones
  • Increase in sleeping
  • Exhaustion and lethargy
  • Morbid, suicidal thoughts
  • Weight loss or gain

Your Questions Answered

  • What is a major depressive episode?
    A major depressive episode is a period of two weeks or longer in which an individual experiences the symptoms of major depression such as hopelessness, loss of pleasure, fatigue, and suicidal thoughts. In particular, the person must experience a low mood and/or a loss of interest in activities.
  • Is major depressive disorder curable?
    Major depressive disorder is a condition that can ebb and flow across a person’s lifetime. Major depressive disorder is therefore not considered “curable,” but it with the right treatment the symptoms of depression can be managed and alleviated over time.
  • What is the best treatment for major depressive disorder?
    A variety of treatment options are available for major depressive disorder, including psychotherapy, anti-depressant medications, cognitive behavioral therapy (CBT), electroconvulsive therapy (ECT), and natural treatments. The treatment plan will differ for each person depending on individual needs, though the “best” treatment for major depressive disorder is often thought to be a combination of medication and therapy.

Dysthymia (Persistent Depressive Disorder)

Dysthymia, also known as persistent depressive disorder, is a long-term form of depression that lasts for years and can interfere with daily life, work, and relationships. People with dysthymia often find it difficult to be happy even on typically joyous occasions. They may be perceived as gloomy, pessimistic, or a complainer, when in reality they are dealing with a chronic mental illness. Symptoms of dysthymia can come and go over time, and the intensity of the symptoms can change, but symptoms generally don’t disappear for more than two months at a time.

Your Questions Answered

  • How is dysthymia different from major depression?
    The depressed mood experienced with dysthymia is not as severe as major depressive disorder, but still evokes feelings of sadness, hopelessness, and loss of pleasure. While the symptoms of depression must be present for at least two weeks to be diagnosed with major depressive disorder, a diagnosis of dysthymia requires having experienced a combination of depressive symptoms for two years or more.
  • What is meant by “high-functioning” depression?
    The term high-functioning depression is often used to refer to dysthymia, or persistent depressive disorder, as due to the chronic nature of this type of depression, many individuals living with the disorder continue to go through the motions of life in a robotic way, seemingly fine to those around them.
  • What is double depression?
    Double depression is a complication of dysthymia. Over time, more than half of people with dysthymia experience worsening symptoms that lead to the onset of a full syndrome of major depression on top of their dysthymic disorder, resulting in what is known as double depression.

Manic Depression (Bipolar Disorder)

Bipolar disorder, sometimes referred to as manic depression, is a mental health condition that causes extreme fluctuations in mood and changes in energy, thinking, behavior, and sleep. With manic depression, you don’t just feel “down in the dumps;” your depressive state may lead to suicidal thoughts that change over to feelings of euphoria and endless energy. These extreme mood swings can occur more frequently–such as every week–or show up sporadically–maybe just twice a year.

Mood stabilizers, such as lithium, can be used to control the mood swings that come with bipolar disorder, but individuals are also prescribed a variety of different medications including antidepressants and atypical antipsychotics.

Your Questions Answered

  • Is bipolar disorder genetic?
    While scientists have not pinpointed one single root cause, it appears genetics are likely to account for around 60-80% of the risk for developing bipolar disorder, indicating the key role heredity plays in this condition. Your risk of developing bipolar disorder is also increased significantly if you have a first-degree relative suffering from the disorder.
  • Can bipolar disorder be cured?
    Currently, there is no cure for bipolar disorder, but it can be managed successfully with a treatment plan involving a combination of medication and psychotherapy.
  • What’s the difference between bipolar 1 and bipolar 2 disorder?
    While all types of bipolar disorder involve extreme highs and lows, the main difference between bipolar 1 and bipolar 2 is the severity of the manic symptoms. With bipolar 1 the mania, or elevated mood, is typically more severe than with bipolar 2. With bipolar 2, the individual experiences hypomania, a less severe form of mania that result in behaviors that are atypical for the individual but not abnormal to society at large.

Postpartum Depression (Peripartum Depression)

Sad feelings and crying bouts that follow childbirth are known as the “baby blues.” The baby blues are common and tend to decrease within a week or two. This type of sadness is often attributed to the dramatic hormonal changes that follow childbirth. Around one in seven women will experience something more extreme than the typical baby blues. However, women that give birth and struggle with sadness, anxiety or worry for several weeks or more may have postpartum depression (PPD). Signs and symptoms of PPD include:

  • Feeling down or depressed for most of the day for several weeks or more
  • Feeling distant and withdrawn from family and friends
  • A loss of interest in activities (including sex)
  • Changes in eating and sleeping habits
  • Feeling tired most of the day
  • Feeling angry or irritable
  • Having feelings of anxiety, worry, panic attacks or racing thoughts

Your Questions Answered

  • Can postpartum depression start months after giving birth?
    Postpartum depression does not necessarily begin immediately following the birth of a baby. Postpartum depression symptoms may start in the first few weeks following childbirth, though sometimes, symptoms of PPD do not begin until months after birth and can emerge at any time during the baby’s first year.
  • Why does postpartum depression occur?
    While the exact cause of postpartum depression is unknown, it is thought to be a result of a variety of factors including: the physical changes resulting from pregnancy; anxiety about parenthood; hormonal changes; previous mental health problems; lack of support; a complicated pregnancy or delivery, and/or changes to the sleep cycle.
  • Can postpartum depression come and go?
    “Women who have suffered from postpartum depression (PPD) are always at risk for future mood episodes thereafter the first experience of depression, potentially since the “switch” for having those episodes is now flipped after the PPD, and also since the stress of motherhood does not go away and can even worsen depending on psychological stressors that are ongoing,” says Jean Kim, M.D. “If the woman is taking medication for the depressive symptoms it may lose effectiveness for whatever reason at several months out, so it wouldn’t necessarily be unheard of for a relapse to occur several months after the initial PPD episode.”

Seasonal Affective Disorder (SAD)

Seasonal affective disorder (SAD) is a type of depression related to the change of season. People who suffer from SAD notice symptoms beginning and ending at about the same times each year. For many, symptoms start in the fall and continue into the winter months, though it is possible for SAD to occur in the spring or summer. In either case, symptoms of depression, such as hopelessness, fatigue, and loss of interest or pleasure in activities, start out mild and progress to be more severe as the weeks go on. Those who experience SAD in the winter have also noted the following unique symptoms:

  • Heaviness in arms and legs
  • Frequent oversleeping
  • Cravings for carbohydrates/weight gain
  • Relationship problems

Your Questions Answered

  • How is seasonal affective disorder (SAD) treated?
    Treatment plans for seasonal affective disorder (SAD) may include medication, psychotherapy, light therapy, or a combination of these options to manage the depression symptoms. Talk therapy can be an invaluable option for those with SAD. A psychotherapist can help you identify patterns in negative thinking and behavior that impact depression, learn positive ways of coping with symptoms, and institute relaxation techniques that can help you restore lost energy.
  • Can seasonal affective disorder happen in the summer?
    Seasonal affective disorder (SAD) in the summer months is more common than you might think. Around 10% of individuals with SAD begin noticing the signs of depression in the summer months.
  • Why does seasonal affective disorder occur?
    The exact cause of seasonal affective disorder (SAD) is still unclear, though experts have made a variety of hypotheses related to the cause of the disorder and why some experience more severe symptoms than others. It has been suggested that the effects of light, a disrupted body clock, low serotonin levels, high melatonin levels, traumatic life events, and even physical illness are connected to the onset of SAD.

Psychotic Depression

According to the National Alliance on Mental Illness, around 20 percent of people with depression have episodes so severe that they develop psychotic symptoms. A diagnosis of major depressive disorder with psychotic features may be given to individuals suffering from a combination of the symptoms of depression and psychosis: a mental state characterized by disorganized thinking or behavior; false beliefs, known as delusions, or false sights or sounds, known as hallucinations.

Your Questions Answered

  • What are the early signs of psychosis?
    Early psychosis refers to the period when a person first starts to appear as though they are losing contact with reality. The early signs of psychosis include suspicion of others, withdrawing socially, intense and inappropriate emotions, trouble thinking clearly, a decline in personal hygiene and a drop in performance at work or school.
  • How is psychotic depression diagnosed?
    To be diagnosed with major depressive disorder with psychotic features the individual must have a depressive episode that lasts two weeks or longer and be experiencing delusions and hallucinations. There are two different types of major depressive disorder with psychotic features, both of which prominently feature delusions and hallucinations. The individual experience major depressive disorder with mood-congruent psychotic features (the content of the hallucinations and delusions is consistent with depressive themes) or with mood-incongruent psychotic features (the content of the hallucinations and delusions does not involve depressive themes).
  • Can psychotic depression turn into schizophrenia?
    Depression is a mood disorder and schizophrenia is a psychotic illness; while both psychotic depression and schizophrenia share psychosis as a symptom, there is no reason to think that psychotic depression would morph into schizophrenia. Conversely, individuals with schizophrenia can become depressed when they realize the stigma surrounding their illness, the poor prognosis, and loss of function.

Premenstrual Dysphoric Disorder (PMDD)

Premenstrual dysphoric disorder, or PMDD, is a cyclic, hormone-based mood disorder, commonly considered a severe and disabling form of premenstrual syndrome (PMS). While up to 85% of women experience PMS, only around 5% of women are diagnosed with PMDD, according to a study in the American Journal of Psychiatry. While the core symptoms of PMDD relate to depressed mood and anxiety, behavioral and physical symptoms also occur. To receive a diagnosis of PMDD, a woman must have experienced symptoms during most of the menstrual cycles of the past year and these symptoms must have had an adverse effect on work or social functioning.

Your Questions Answered

  • What is the difference between PMDD and PMS?
    Premenstrual dysphoric disorder (PMDD) is a more serious condition than premenstrual syndrome (PMS). The symptoms present with PMS do not generally interfere with everyday function and are less severe in their intensity. While it is normal for women to experience fluctuation in mood in the days leading up to menstruation, the psychological symptoms of severe depression, anxiety, and suicidal thoughts do not occur with PMS.
  • What is the best medication for PMDD?
    For the symptoms of PMDD related to mood and anxiety, a group of antidepressants named selective serotonin reuptake inhibitors (SSRIs) can be prescribed; sertraline, fluoxetine, and paroxetine hydrochloride have all been approved by the FDA as medications which may be prescribed to alleviate symptoms.
  • How long do PMDD symptoms last?
    The symptoms of premenstrual dysphoric disorder (PMDD) typically reoccur each month prior to and during menstruation. Symptoms usually begin 7-10 days prior to menstruation and decrease in intensity within a few days of the period beginning. Symptoms disappear completely until the next premenstrual phase.

Atypical Depression

Despite its name, atypical depression may in fact be one of the most prominent types of depression. Atypical depression is different from the persistent sadness or hopelessness that characterizes major depression. It is considered to be a “specifier” or subtype of major depression that describes a pattern of depression symptoms, including: oversleeping, overeating, irritability, heaviness in the arms and legs, sensitivity to rejection, and relationship problems. One of the main hallmarks of atypical depression in the ability for the mood of the depressed individual to improve following a positive event.

Your Questions Answered

  • How serious is atypical depression?
    Just as with any type of depression, atypical depression is a serious mental health condition, and is associated with an increased risk of suicide and anxiety disorders. Atypical depression often starts in the teenage years, earlier than other types of depression, and can have a more long-term (chronic) course.
  • How do you treat atypical depression?
    Atypical depression responds well to treatment comprised of both medications and psychotherapy. Monoamine oxidase inhibitors (MAOIs) and other antidepressants, such as SSRIs and tricyclic antidepressants are the most common medications prescribed to treat atypical depression.
  • Can atypical depression be cured?
    There is no one-size-fits-all treatment to “cure” atypical depression, though it can be successfully managed with a combination of medication and psychotherapy. Remission is the goal for atypical depression, though it is important to remember that depression has a high risk of reoccurrence so it is important to be conscious of any reemerging symptoms.

Situational Depression (Reactive Depression/Adjustment Disorder)

Situational depression, otherwise known as reactive depression or adjustment disorder, is a short-term, stress-related type of depression. It can develop after a person experiences a traumatic event or a series of changes to their everyday life. Examples of events or changes that may trigger situational depression include but are not limited to: divorce, retirement, loss of a friend, illness, and relationship problems. Situational depression is therefore a type of adjustment disorder, as it stems from a person’s struggle to come to terms with the changes that have occurred. Most people who experience situational depression begin to have symptoms within about 90 days following the triggering event.

Your Questions Answered

  • How is situational depression different from clinical depression?
    If you have situational depression you will experience many of the same symptoms a someone with major depressive disorder. The key difference is situational depression is a short-term response triggered by an event in someone’s life and the symptoms will resolve when the stressor no longer exists, or the individual is able to adapt to the situation. Unlike situational depression, major depressive disorder is considered a mood disorder and typically involves chemical imbalances in the brain.
  • How is situational depression diagnosed?
    In order to be diagnosed with situational depression, a person must be experiencing psychological and behavioral symptoms within 3 months of an identifiable stressor, that are beyond what would be considered an ordinary response, and improve within 6 months after the stressor is removed.
  • Who is at risk of developing situational depression?
    There is no way to predict which person out of a group of people experiencing the same stressor will develop situational depression, though it is believed your social skills before the event and the way in which you deal with stress may play a role.

Disruptive Mood Dysregulation Disorder (DMDD)

DMDD is a fairly recent diagnosis, appearing for the first time in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. The DSM-5 classifies DMDD as a type of depressive disorder, as children diagnosed with DMDD struggle to regulate their moods and emotions in an age-appropriate way. As a result, children with DMDD exhibit frequent temper outbursts in response to frustration, either verbally or behaviorally. In between outbursts, they experience chronic, persistent irritability.

Your Questions Answered

  • How is DMDD different from bipolar disorder?
    While the key feature of DMDD is irritability, the hallmark of bipolar disorder is the presence of manic or hypomanic episodes. Although DMDD and bipolar disorder can both cause irritability, manic episodes tend to occur sporadically, while in DMDD the irritable mood is chronic and severe.
  • What is the treatment for DMDD?
    A combination of psychotherapy and parent management techniques are the first step towards teaching children coping skills for regulating their moods and emotions and teaching parents how to manage outbursts. However, medication may also be prescribed if these methods alone are not effective.
  • Can children grow out of DMDD?
    Children are unlikely to simply grow out of DMDD without learning how to effectively regulate their moods and emotions. If you think your child may have DMDD, seek advice from a mental health professional for diagnosis and an effective treatment plan.

Living with depression can feel like an uphill battle, but it isn’t something you have to face alone. You can take our free, confidential depression test, as a preliminary self-assessment for the symptoms of depression.

It’s important to know that physical illness also increases the risk of developing severe depressive illness. Depression can be caused by a whole variety of medical conditions that effect the body’s systems or from chronic illnesses that cause ongoing pain. It is particularly common among those who have illnesses such as the following:

  • Cancer
  • Coronary heart disease
  • Diabetes
  • Epilepsy
  • Multiple sclerosis
  • Stroke
  • Alzheimer’s disease
  • HIV/AIDS
  • Parkinson’s disease
  • Systemic lupus erythematosus
  • Rheumatoid arthritis

What’s more, depression can be induced by certain substances and medications, so be prepared to have an open and honest discussion with your mental health professional about your alcohol intake and any prescribed or recreational drug use.

If you think you may be suffering from any of these different types of depression, we urge you to reach out to your doctor or a mental health professional to get the diagnosis, treatment, and support you need.

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Last Updated: Oct 15, 2019