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Types of Depression

1. Major Depressive Disorder

Major Depressive Disorder is sometimes called ‘Major Depression’, ‘Clinical Depression’, ‘Unipolar Depression’ or in the most simplest terms – Depression.

The symptoms are experienced most days for at least two weeks.

These symptoms have an adverse impact on an individual’s day to day functioning.

It can be described as melancholic or psychotic which in a way constitute the levels of depression.

2. Melancholia

Melancholia is a severe form of major depression where many of the physical symptoms of depression are present. One of the major changes is that the person starts to move more slowly.

Symptoms of Melancholic Depression

As per the American Psychiatric Association (APA), melancholic depression is listed as a subtype of MDD (Major Depressive Disorder). When someone shows signs of depression and melancholia, the diagnosis is “major depressive disorder with melancholic features.”

The symptoms of melancholic depression would include:

  • Loss of pleasure in daily activities
  • Absence of reactivity to positive news and events
  • Despair and worthlessness
  • Sleep disturbance
  • Weight loss
  • Excessive or inappropriate guilt

The individual experiences profound bleakness and has no desire to socialize. The most distinctive feature in this type of depression is that the sufferers tend to wake early in the morning and their symptoms are the worst at this time of the day.

3. Psychotic Depression

Psychotic depression is a subtype of major depression that occurs when a severe depressive illness includes some form of psychosis. In psychotic depression, people seem to be disconnected from reality.

Depressive psychosis is a combination of symptoms of major depression and psychotic symptoms. Depression occurs when you have negative feelings that affect your daily life.

Examples of psychotic symptoms include:

  • Delusion
  • Hallucinations
  • Paranoia

As per the Journal of Clinical Psychiatry, these delusions tend to be guilt-ridden, paranoid, or related to your body. For example, a sufferer may have a delusion that a parasite is eating his intestines and that he deserves it because he is a ‘horrible’ person.

Hallucinations may include seeing or hearing things which don’t exist in reality. For example, one may hear voices criticizing him, saying things such as "you're not good enough" or "you don't deserve to live."

These delusions and hallucinations seem real to the person who is experiencing them, which may even lead to him causing harm to himself or people around him. This is why it’s critical for someone with psychotic depression to seek help at the earliest.

4. Treatment Resistant Depression

This is the chronic form of depression that does not respond to two different antidepressants from different classes. Also called refractory depression, this is the type of depression that lingers even after several trials of medication and doses are completed.

The term Treatment-resistant depression (TRD) was first coined in the year 1974. This is the chronic form of depression that does not respond to two different antidepressants from different classes.

Also called refractory depression, this is the type of depression that lingers even after several trials of medication and doses are completed.

This form of depression can leave people with a constant feeling of hopelessness and discouragement. Weeks, months or even years can pass by without any satisfactory relief.

Common symptoms of Treament-Resistant Depression:

  • Concentration and making decisions becomes more difficult
  • Feeling sad and hopeless
  • Significant changes in weight or appetite
  • Restlessness
  • Feeling tired or lethargic
  • Social withdrawal

5. Antenatal and postnatal depression

Also known as Postpartum depression (PPD), this is a type of clinical depression which can affect both genders after childbirth. Globally, post-partum depression has been reported in almost 10% to 20% of mothers, and it can start from the moment of birth, or may result from depression evolving continuously since pregnancy.

Maternal depression is extremely different from the usual ‘baby blues’. Not only does this form of depression have an adverse effect on the mother, but it also has a huge impact on her relationship with her baby, the child’s development, the mother’s relation with her husband and also with the other family members.

Let’s take a closer look at some research findings to understand its impact

Fisher and colleagues looked at studies that had tried to identify the prevalence of both prenatal and postnatal common mental disorders in low income and middle income countries. They found that the prevelance of mental disorders among women in the prenatal phase is 16 percent, while those in the postnatal phase constituted 20 percent of the total population. This number was a mean prevalence of 13 studies.

Research done on maternal depression as a predictor of child development problems

  • 17 studies have found that maternal depression is associated with children who are underweight
  • 12 studies revealed that depression raises the chance of stunted children two times
  • 2 studies showed a strong association between maternal depression and diarrhea in kids

And then, there are fewer studies on other child development issues. These studies have confirmed, that maternal depression is associated with sub-optimal cognitive development, emotional development, and it is also associated with infectious illness and hospital admission, along with reduced complete immunization.

6. Manic Depressive Disorder/ Bipolar Disorder

Bipolar disorder, formerly known as manic disorder is a complex disorder in which a person experiences extreme variances in thinking, mood, and behaviour from the highs of mania on one extreme, to the lows of depression on the other.

The cycles of bipolar disorder lasts for days, weeks, or months. And unlike ordinary mood swings, the mood shifts in bipolar disorder are so intense that they interfere with your ability to function.

People who have bipolar disorder commonly go through periods of depression or mania.

What Are the Symptoms?

The symptoms of bipolar disorder include mood shifts (sometimes quite extreme) as well as changes in:

  • Energy
  • Activity levels
  • Sleep patterns
  • Behaviors

People with bipolar disorder experience intense emotional states referred to as "mood episodes” and on the other extreme end, they may experience “manic episodes”.

Let’s take a closer look at the characteristic features of both these different forms of ‘episodes’

Depressive mood episode:

  • Problem in concentration and decision-making
  • Restlessness
  • Changes in eating or sleeping habits
  • Feelings of emptiness or worthlessness
  • Loss of interest or pleasure in interesting activities
  • Behavioral changes
  • Fatigue or low energy
  • Suicide attempt

Manic episode:

  • Long periods of intense joy or excitement
  • Extreme irritability, agitation, or a feeling of being "wired"
  • Being easily distracted or restless
  • Having racing thoughts
  • Speaking very quickly
  • Drowning into work (excessively goal directed)
  • Having little need for sleep
  • Unrealistic beliefs about one's abilities
  • Participating in impulsive or high-risk behaviors such as gambling, spending sprees, making unwise investments and so on

The exact state of the condition differs from person to person. Some people may experience mostly depressed states. Other people may have mostly manic phases. It can even be possible to have both depressed and manic symptoms simultaneously.

Like all the other forms of depression, bipolar disorder is also a curable and treatable condition. Untreated symptoms of bipolar disorder will only keep getting worse.

It’s estimated that about 15 percent of people with untreated bipolar disorder commit suicide.

Click Here to know more about types of bipolar

7. Dysthymic disorder

Dysthemia / dysthymic disorder or Persistent Depressive Disorder (PDD) is a mild or moderate form of depression that lasts for at least two years. Some people suffer from dysthymia for many years.

The symptoms of dysthymia are the same as those of major depression but fewer in number and not as intense.

Even though this form of depression is less severe, it is extremely enduring.

It affects women two to three times more often than men. A person can be diagnosed with PDD, when he/she has had continuous depressed mood for two years or more.

For children, the duration only needs to be one year, and their mood may be irritable rather than sad or depressed. This chronic sad/irritable/ depressed mood becomes so consistent, that it may seem to blend with an individual’s personality and seem like an integral and major part of their personality.

On an average, 3% - 6% of the population may be affected by dysthymia throughout.

Genes may play an important role in the development of this disorder.

It tends to develop early in a person's life and unfortunately, most people delay approximately ten years before every seeking treatment.

Dysthymic disorder increases the chance of developing major depressive disorder in the future. Of those with dysthymia approximately 10% usually go on to develop major depression. This presence of both the conditions is known as "double depression."

The long-term problems of dysthymia may affect interpersonal relationships as well as how a person perceives himself or herself.

8. Seasonal Affective Disorder​

SAD is a condition that affects a person, particularly during fall or winter, and ends when spring arrives. At other months during the year a person's mood will be normal.

It's usually diagnosed after the person has had the same symptoms during winter for a couple of years.

People with SAD depression are more likely to experience a lack of energy, sleep too much, overeat, gain weight and crave for carbohydrates.

SAD is not very common in India and more likely to be found in countries with shorter days and longer periods of darkness.​

Light therapy is the main treatment for SAD.

Medicines and counseling may also help.

9. Existential depression

Existential depression is a condition which may occur when a person comes face to face with issues of life, death, freedom and the meaning of their life. As the name suggests they may question their very ‘existence’.

In order to understand the causes of existential depression, Yalom (1980) describes four ‘ultimate concerns’ or issues that people may question–death, freedom, isolation and meaninglessness.

  • Death is an inevitable occurrence.
  • Freedom, in an existential sense, would mean giving the world a structure which we ourselves create.
  • Isolation recognizes that no matter how close we become to another person, a gap always remains, and we are nonetheless alone.
  • Meaninglessness stems from the first three

Most often, people with existential depression are more prone to be ‘idealists’ and ‘intense’ by nature. Therefore, they experience disappointment and frustration which occurs when ideals are not reached.

They are quick to notice inconsistencies and absurdities in society and in behaviors of people around them. They may question everything around them.

For example, people with existential depression might ask themselves, “What is the meaning of my life? Will I ever find someone who truly understands and believes in me no matter what? Does god care about me? Does anyone else truly care about me? what is the purpose of existence? “what happens after death? why was I born?”

Signs of existential depression include:

  • Continuous “deep thoughts” about the meaning and nature of life
  • Feeling disconnected from others
  • Feeling misunderstood
  • One may feel he’s at a “different level” from others
  • Chronic loneliness
  • Sensations of being “dead”, “numb” or “empty” inside
  • Disinterest in social contact because it feels shallow
  • Melancholic moods
  • Belief that most things are “futile” or “meaningless”
  • Contemplating suicide

In a way, existential depression sufferer can be considered as a “gifted” individual — a poet, artist, philosopher, healer, mystic or sage in the making.

Most often they are people extremely spiritual, who are constantly in a quest of being in touch with their inner-self…their soul!

And when the worldly affairs and issues come in between their journey to connect with their soul, they may feel misplaced and misfit in the society. This can lead them to be diagnosed with existential depression.