In uncertain times – such as the ones that we currently face – it is common for those that suffer from depression to have episodic incidents in which their symptoms will increase in severity and frequency.
However, the standardized definition of depression – of feeling low, running on empty with long periods of inactivity and feeling unable to cope or move on – is actually a more complex and multi-layered mental illness.
There are actually eight classified forms of depression and they all, in some form or another, affect the sufferer in different ways. In some cases, they can negatively change the brain chemistry of the sufferer. ¹
However before we can go into the details, we first need to get a macro lens on depression in order to better understand it and all of its complexities.
Throughout this article, we’re going to explore the types of depression and the effects it has on our psychology. At the end, we invite you to ask further questions.
What is Depression?
Most of us have a basic understanding of what depression is. However, most don’t fully comprehend the severity of this disease.
The Mayo Clinic cities, on average, 3 million cases of depression per year. Depression can affect us each in different ways and it can come in several unique forms, which are classified on the National Institute of Mental Health’s website. ²
The rate of those that are suffering from depression and depression-related disorders has risen considerably. It is such a problem in the United States that untreated and classified depression is responsible for more than 200 million days lost from work each year. ³
And the US isn’t the only one having a depression epidemic, it’s a global situation. According to the World Health Organisation, less than 50 percent of those living with depression globally receive adequate treatment.
Depression: More than Just the Blues
Depression isn’t just one disorder, in fact, it’s a mental illness that appears in a multitude of possibilities. According to the National Institute of Mental Health, there are actually eight defined differential forms that depression takes the form of:
- Major Depression
- Persistent Depression
- Manic Depression
- Depressive Psychosis
- Perinatal Depression
- Premenstrual Depression
- Season Depression
- Situational Depression
That seems like a lot of forms for what on the surface seems like someone who is just wallowing in the deep hues of their bluesiest blues, but don’t let the sheer number of different diagnoses overwhelm you.
We’re going to go through each of these disorders, their definitions, symptoms, and treatment plans.
Major depression is a serious mental disorder in which it’s symptoms last more than two weeks and usually results in the sufferer having low moods, coupled with bouts of anxiety, insomnia, hopelessness, and sometimes the abuse of drugs and alcohol.
Major Depression is the most common form of depressive-related disorders and is the “textbook” definition of what someone would think depression looks like. However, that isn’t to say it’s not a disorder that shouldn’t be treated with the utmost concern and care.
The most common symptoms of Major Depression Disorder are the following:
- Feelings of sadness, tearfulness, emptiness or hopelessness
- Angry outbursts, irritability or frustration, even over small matters
- Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports
- Sleep disturbances, including insomnia or sleeping too much
- Tiredness and lack of energy, so even small tasks take extra effort
- Reduced appetite and weight loss or increased cravings for food and weight gain
- Anxiety, agitation or restlessness
- Slowed thinking, speaking or body movements
- Feelings of worthlessness or guilt, fixating on past failures or self-blame
- Trouble thinking, concentrating, making decisions and remembering things
- Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide
- Unexplained physical problems, such as back pain or headaches
Persistent depression disorder (also referred to as dysthymia) is a chronic form of depression. People who struggle with this type of depression usually have most (if not all) of the symptoms of major depression. The biggest difference is persistent depression is exacerbated due to the repeating, cyclic nature in which these side effects continuously seem to crop up from time to time. ⁷
Due to being a chronic condition, a persistent depressive disorder cannot truly be cured. However, it can be treated.
The symptoms can be dulled through targeted medication and talk therapies, all designed to bring the sufferer out of the state of persistent depression and – hopefully, at the same time – educate them on ways to cope with their repeating set of side effects.
The causes of persistent depression aren’t truly known but like Major Depression, it could be brought on by one or many sources, including:
- Biological Factors – changes within the brain and it’s brain chemistry
- Genetics – inherited traits passed down by family members
- Trauma/Stress – brought on by severe, traumatic or stressful life events which are considered “trigger events” in which the sufferer is thrown into a state of depression directly after said event.
If most symptoms of persistent depressive disorder occur before the age of 21 it’s considered an early-onset persistent depressive disorder. If the symptoms follow after the age of 21, then it’s late-stage onset persistent depressive disorder.
Both kinds of persistent depressive disorders are diagnosed through some sort of psychological and physical examination performed by a health or mental health professional.
Following these examinations, you’ll receive a form of psychotherapy along with prescriptions of anti-depressants, such as:
- Selective Serotonin Reuptake Inhibitors (SSRIs)
- Serotonin and Norepinephrine Reuptake Inhibitors ( SNRIs)
Also, certain lifestyle or home remedies might be recommended in order to maintain routine healthy function.
For example, it can help to develop a knowledgeable support team of friends and family members. Each of whom knows you and your symptoms. They’ll also help pay attention to warning signs can help aid in taking better care of oneself during persistent depression cycles.
Manic Depression Disorder or Bipolar Disorder
Manic depression disorder is an episode of bipolar disorder – a condition where those who struggle with suffering from episodes of really high highs and terribly low lows. Bipolar disorder has affected an estimated 2.8% of U.S. adults within the last year, according to the NIMH. ¹⁰
There are three kinds of bipolar, all of which have clear shifts in mood, behaviors energy, and activity levels. These mood shifts range from periods of extreme highs and terrible lows. However that isn’t to say that these disorders don’t have their own specified differences, they do.
According to the National Institute of Mental Health, there are three different defined bipolar disorders, each with their own unique set of symptoms. ¹⁰
- Bipolar I Disorder
Bipolar I Disorder is a form of bipolar disorder that is defined by manic episodes that can last at least a week or by manic symptoms that are so severe that the person needs hospitalization.
Usually, with Bipolar I Disorder, the sufferer has episodes of depression with mixed features, meaning that they have depressive and manic symptoms often at the same time.
- Bipolar II Disorder
Bipolar II is defined by patterns of depressive episodes and overly manic episodes but these patients do not suffer from the same full-blown manic episodes that are typical of Bipolar I Disorder.
Also, those that suffer from Bipolar II Disorder do not have mixed experiences when it comes to their manic and depressive episodes. It’s often one or the other and the two episodic experiences often not mixed together.
- Cyclothymia or Cyclothymic Disorder
Defined by periods of hypomanic symptoms as well as periods of depressive mood shifts that last at least 2 years. However, the symptoms don’t often meet the diagnostic requirements for a hypomanic episode and a depressive episode, and therefore are classified under their own diagnostic disorder: Cyclothymia.
Diagnosing bipolar in it’s three different definitions often occurs during adolescence or in early adulthood. However, it can develop in children, though, it’s rare. It is more common to see bipolar disorder developing in women during or just after pregnancy and can couple with postpartum depression.
The medications that are most recommended in cases of bipolar disorder are mood stabilizers and anti-psychotics. Talk therapy treatments, also considered as psychotherapy which usually involves sitting down with a mental health professional that specializes in bipolar mood disorders and conversing with them through the symptoms that are bothering you.
The psychologist might also help in finding support and guidance through bipolar episodes and significant mood shifts and helping the patient deal with the consequences that might arise during these radical mood changes.
Alternative therapies for bipolar disorders can also help aid in recovery from mood shifts and ease some of the severity of symptoms. Going beyond treatment, having a regulated diet and exercise plan can help. Not to mention, having a dedicated support team of loved ones and friends can remarkably improve the day to day life of those suffering from bipolar disorders.
According to WebMD, Depressive Psychosis or Psychotic Depression is a serious mental condition that requires hospitalization. It is a sub-type of major depression and usually occurs during a severe depressive illness that coincides with another form of psychosis. The psychosis can take the form of visual and auditory hallucinations.
The major difference between someone dealing with psychotic depression rather than major depression or other non-psychotic depression disorders is the fact that the sufferer is usually out of touch with reality. Therefore, such psychosis is adding to the underlying depression issue, thus making it more difficult to come out of depressive episodes due to being out of touch.
Unlike other forms of depression, most of those dealing with psychotic depression are diagnosed while visiting ERs or hospitals during or after a major depressive psychotic episode. According to the NIMH, 25% of those that are admitted into a hospital due to depression are eventually diagnosed with psychotic depression disorder.
Perinatal depression (more commonly known as post-partum depression) usually affects new mothers after their baby is born. The cause of perinatal depression could be due to the imbalance of hormones that occurs during pregnancy in expectant mothers.
Postpartum depression has become widely known as there have been efforts in recent years to spread awareness and understanding of the disorder. Due to these efforts, more and more mothers of newborns have felt encouraged to come forward with their own tales of suffering from their challenges with perinatal depression.
In fact is so common that, on average, 1 in 20 women in the US will experience a major depressive disorder while being pregnant and it’s estimated that between 10 and 20 percent of women will develop some kind of pregnancy-related mood disorders during their impregnation period.
Postpartum depression can worsen into a much more concerning condition called postpartum psychosis wherein the patient will develop a psychosis on top of the depression which can lead to the following symptoms: ⁸
- Auditory or visual hallucinations (or in rare cases, both simultaneously)
- Delusional thoughts or beliefs
- Harmful or suicidal thoughts or actions
- In extreme cases, the homicidal thoughts or actions related to the newborn.
Postpartum psychosis is a rare but concerning condition that should be treated with the utmost care and consideration for not only the sufferer but for their loved ones as well. Postpartum psychosis cases should be taken directly to a medical professional and the sufferer should be placed in restrictive emergency care for the safety of themselves and their newborn child.
However, to adequately treat postpartum depression and psychosis the care plan is essentially the same – minus a few differences in medication. Most times the treatment for postpartum depression and psychosis is a joint venture between talk therapy with a licensed and trained therapist in perinatal mood disorders as well as a prescription of anti-depressants or anti-psychotic medications.
Premenstrual depression disorder (PMDD) is most commonly referred to as PMS (or premenstrual dysphoric disorder) and is most common in women.
PMDD is technically different than normal, ordinary PMS, and often occurs about a week or two weeks before a period begins.
PMDD has a noted difference in its severity of symptoms that follow closely to the symptoms of PMS but is highly intensified and in some cases can be disabling for the sufferer. The most common side effects of PMDD are, as listed by the Mayo Clinic: ¹⁶
- Insomnia or Excess Sleepiness
- Mood Swings
- Increased Irritability
- Social Dysfunction
- Lack of concentration
- Muscle Aches and Pains in the pelvis and breasts
PMDD, like PMS, is usually self-diagnosable and affects women of varying different age groups but usually starts around puberty. The treatment is mostly through self-care.
Seasonal depressive disorder is a very real depressive disorder that affects over 3 million Americans a year. Also referred to as seasonal affective disorder (SAD), this condition is characterized by depression that occurs at or around the same time every year.
SAD usually affects those during the winter when there is very little sunlight or availability for outside activity. Most commonly affecting those on the East Coast of the United States and also in northern regions.
For most people, SAD typically begins at the tail end of fall and lasting until early spring. ¹¹
The most common side effects and symptoms with SAD are:
- Feeling depressed most of the day, nearly every day
- Losing interest in activities you once enjoyed
- Having low energy
- Having problems with sleeping
- Experiencing changes in your appetite or weight
- Feeling sluggish or agitated
- Having difficulty concentrating
- Feeling hopeless, worthless or guilty
- Having frequent thoughts of death or suicide
However, there are season-specific symptoms that can affect the sufferer during specific seasons which are listed below:
SAD in the fall and winter:
- Appetite changes, especially a craving for foods high in carbohydrates
- Weight gain
- Tiredness or low energy
SAD in the spring and summer:
- Agitation or anxiety
- Poor appetite
- Trouble sleeping (insomnia)
- Weight loss
Diagnosing SAD can be quite difficult for doctors and mental health professionals, so it’s on the patient to be aware of their symptoms and if their suffering to reach out for help and guidance.
The most common examinations in order to diagnose SAD are a physical exam which includes an in-depth questionnaire by a medical professional, a psychological evaluation by a mental health professional and even in rare cases, lab tests to make sure the thyroid is functioning properly as the complications with the thyroid gland have been known to stir up depression-related symptoms in patients.
Treating SAD includes talk therapy, some anti-depressant medication therapies as well as light therapy, a course of treatment in which the patient is exposed to measured exposure to artificial light that mimics natural light in order to affect brain chemicals linked to mood, sleep, and behavior which might ease SAD symptoms. ¹²
Situational depression is a short-term form of depression usually brought on and exacerbated by stress or stressful activities or events. Situational depression is linked with trauma as traumatic events are usually referred to as “trigger events” in which they set off depression-like symptoms¹³.
These kinds of traumatic trigger events can be caused by problems at work or school, a persistent illness, the loss of loved one, or problems with friends or loved ones that are consistent and ongoing. However, all cases are unique and usually aren’t simple to solve.
Biological factors like brain structure and chemistry malformations, abnormalities in hormonal balance, and genetic changes can be responsible for increasing one’s risk of developing this kind of depressive disorder.
Situational and life experiences like existing mental health issues, difficult life circumstances occurring over the course of a short period of time, and going through enormous amounts of psychological, physical, or emotional stress in a short period of time can also increase the likelihood of situational depression…
The symptoms of situational depression are wide-ranging but here’s a list of some of the major, recurring side effects that are noted in most cases: ¹⁴
- lack of enjoyment in normal activities
- regular crying
- constant worrying or feeling anxious or stressed out
- sleeping difficulties
- disinterest in food
- trouble focusing
- trouble carrying out daily activities
- feeling overwhelmed
- avoiding social situations and interaction
- not taking care of important matters like paying your bills or going to work
- thoughts or attempts at suicide
Diagnosing and treating situational depression requires the sufferer to be seen by a medical or mental health professional, having an examination done by said professional and finding key links to stress-related events, and developing depressive-related symptoms around the same time. ¹³
The treatment involves a pointed attack plan of medication and specific talk therapy regimens including Conginaitve Behavioral Therapy (CBT) in order to bring symptoms under control and help ease the patient out of their suffering. ¹⁵
Solving the Enigma of Depression and It’s Affect on the Brain
Now that we have come to understand the eight major depressive disorders, how do we go about understanding depression as an illness and what impact does it actually have on our brains?
Luckily, and an organization known as the ENIGMA Network is striving to solve our most complicated queries on depression and its impact on our brains and it’s chemistry.
The Engima Network is a neurological research group consisting of researchers all across the globe. They are all a part of this Enigma study lab originally founded by the Mark and Mary Stevens Neuroimaging and Informatics Institute at the University of Southern California.
This worldwide research group, headed up by the USC’s Neurosciences Study Institute (INI) came up with a breakthrough discovery in mental disorders and their effect on the brain.
Through a study of pooling over 9,000 MRI scans of sufferers of depressive disorders the researchers from Enigma found that almost 20 percent of their patients from their pool suffered from physical damage to their brain through the shrinkage of the hippocampus region of their brain tissue.
The study found this causal relationship in which those with “persistent depression” had result showing a shrinkage in the hippocampus. This result was of course striking, with over 1,700 of the 9,000 patients presenting, “robust reductions in the hippocampal volume” of the brain. ¹
Depression can have a physiological effect on the sufferer. It can affect the central nervous system, causing connectivity issues when it comes to memory and memory retention in the brain⁵. It can shrink and damage certain portions of the brain and it can lead to devastating consequences when it comes to the patient’s day to day life and overall fulfillment in life.
So what does this all mean, you must be asking yourself, after reading over the research on the different definitions of depression and pouring over the statistical data of the Engima Study.
Well, what it means is that there is substantial definitive proof that serious depressive disorders, like persistent depressive disorder in this particular case, can have a lasting and damaging impact on the brain.
The evidence is clear and concise: Depression and it’s subsequent sub-classifications can be a damaging and dire disorder that can lead to long last, and in some cases permanent damage.
It is imperative to not only understand depression and it affects the mind and body but also to be aware of it in yourself and your loved ones. Undiagnosed depression is a major issue in the United States, it has profound and costly consequences if the disorder continues to persist without being checked.
All of these consequences can be avoided if the patient and the patient’s loved ones are armed with knowledge and have the power to seek help when necessary.
Still have questions concerning the types of depression?
We invite you to ask them in the comment’s section below. If you have any further information to share – whether personal or professional – we’d also love to hear from you.
¹ Mind Journal: “Depression Isn’t A Choice, It’s A Kind of Brain Damage”
² National Institute of Mental Health: “Stat Sheet On Depression”
³ The World Health Organization” Definition of Depression – A Fact Sheet”
⁴ Substance Abuse and Mental Health Services: “NSDUH Report of Major Depressive Episodes Among Full-Time College Students & Other Young Adults”
⁵ Healthline: “The Effects of Depression On and Inside the Body”
⁶ Mayo Clinic: “Clinical Depression: What Does That Mean?”
⁷ Healthline: “Perinatal Depression”
⁹ Mayo Clinic: “Persistent Depressive Disorder”
¹⁰ National Institute of Mental Health: “Bipolar Disorder – Overview”
¹¹ Mayo Clinic: “Seasonal Affective Disorder – An Overview”
¹² Mayo Clinic: “Light Therapy – An Overview”
≈ Healthline: “Situational Depression – An Overview”
¹⁴ Healthline: “Symptoms of Situational Depression”
¹⁵ Healthline “Treatments for Situational Depression”
¹⁶ Mayo Clinic: “Premenstrual Dysphoric Disorder – Different Than PMS?”