January 23, 2012

The Types of Depression


I am writing this blog to give you some information for my two following blogs. I am presenting information about the different types of depression. Many people speak of depression and write about depression, but seldom do they specify what type of depression they are talking discussion. I am guilty of this, and I have read many studies and articles guilty of this. I firmly believe this is because as a layperson, the classification of the different types of depression is not an easy topic to understand.

Feeling sad or what many of us refer to as being depressed can be a form of depression if it lasts for more than a few hours. Being sad for a few hours and then becoming your normal self is generally not considered depression. Can we be in a state of depression for a few days without being clinically depressed? This is a difficult determination and there seems to be few people willing to classify this as a mild form of depression. Most professionals find a way to hide it in technical terms that are hard to understand.

In my own unprofessional understanding, about 67 percent of people with diabetes do suffer from some type of depression; however, most of the time you will see this listed as just depression with no definitive definition. Then about 19 percent of people with diabetes suffer from serious depression and again no accurate definition accompanies this statement.

I must preface the following as being about all types of depression and not just about depression associated with diabetes although it can include depression. When talking about depressions types, understand that some sources will use different terms for the same type. There are several forms or types of depression or depressive disorders. This source says major depressive disorder and dysthymic disorder are the most common. Although this is not clearly stated, I would assume this to be for the more serious forms of depression. However, one source uses dysthymic disorder for mild to moderate depression.

Major depressive disorder is also known as major depression. With this disorder, a patient suffers from a combination of symptoms that undermine his ability to sleep, study, work, eat, and enjoy activities he used to find pleasurable. Experts say that major depressive disorder can be very disabling, preventing the patient from functioning normally. Some people experience only one episode, while others have recurrences.

Dysthymic disorder is also known as dysthymia, or mild chronic depression. The patient will suffer symptoms for a long time, perhaps as long as a couple of years, and often longer. However, the symptoms are not as severe as in major depression, and the patient is not disabled by it. However, he may find it hard to function normally and feel well. Some people experience only one episode during their lifetime, while others may have recurrences.

A person with dysthymia might also experience major depression, once, twice, or more often during his lifetime. Dysthymia can sometimes come with other symptoms. When they do, it is possible that other forms of depression are diagnosed. When severe depressive illness includes hallucinations, delusions, and/or withdrawing from reality, the patient may be diagnosed with psychotic depression.

I will mention postpartum depression in passing because it affects women after giving birth and is not part of the discussion about diabetes although women with diabetes may have this as well.

SAD (seasonal affective disorder) is much more common the further from the equator you live. A person who develops a depressive illness during the winter months might have SAD. The symptoms go away during spring and/or summer. In some countries, where winter can be very dark for many months, patients commonly undergo light therapy - they sit in front of a special light. Light therapy works for about half of all SAD patients. In addition to light therapy, some people may need antidepressants, psychotherapy, or both. Light therapy is becoming more popular in other northern countries, such as Canada and the United Kingdom.

Bipolar disorder (manic-depressive illness) is a mood disorder characterized by chronic mildly depressed or irritable mood often accompanied by other symptoms (as eating and sleeping disturbances, fatigue, and poor self-esteem). It is not as common as major depression or dysthymia. A patient with bipolar disorder experiences moments of extreme highs and extreme lows. These extremes are known as manias.

Some illnesses accompany, precede, or cause depression such as anxiety disorders, and include PTSD (post-traumatic stress disorder), OCD (obsessive-compulsive disorder), social phobia; generalized anxiety disorder and panic disorder often accompany depression. If you are dependent on alcohol or narcotics, you may have a significantly higher risk of having depression.

Depression is more common for people who suffer from HIV/AIDS, heart disease, stroke cancer, diabetes, Parkinson's disease, and many other illnesses. According to studies, if a person has depression as well as another serious illness he or she is more likely to have severe symptoms, and will find it harder to adapt to his medical condition. Studies have also shown that if these people have their depression treated the symptoms of their co-occurring illness improve.

Other types or sub-types of depressions I include here are:
  • atypical depression (sub-type of major depression or dysthymia
  • chronic depression is a major depressive episode that lasts for at least two years
  • endogenous depression is defined as feeling depressed for no apparent reason
  • situational or reactive depression (also known as adjustment disorder with depressed mood) that develops in response to a specific stressful situation or event like job loss, end of a relationship, death in family, etc.
  • agitated depression which is a type of major depressive disorder
  • psychotic depression is a major depressive disorder with psychotic symptoms like hallucination and delusions
  • melancholic and catatonic depression which are sub-types of major depressive disorder

There are obviously many more subtypes, but finding anything descriptive of the short-lived or short-term depressive nature is very difficult to find. So what other than the term of mild depression are we left with for describing what many of us feel that we have or are we just feeling sad and let down.

Two of the above types do come close to being mild and not serious – SAD and situational or reactive depression. The first generally only last for the winter months and the second for about three months and then not until about three months following the cause of the depression. While not in the category of major depression, the short time can be very depressive and symptoms can vary from mild to deep.

The articles used in this blog include article 1, article 2, article 3 and article 4.

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