What Is Depression?
Types of Depression
When many people talk about depression, they are often referring to Major Depressive Disorder (MDD). This is one of the most common types of depression, but there are many other types. While the symptoms of each type overlap significantly, the difference pertains to a variety of factors. These factors include such things as severity of symptoms, timeframe, precipitating events, and underlying cause (e.g. depression caused by a medical condition or substance). Following is a brief description of several different types of depression:
Major Depressive Disorder: A very common type of depression, the symptoms must last for a minimum of two weeks. A major depressive episode may be a one-time incident, but in many cases there are recurring episodes. Symptoms may be mild to severe.
Adjustment Disorder with Depressed Mood: A major life stressor is the precipitating factor in this type of depression, such as losing one’s job or the end of a significant relationship. The symptoms are milder than MDD, but significant enough to warrant treatment.
Dysthymic Disorder: Although this type of depression shares many of the same symptoms of MDD, they are less severe. This is a chronic type of depression in which the symptoms last for at least two years and often continue for many years.
Seasonal Affective Disorder (SAD): This is sometimes referred to as seasonal depression. The distinguishing characteristic of SAD is that it occurs during a specific season – typically during the winter months – each year. However, for some people the episodes occur during the spring or summer.
Bipolar Depression: For many years, this type of depression was called “manic depression”. It cannot be diagnosed unless the individual has had a manic or hypomanic episode at some point. Manic symptoms include unusually high energy, limited need for sleep, and grandiosity. Individuals with bipolar disorder often experience a major depressive episode soon after a manic episode.
Other types of depression include postpartum depression, substance-induced depression, depression due to a medical disorder, psychotic depression, and atypical depression.
Primary Symptoms of Depression
Depression affects each individual differently. Some may experience a limited number of symptoms – just enough to meet the criteria for a diagnosis – while others may experience the full range of symptoms. Also, each episode can be different. Following are the most frequent symptoms of depression:
- Depressed or sad mood most of the time
- Low energy
- Feelings of hopelessness
- Decreased appetite
- Problems sleeping, particularly early morning awakening, or sleeping excessively
- Difficulties concentrating and / or making decisions
- Significant agitation or restlessness
- Loss of interest in or pleasure from most activities
- Withdrawal from family and friends
- Excessive or inappropriate guilt
- Feelings of worthlessness
- Thoughts of suicide
Causes of Depression
As with most psychiatric disorders, no one knows for sure what actually causes depression. The general consensus among experts is that there are likely several factors that make a person vulnerable to developing depression. These factors include:
Genetics: Depression is more likely to occur in individuals who have one or more family members with depression as well. This suggests a genetic component that may make them more prone to developing it.
Biological factors: These include brain anomalies or changes, neurotransmitters, and hormones.
Life events: Many individuals experience a depressive episode following a significant life event. These may include things like the loss of a loved one, retirement, losing a job or starting a new job, moving to a new city, or a variety of other stressors.
Childhood trauma: Individuals who experienced significant trauma in their childhood, such as physical or sexual abuse or losing one or both of their parents at an early age are often more vulnerable to developing depression.
Other psychiatric disorders: Any significant psychiatric disorder takes a toll on a person’s life. Individuals with other psychiatric disorders are often more vulnerable to developing depression as well.
Illness and / or medication: Certain illnesses as well as a variety of medications can cause depression or make one more vulnerable to developing it.
Substance abuse or addiction: A high percentage of individuals who regularly abuse substances such as alcohol or drugs, or who are addicted to them, also have depression.
Risk Factors for Depression
Studies have found that certain factors make some individuals more likely to develop depression than others. These include:
- Being female – depression occurs almost twice as often in women as men
- A family history of depression, suicide, or alcoholism
- Childhood trauma
- Recent stressful life events, particularly a major loss
- A melancholy temperament
- Recently giving birth
- Alcohol, drug, or nicotine abuse
- Social isolation
- Lower socioeconomic status
- Bouts of depression in childhood
- Serious illness
- Taking certain medications that can trigger depression
Treatment for Depression
The treatment for depression typically involves psychotherapy and / or medication. Psychotherapy for depression may include a variety of different approaches. Cognitive behavioral therapy (CBT) is one of the most effective types of psychotherapy for depression, according to a variety of studies. CBT is effective because it addresses the irrational thoughts and faulty beliefs (e.g. “I always fail” or “I am worthless”) that fuel depression.
Antidepressant medications can also be very helpful. In fact, antidepressants are some of the most frequently dispensed medications. Antidepressant drugs work by targeting certain neurotransmitters in the brain (particularly serotonin and norepinephrine) that play a significant role in mood. While they can be effective, there is often a lot of trial and error involved before finding the best medication and dose. That being said, they don’t work for many people.
Medication alone is rarely the most effective treatment for depression. This is because medication treats the symptoms only. It does not address the underlying issues that lead to the depression or contribute to it on an ongoing basis. It is not uncommon for the depressive symptoms to return at some point after the medication is stopped. This is often the case for individuals who have a history of recurrent depression.
For some individuals, a combination of medication and psychotherapy is the best treatment. Medication helps people with more serious depression to function well enough to benefit from psychotherapy.
Alternative treatments and natural remedies may also be helpful in the treatment of depression, especially when used in conjunction with psychotherapy or medication. These include hypnotherapy, acupuncture, regular exercise, supplements (such as fish oil), yoga, and meditation.