The Different Types of Depression

Any type of depression must be taken seriously, but people can experience it differently and under different circumstances.

Major Depressive Disorder

This diagnosis is applied when you have experienced five or more of the symptoms discussed in the previous section for two weeks or longer. In addition, your symptoms have resulted in significant changes in your ability to function at work or school, and socially.

Some people with major depressive disorder can experience psychosis where their thinking is disordered and out of touch with reality. Given the features of depression, their thoughts are most likely to be ones that are devaluing (I’m worth nothing. The world would be a better place without me). People can become focused on thoughts and perhaps plans of suicide. In the absolute rarest of cases, these thoughts can evolve into an overwhelming belief that those they love must die too, so they can be spared the inevitable pain of living.

A major depressive disorder can occur once in a lifetime, never to return – or episodes can be recurrent.

Dysthymic Disorder

“Dysthymic” is a medical term for a form of depression where people experience low moods for a long time. They may still function, but struggle with lack of interest, poor appetite, insomnia, low self-esteem, limited concentration and feelings of hopelessness. Without treatment, this type of depression can go on for years, leaving people thinking that this is “just the way I am” – along with a sense that everyone, but them, knows how to get along in life, be successful and have fun. People with a dysthymic disorder may – or may not have experienced bouts of major depression.

Treatment Resistant Depression

Treatment resistant depression (TRD) is defined in research as what patients are experiencing when they have been diagnosed with a major depressive disorder, but fail to respond to at least two different courses of anti-depressives. Research reports the incidence level of TRD (among those diagnosed with depression) to be 21.7%, although some studies show that figure can be as high as 50 – 60%. A hampering factor for more robust research may be that people, while knowing full well that they are suffering, do not know that their clinician has designated their experience as TRD. Some family physicians aren’t aware of or don’t use the term. This confusion occurs because TRD is not an official psychiatric diagnosis, but is instead a clinical descriptor used to report what is happening for patients.

Additional experiences for TRD patients are longer episodes of depression and the presence of other physical and psychiatric illnesses.

Depression and Anxiety

It is not uncommon for people diagnosed with depression to also experience anxiety (50% of people with depression also have symptoms of anxiety). The reverse is also true. People whose primary diagnosis is anxiety are found also to be experiencing depression.

People with both depression and anxiety have more severe symptoms and respond more poorly to anti-depressants. Their lives are also more severely affected.

Treatment is highly likely to involve medications for both depression and for anxiety. Finding the right combination can take time as each person is different and can respond differently.

Postpartum Depression

Postpartum depression most commonly occurs about three months after giving birth, but can take up to a year to emerge. Contributing factors include the hormonal changes in your body during pregnancy and after delivery, lack of sleep, a history of depression or bipolar disorder, and stressful life circumstances.

Postpartum psychosis is extremely rare, but incredibly serious. It involves delusional thinking that can include the new mother having thoughts of harming herself and/or her baby. Medical attention must be sought immediately. Call 911 if you have to.

Seasonal Affective Disorder (SAD)

SAD is triggered by the low light and grey days of winter. It is not surprising that SAD is more common in northern countries, like Canada. Many people get the winter blues, but SAD is true depression with people withdrawing, missing work and social events due to their symptoms. Treatment for mild versions of SAD can be as simple as getting outdoors more often or, for those who can afford it, taking a vacation to the sun. For severe versions of SAD, people are prescribed antidepressants and undergo “light therapy,” which means daily exposure to light boxes that emit full spectrum light – just like sunlight.