Different types of depression

There are three main categories under which most types of depression are classified. Temporary, Moderate or Severe. Some experts prefer to call Temporary Depression as Mild Depression and Severe Depression as Major Depression. There are still other types of depression like, Bipolar Disorder (or Manic Depression), Dysthymia and Adjustment disorders with depression.

Temporary Sadness :

This type of depression generally happens after there is a death in the family, a divorce or some other major disappointment. Depressed people seem to be aware of the reason for their feeling sad (or miserable) but cannot get rid of that feeling. This kind of ‘reactive depression’ begins to affect their daily routine. Support, understanding, a little warmth and sharing of grief by family members and friends is often enough to relieve the symptoms.

Moderate Depression :

Moderately depressed people often feel that their lives are falling apart. Such depression may be caused by Adjustment Disorders. Like an illness or sudden death in the family, the loss of a lucrative job or a marriage break-up. It takes a fairly long time for moderately depressed people to get out this situation. It generally requires the help of medications and maybe, some psychotherapy and/or counselling. If moderate depression is not treated in time there is always the danger of the person slipping into what is described as major depression. Such depression affects a person’s career and family life. Typically, they can hold on to their jobs but they in turn are non-productive; they can stay with their family and friends but do not enjoy their company.

Severe Depression :

Severely depressed people feel like they have fallen into a black hole or a bottomless pit. They are quite convinced that things are in a very bad shape and that they will only get worse. They cannot cope with their daily routine. As compared to a moderately depressed person, severely depressed people may absent themselves from work. They can see their life, family, career falling apart but are unable to do anything about it. They may even harbour suicidal tendencies. Anyone who is severely depressed should (and with full encouragement from others) seek immediate professional care and help.

Bipolar Disorder :

Earlier called manic-depression. It is a relatively uncommon medical illness. A person suffering from Bipolar Disorder exhibits extreme mood swings from ‘low’ to ‘high’. During the so called ‘low’ phase, the depressed people exhibit symptoms of Major depression (mentioned above). While in the ‘high’ (manic) phase, they believe they are capable of doing anything, like embarking on risky business ventures, sexual relationships or go on spending sprees. They often speak very rapidly and may jump from one subject to the next.

People with bipolar disorder are usually unaware that there is a problem with them. Some of them may spend months together in one phase and then swing to the other extreme, while others swing between the two extremes more frequently. Bipolar depression, which is caused by chemical imbalances can be treated with proper medications.

Dysthymia :

This is sometimes referred to as Chronic Depression. It is characterised by many of the symptoms that are seen in major depression. Though much less intense, the symptoms tend to last much longer. Dysthymia is described as a “veil of sadness”. In this type of depression, there may not be disturbances in sleep, appetite, sexual drive etc. Suicidal thoughts are usually not present. However the family, social, professional lives of such persons may be impaired because they exhibit a much lower level of physical and emotional energy.

Causes

Sometimes there may be an obvious reason for becoming depressed, sometimes not. There is usually more than one cause and different people have different reasons.

It may seem obvious why – a relationship breakdown, bereavement or even the birth of a child – but sometimes it’s not clear. Either way, it can become so bad that you need help.

Often people don’t realise how depressed they are, because the depression has come on gradually. They may try to struggle on and cope by keeping busy. This can make them even more stressed and exhausted. This can cause physical pains, such as constant headaches, or sleeplessness.

Some of the more common factors involved in depression are:

* Family history. Genetics play an important part in depression. It can run in families for generations.

* Trauma and stress. Things like financial problems, the breakup of a relationship, or the death of a loved one can bring on depression. You can become depressed after changes in your life, like starting a new job, graduating from school, or getting married.

* Pessimistic personality. People who have low self-esteem and a negative outlook are at higher risk of becoming depressed. These traits may actually be caused by low-level depression (called dysthymia).

* Physical conditions. Serious medical conditions like heart disease, cancer, and HIV can contribute to depression, partly because of the physical weakness and stress they bring on. Depression can make medical conditions worse, since it weakens the immune system and can make pain harder to bear. In some cases, depression can be caused by medications used to treat medical conditions.

* Other psychological disorders. Anxiety disorders, eating disorders, schizophrenia, and (especially) substance abuse often appear along with depression.

Symptoms

For major depression, you may experience five or more of the following for at least a two-week period:

* Persistent sadness, pessimism
* Feelings of guilt, worthlessness, helplessness or hopelessness
* Loss of interest or pleasure in usual activities, including sex
* Difficulty concentrating and complaints of poor memory
* Worsening of co-existing chronic disease, such as rheumatoid arthritis or diabetes
* Insomnia or oversleeping
* Weight gain or loss
* Fatigue, lack of energy
* Anxiety, agitation, irritability
* Thoughts of suicide or death
* Slow speech; slow movements
* Headache, stomachache, and digestive problems

In children and adolescents, symptoms of depression may include:

* Insomnia, fatigue, headache, stomachache, dizziness
* Apathy, social withdrawal, weight loss
* Drug abuse or alcohol abuse, a drop in school performance, difficulty concentrating
* Isolation from family and friends
* For dysthymia (minor, but long-term depression), symptoms are less intense and fewer in number, but long-lasting.

Treatments

There are two types of treatment available: talking treatments and medication. Both can be accessed through your doctor.

Talking treatments

* Counselling helps you to talk about your feelings in private with a sympathetic professional. Your GP may have a counsellor at the surgery.
* Cognitive Behavioural Therapy can help to overcome the powerful negative thoughts that are part of depression.
* Interpersonal and dynamic therapies can help if you have difficulties getting on with other people. A relationship counsellor might be helpful if you’re having difficulties with your partner.
* If you have a disability or are caring for a relative, a self-help group may give you support.

Medication

Antidepressants can be effective if depression is severe or goes on for a long time. They may help feelings of anxiety and help you to deal with problems effectively again.

The effects of antidepressants won’t usually be felt straight away – people often don’t notice any improvement in their mood for two or three weeks. As well as tablets, an alternative remedy called St John’s Wort is available from chemists. There is evidence that it’s effective in mild to moderate depression. It seems to work in much the same way as some antidepressants, but some people find that it has fewer side effects. You should discuss taking it with your doctor, particularly if you‘re taking other medication.

Like all medicines, antidepressants have some side effects, though these are usually mild and tend to wear off as the treatment goes on. The newer antidepressants (called selective serotonin reuptake inhibitors) may cause nausea and anxiety for a short while. The older antidepressants can cause dry mouth and constipation. Unless the side effects are very bad, your doctor will usually advise you to continue with the tablets.

Four out of five people with depression will get better without help. The shorter the time you have been depressed, the better the chance that it will lift on its own. However, even with treatment, one in five people will still be depressed two years later.