Types of Depression

"How heavy the days are. There is not a fire that can warm me, not a sun to laugh with me. Everything is base. Everything cold and meaningless. And even the beloved dear stars look desolately down." (Hermann Hesse, German novelist and poet,1877-1962)

Hesses' words probably sums up what depression feels like. Depression is a medical disorder (just like diabetes, high blood pressure, or heart disease) that day after day affects your thoughts, feelings, physical health, and behaviour. For 20-35 per cent of depressed people, a normal routine is all but impossible. Others have instances of depression, followed by feelings of well being. Still others have terrible lows that alternate with inappropriate highs. No wonder, depression is often considered to be like a roller coaster ride.

Just as any other disease, depression too manifests itself in various forms. Diagnosis of each kind varies and is mostly determined by the intensity of the symptoms, their duration and the specific causes of the symptoms.
The most common forms of depression include:

    * Clinical Depression
    * Dysthymia
    * Manic Depressive, or Bipolar Depression
    * Major Depression
    * Seasonal Affective Disorder (SAD)
    * Normal Depressed Mood & Grief
    * Adjustment Disorder with Depressed Mood
    * Atypical Depression
    * Post-partum Depression

Clinical Depression: When depression is serious enough to require treatment, it is called clinical depression. When the symptoms are more severe, someone is said to be suffering from major depression. This condition tends to be episodic in nature.
Dysthymia: This refers to a low to moderate level of depression that persists for at least two years, and often longer. While the symptoms are not as severe as major depression, they are more enduring, and resistant to treatment. It is characterised by chronic depression, but with less severity than major depression. Low energy, sleep or appetite disturbances and low self-esteem are usually part of the clinical picture as well. People with Dysthmia often report that they do not ever recall not feeling depressed, at the same time they nay be relatively functional in managing their life. Dysthymia may or may not have a triggering life event. Quite often, there is nothing to blame it on, no loss or life change. This can be confusing for both the person affected, and their loved ones. But just as you can catch a cold seemingly out of nowhere, you can also slip into dysthymia for no apparent reason.

Manic Depression or Bi-Polar Depression: This type of depression is characterised by extremes of mood. The patient experiences absolute highs (mania) and absolute lows (depression). This illness involves major depressive episodes alternating with high-energy periods of wildly unrealistic activity. A manic friend might, for example, call at 3 a.m. to announce in all seriousness that she's flying to Hollywood immediately to marry Robert Redford, and star in his next movie. Statistics suggest that on an average four out of 10 episodes in a year, without preventive treatment is common. Every individual with manic-depressive disorders has a unique pattern of mood cycles, combining depression and manic episodes that is specific to that individual, but predictable once the pattern is identified. Manic depressive disorders typically begin in adolescence or early adulthood and continue throughout life. It is often not recognised as a psychological problem. Typically, bipolar disorder develops without any clear cause.

Major Depression: This is the most serious type of depression in terms of the number of symptoms and their severity, but there are significant individual differences in the symptoms and severity. You do not need to feel suicidal to have a major depression, and you do not need to have a history of hospitalisation either, although both of these factors are present in some people suffering from major depression.
Major depression is manifested by a combination of symptoms. It interferes with the ability to work, sleep, eat, and enjoy once-pleasurable activities. These disabling episodes of depression can occur once, twice, or several times in a lifetime. A major depression can result from a single traumatic event in your life, or may develop slowly as a consequence of numerous personal disappointments and life problems. Some people appear to develop the symptoms of a major depression without any obvious life crises causing it. Other individuals have had less severe symptoms of depression for a long time, and a life crisis results in increased symptom intensity.
Major depression should be differentiated from a normal grief response. The grief response is typically shorter in duration and does not affect a person's self-esteem. All of us are familiar with stress, and sometimes the stress in our lives can cause us to experience profoundly sad moods. These sad moods are to be expected on occasion, and they are a normal reaction to specific situations such as the loss of a loved one, money or marital problems, or other emotionally stressful events.

Seasonal Affective Disorder (SAD): This condition is often called "winter blues." A reaction to lack of sunlight in winter, mild or major depression develops in late fall and clears up in early spring. As the distance from the equator increases, this condition becomes more common. In the northern hemisphere, December, January, and February are the worst months.

Normal Depressed Mood & Grief: These conditions are natural reactions to losses in life. They typically involve sadness, lethargy, and in serious cases -- for example, grief after the death of a loved one -- often despair, anger, insomnia, poor appetite, or weight gain, obsessive thoughts about the lost person, and terrible guilt about any problems in the depressed person's relationship with the deceased individual. What makes these reactions normal is that people eventually recover. After losing a ball game, it may take a day or two to bounce back. After a lay-off, it may take a few months. After the death of a loved one, it may take up to a year. Adjustment Disorder with Depressed Mood: Life is full of changes. Coping with them can be difficult. Many people feel overwhelmed and "crazy" for a while. Then they get things under control. If they don't, and they become persistently gloomy, angry, and unable to cope, it's most likely adjustment disorder with depressed mood. Adjustment disorder with depressed mood presumes a triggering life event -- the change you have to adjust to.

Atypical Depression: "Atypical" means unusual. Instead of feeling unrelenting gloominess and lethargy, a person with this condition might seem deeply depressed for a few days, then fine for a while, or anxious and irritable. Like many other forms of depression, the atypical variety often develops without a triggering event.

Post Partum Depression: New mothers typically expect to feel overjoyed after giving birth. But because of the enormous hormonal changes of delivery and the challenges of dealing with an infant, two-thirds of women feel transient sadness. About 10-15 per cent become clinically depressed. And about one in 1,000 become so severely depressed that they need to be hospitalised for their own safety and the safety of their baby.

Psychotic Depression: This is one of the most bewildering forms of depressive illness, both for the sufferer and for those around him or her. Psychotic people can be said to have lost touch with reality. That is to say that they perceive the world in a radically different way. They may be hallucinating or even suffering form a range of thought disorders, which cause them to completely misinterpret events.
The various kinds of depression have no clear-cut boundaries and it takes professional judgement to distinguish when normal sadness crosses over to depression. However, whatever the type, depression needs to be treated at the earliest lest it assumes suicidal proportions.