Depression - Its Many Forms

What is depression?

Depression is when you feel sad and uninterested in daily life. You may have other symptoms as well. Depression can be mild to severe. It can last for a short time or a long time.

We all have times when we feel sad and "blue." However, when you feel this way for more than 2 weeks in a row, it is called clinical depression. Clinical depression is a medical problem.

There are several kinds of clinical depression. The main types are:

• Adjustment Disorder with Depressed Mood. You are depressed because something major has happened to you. Examples are events such as the breakup of a relationship, a major financial loss, moving, or being laid off from work. ADDM usually lasts a few weeks to a few months.
• Bipolar Disorder. This type used to be called manic depression. In bipolar disorder you have both major depression and mania. Mania is when you have excess energy and behavior for at least 1 week. In a manic episode you may be much more talkative than usual, need little or no sleep, be very irritable, be very anxious, or be very impulsive such as driving recklessly or going on a buying spree.
• Cyclothymic Disorder. In this type of depression you go back and forth between mild mania and mild depression. During any 2-year period you have either mild mania or depression almost constantly.
• Dysthymia. If you have mild depression almost every day for 2 or more years, it is called dysthymia. If you have dysthymia, you may also have major depression at certain times in your life.
• Major Depression. Severe depression which lasts more than 2 weeks and is not caused by a specific event is called major depression. You may have major depression only once, or you may have it many times in your life.
• Mood Disorder Due to a General Medical Condition. Many medical problems can create changes in your body that cause depression. Some examples are strokes, Parkinson's disease, hormone problems, and certain cancers. This is not the same as being depressed about your illness.
• Postpartum Depression. Many women have mild to severe depression after their children are born. This type of depression may last a few weeks to a few months.
• Seasonal Affective Disorder. Some people are sensitive to getting less sunlight. In colder climates you may get depressed as the days become shorter in the winter. This form of depression can sometimes be severe.
• Substance-Induced Mood Disorder. Drugs such as alcohol, cocaine, sedatives, and amphetamines can bring on depression. Stopping drug use for a few weeks usually improves your mood and ability to function. This depends on how long and how much the drug has been used.

How does it occur?

Depression can begin at any age. It usually begins in the young adult years unless it is caused by medical or substance abuse problems. It may come on slowly over weeks or months, but it can also come on suddenly.

The exact cause of depression is not known. It may result from chemical imbalances in the brain and nervous system. You may have abnormal levels of the chemicals that your nervous system uses to send signals to and from the brain. Depression tends to run in families. Stress also plays a part.

Depression is found all over the world. It is more common in women than in men. Symptoms may be different across cultures.

You are at a greater risk of developing depression if you:

• have parents or family members who have had depression
• often use alcohol or drugs
• have medical problems
• get very little exercise
• are under a great deal of stress
• have few personal and social supports

What are the symptoms?

Besides feeling sad and uninterested in things you usually enjoy, you may also:

• be irritable and aggressive
• have trouble falling asleep, wake up very early, or sleep too much
• notice changes in your appetite and weight, either up or down
• feel more anxiety and panic
• notice changes in your energy level, usually down but sometimes feeling overexcited
• lose sexual desire
• feel worthless and guilty
• not be able to concentrate or remember things
• feel hopeless or just not care about anything
• have unexplained physical symptoms
• think often about death or suicide

How is it diagnosed?

Your healthcare provider or a mental health professional can tell you if your symptoms are caused by clinical depression. He or she will ask about your symptoms and any drug or alcohol use. You may be asked to have some lab tests to rule out medical problems such as hormone imbalances. There are no lab tests that directly diagnose depression.

How is it treated?

You should not try to overcome clinical depression by yourself. Depression is a physical illness as well as a psychological one. Do not expect yourself to "snap out of it." Depression can be successfully treated with psychotherapy, antidepressant or mood stabilizing medicines, or a combination of these therapies. Discuss this with your healthcare provider or therapist.

How long will the effects last?

Different kinds of depression last for different amounts of time. Experts do not fully understand why. Often depression lasts a few weeks and never comes again. It can also last months or years. Some people have bouts of depression over and over all their lives.

When should I seek help?

Do not try to overcome depression all by yourself. Seek professional help if you believe that you or a loved one has the symptoms of clinical depression. Get emergency care if you or a loved one have serious thoughts of suicide or harming others.

For more information, see:
Depression: Its Symptoms and Treatment
Adjustment Disorders with Depressed Mood
Bipolar Disorder
Cyclothymia
Dysthymia
Major Depression
Mood Disorders due to a Medical Condition
Postpartum Depression
Premenstrual Dysphoric Disorder
Seasonal Affective Disorder
Substance Induced Mood Disorder
Cognitive Therapy