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“Overthinking the past is depression, overthinking the future is anxiety. Be present!”

 

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2. Mental Health Notes™   📄 @depressionnote 9h9 hours ago

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Shoutout to everyone fighting severe depression, severe anxiety or any other battles with your mind
 

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3. Joel OsteenVerified account @JoelOsteen 3h3 hours ago

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God says you will rule over your enemies. You’re going to rule over addiction. You’re going to rule
over depression, rule over anger. God is putting an end to what’s been hindering you.

Depression (major depressive disorder)

 Symptoms & causes
 Diagnosis & treatment
 Doctors & departments
 Care at Mayo Clinic

Print
Overview

Depression is a mood disorder that causes a persistent feeling of sadness and loss of
interest. Also called major depressive disorder or clinical depression, it affects how you
feel, think and behave and can lead to a variety of emotional and physical problems.
You may have trouble doing normal day-to-day activities, and sometimes you may feel
as if life isn't worth living.

More than just a bout of the blues, depression isn't a weakness and you can't simply
"snap out" of it. Depression may require long-term treatment. But don't get discouraged.
Most people with depression feel better with medication, psychotherapy or both.

Depression care at Mayo Clinic

Symptoms

Although depression may occur only once during your life, people typically have multiple
episodes. During these episodes, symptoms occur most of the day, nearly every day
and may include:

 Feelings of sadness, tearfulness, emptiness or hopelessness

 Angry outbursts, irritability or frustration, even over small matters

 Loss of interest or pleasure in most or all normal activities, such as sex, hobbies
or sports

 Sleep disturbances, including insomnia or sleeping too much

 Tiredness and lack of energy, so even small tasks take extra effort

 Reduced appetite and weight loss or increased cravings for food and weight gain

 Anxiety, agitation or restlessness

 Slowed thinking, speaking or body movements

 Feelings of worthlessness or guilt, fixating on past failures or self-blame

 Trouble thinking, concentrating, making decisions and remembering things

  Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or
suicide

 Unexplained physical problems, such as back pain or headaches

For many people with depression, symptoms usually are severe enough to cause
noticeable problems in day-to-day activities, such as work, school, social activities or
relationships with others. Some people may feel generally miserable or unhappy without
really knowing why.

Depression symptoms in children and teens

Common signs and symptoms of depression in children and teenagers are similar to
those of adults, but there can be some differences.

 In younger children, symptoms of depression may include sadness, irritability,

clinginess, worry, aches and pains, refusing to go to school, or being underweight.

 In teens, symptoms may include sadness, irritability, feeling negative and

worthless, anger, poor performance or poor attendance at school, feeling
misunderstood and extremely sensitive, using recreational drugs or alcohol, eating
or sleeping too much, self-harm, loss of interest in normal activities, and avoidance
of social interaction.

Depression symptoms in older adults

Depression is not a normal part of growing older, and it should never be taken lightly.
Unfortunately, depression often goes undiagnosed and untreated in older adults, and
they may feel reluctant to seek help. Symptoms of depression may be different or less
obvious in older adults, such as:

 Memory difficulties or personality changes

 Physical aches or pain

 Fatigue, loss of appetite, sleep problems or loss of interest in sex — not caused
by a medical condition or medication

 Often wanting to stay at home, rather than going out to socialize or doing new
things
  Suicidal thinking or feelings, especially in older men

When to see a doctor

If you feel depressed, make an appointment to see your doctor or mental health
professional as soon as you can. If you're reluctant to seek treatment, talk to a friend or
loved one, any health care professional, a faith leader, or someone else you trust.

When to get emergency help

If you think you may hurt yourself or attempt suicide, call 911 or your local emergency
number immediately.

Also consider these options if you're having suicidal thoughts:

 Call your doctor or mental health professional.

 Call a suicide hotline number — in the U.S., call the National Suicide Prevention
Lifeline at 1-800-273-TALK (1-800-273-8255). Use that same number and press
"1" to reach the Veterans Crisis Line.

 Reach out to a close friend or loved one.

 Contact a minister, spiritual leader or someone else in your faith community.

If you have a loved one who is in danger of suicide or has made a suicide attempt,
make sure someone stays with that person. Call 911 or your local emergency number
immediately. Or, if you think you can do so safely, take the person to the nearest
hospital emergency room.

Request an Appointment at Mayo Clinic

Causes

It's not known exactly what causes depression. As with many mental disorders, a variety
of factors may be involved, such as:

 Biological differences. People with depression appear to have physical

changes in their brains. The significance of these changes is still uncertain, but
may eventually help pinpoint causes.
  Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that
likely play a role in depression. Recent research indicates that changes in the
function and effect of these neurotransmitters and how they interact with
neurocircuits involved in maintaining mood stability may play a significant role in
depression and its treatment.

 Hormones. Changes in the body's balance of hormones may be involved in

causing or triggering depression. Hormone changes can result with pregnancy and
during the weeks or months after delivery (postpartum) and from thyroid problems,
menopause or a number of other conditions.

 Inherited traits. Depression is more common in people whose blood relatives

also have this condition. Researchers are trying to find genes that may be involved
in causing depression.

Risk factors

Depression often begins in the teens, 20s or 30s, but it can happen at any age. More
women than men are diagnosed with depression, but this may be due in part because
women are more likely to seek treatment.

Factors that seem to increase the risk of developing or triggering depression include:

 Certain personality traits, such as low self-esteem and being too dependent, self-
critical or pessimistic

 Traumatic or stressful events, such as physical or sexual abuse, the death or

loss of a loved one, a difficult relationship, or financial problems

 Blood relatives with a history of depression, bipolar disorder, alcoholism or

suicide

 Being lesbian, gay, bisexual or transgender, or having variations in the

development of genital organs that aren't clearly male or female (intersex) in an
unsupportive situation

 History of other mental health disorders, such as anxiety disorder, eating

disorders or post-traumatic stress disorder

 Abuse of alcohol or recreational drugs

 Serious or chronic illness, including cancer, stroke, chronic pain or heart disease
  Certain medications, such as some high blood pressure medications or sleeping
pills (talk to your doctor before stopping any medication)

Complications

Depression is a serious disorder that can take a terrible toll on you and your family.
Depression often gets worse if it isn't treated, resulting in emotional, behavioral and
health problems that affect every area of your life.

Examples of complications associated with depression include:

 Excess weight or obesity, which can lead to heart disease and diabetes

 Pain or physical illness

 Alcohol or drug misuse

 Anxiety, panic disorder or social phobia

 Family conflicts, relationship difficulties, and work or school problems

 Social isolation

 Suicidal feelings, suicide attempts or suicide

 Self-mutilation, such as cutting

 Premature death from medical conditions

Prevention

There's no sure way to prevent depression. However, these strategies may help.

 Take steps to control stress, to increase your resilience and boost your self-
esteem.

 Reach out to family and friends, especially in times of crisis, to help you

weather rough spells.

 Get treatment at the earliest sign of a problem to help prevent depression

from worsening.
  Consider getting long-term maintenance treatment to help prevent a relapse
of symptoms.

Research suggests that depression doesn't spring from simply having too much or too
little of certain brain chemicals. Rather, there are many possible causes of depression,
including faulty mood regulation by the brain, genetic vulnerability, stressful life events,
medications, and medical problems.Apr 11, 2017
Irritability, anger, and agitation are often the most noticeable symptoms in depressed
teens—not sadness. They may also complain of headaches, stomachaches, or other
physical pains.May

What Is Depression?
Depression (major depressive disorder) is a common and serious medical illness that
negatively affects how you feel, the way you think and how you act. Fortunately, it is
also treatable. Depression causes feelings of sadness and/or a loss of interest in
activities once enjoyed. It can lead to a variety of emotional and physical problems and
can decrease a person’s ability to function at work and at home.

Depression symptoms can vary from mild to severe and can include:

o Feeling sad or having a depressed mood

o Loss of interest or pleasure in activities once enjoyed
o Changes in appetite — weight loss or gain unrelated to dieting
o Trouble sleeping or sleeping too much
o Loss of energy or increased fatigue
o Increase in purposeless physical activity (e.g., hand-wringing or pacing) or
slowed movements and speech (actions observable by others)
o Feeling worthless or guilty
o Difficulty thinking, concentrating or making decisions
o Thoughts of death or suicide

Symptoms must last at least two weeks for a diagnosis of depression.

Also, medical conditions (e.g., thyroid problems, a brain tumor or vitamin deficiency) can
mimic symptoms of depression so it is important to rule out general medical causes.

Depression affects an estimated one in 15 adults (6.7%) in any given year. And one in
six people (16.6%) will experience depression at some time in their life. Depression can
strike at any time, but on average, first appears during the late teens to mid-20s.
Women are more likely than men to experience depression. Some studies show that
one-third of women will experience a major depressive episode in their lifetime.
Depression Is Different From Sadness or Grief/Bereavement

The death of a loved one, loss of a job or the ending of a relationship are difficult
experiences for a person to endure. It is normal for feelings of sadness or grief to
develop in response to such situations. Those experiencing loss often might describe
themselves as being “depressed.”

But being sad is not the same as having depression. The grieving process is natural
and unique to each individual and shares some of the same features of depression.
Both grief and depression may involve intense sadness and withdrawal from usual
activities. They are also different in important ways:

o In grief, painful feelings come in waves, often intermixed with positive memories
of the deceased. In major depression, mood and/or interest (pleasure) are
decreased for most of two weeks.
o In grief, self-esteem is usually maintained. In major depression, feelings of
worthlessness and self-loathing are common.
o For some people, the death of a loved one can bring on major depression.
Losing a job or being a victim of a physical assault or a major disaster can lead to
depression for some people. When grief and depression co-exist, the grief is
more severe and lasts longer than grief without depression. Despite some
overlap between grief and depression, they are different. Distinguishing between
them can help people get the help, support or treatment they need.

Risk Factors for Depression

Depression can affect anyone—even a person who appears to live in relatively ideal
circumstances.

Several factors can play a role in depression:

o Biochemistry: Differences in certain chemicals in the brain may contribute to

symptoms of depression.
o Genetics: Depression can run in families. For example, if one identical twin has
depression, the other has a 70 percent chance of having the illness sometime in
life.
o Personality: People with low self-esteem, who are easily overwhelmed by stress,
or who are generally pessimistic appear to be more likely to experience
depression.
o Environmental factors: Continuous exposure to violence, neglect, abuse or
poverty may make some people more vulnerable to depression.

How Is Depression Treated?

Depression is among the most treatable of mental disorders. Between 80 percent and
90 percent of people with depression eventually respond well to treatment. Almost all
patients gain some relief from their symptoms.

Before a diagnosis or treatment, a health professional should conduct a thorough

diagnostic evaluation, including an interview and possibly a physical examination. In
some cases, a blood test might be done to make sure the depression is not due to a
medical condition like a thyroid problem. The evaluation is to identify specific symptoms,
medical and family history, cultural factors and environmental factors to arrive at a
diagnosis and plan a course of action.

Medication: Brain chemistry may contribute to an individual’s depression and may factor

into their treatment. For this reason, antidepressants might be prescribed to help modify
one’s brain chemistry. These medications are not sedatives, “uppers” or tranquilizers.
They are not habit-forming. Generally antidepressant medications have no stimulating
effect on people not experiencing depression.

Antidepressants may produce some improvement within the first week or two of use.
Full benefits may not be seen for two to three months. If a patient feels little or no
improvement after several weeks, his or her psychiatrist can alter the dose of the
medication or add or substitute another antidepressant. In some situations other
psychotropic medications may be helpful. It is important to let your doctor know if a
medication does not work or if you experience side effects.

Psychiatrists usually recommend that patients continue to take medication for six or
more months after symptoms have improved. Longer-term maintenance treatment may
be suggested to decrease the risk of future episodes for certain people at high risk.

Psychotherapy: Psychotherapy, or “talk therapy,” is sometimes used alone for treatment

of mild depression; for moderate to severe depression, psychotherapy is often used in
along with antidepressant medications. Cognitive behavioral therapy (CBT) has been
found to be effective in treating depression. CBT is a form of therapy focused on the
present and problem solving. CBT helps a person to recognize distorted thinking and
then change behaviors and thinking.

Psychotherapy may involve only the individual, but it can include others. For example,
family or couples therapy can help address issues within these close relationships.
Group therapy involves people with similar illnesses.

Depending on the severity of the depression, treatment can take a few weeks or much
longer. In many cases, significant improvement can be made in 10 to 15 sessions.

Electroconvulsive Therapy (ECT) is a medical treatment most commonly used for

patients with severe major depression or bipolar disorder who have not responded to
other treatments. It involves a brief electrical stimulation of the brain while the patient is
under anesthesia. A patient typically receives ECT two to three times a week for a total
 of six to 12 treatments. ECT has been used since the 1940s, and many years of
research have led to major improvements. It is usually managed by a team of trained
medical professionals including a psychiatrist, an anesthesiologist and a nurse or
physician assistant.

Depression
Persistent Sadness & Loss of Interest in Life
Article by:
 Dina Cagliostro, PhD

Jump to: Statistics   Causes of Depression   Types   Signs & Symptoms   Treatment

What Is Depression?
Being depressed often feels like carrying a very heavy burden, but you are not alone in
this struggle. Millions of Americans suffer from some form of depression every year,
making it one of the most common mental disorders in the country.

Gaining a deeper understanding of depression can help begin the journey to recovery.
Taking some time to learn more about the causes and symptoms of depression will assist
you greatly when it comes time to consider methods of treatment.

Depression is more than just feeling sad. Everyone feels upset or unmotivated from time
to time, but depression is more serious. It is a mood disorder characterized by prolonged
feelings of sadness and loss of interest in daily activities. If these symptoms persist for a
period of at least two weeks, it is considered a depressive episode.

Article continues below

Do you feel depressed?
Take one of our 2-minute Depression quizzes to see if you or a loved one could benefit
from further diagnosis and treatment.
Take Depression QuizTake Partner Depression Quiz

Patient Statistics
According to the National Institute of Mental Health (NIMH), major depression is one of
the most common mental disorders in the United States. 1

Data from the Substance Abuse and Mental Health Services Administration (SAMHSA)
shows that in 2017, an estimated 17.3 million adults in the United States reported having
at least one major depressive episode in the previous 12 months. That’s 7.1% of all US
adults ages 18 and older. Adult females have a higher prevalence of experiencing a major
depressive episode than their male counterparts—8.7% compared to 5.3% in adult males.
Depression in the adolescent population (ages 12 to 17) has also increased. An estimated
3.2 million adolescents had at least one major depressive episode—a number that
represents 13.3% of the adolescent population.

Not only is depression prevalent, but it also creates the heaviest burden of disability
among mental and behavior disorders. According to a 2010 World Health Organization
(WHO) report, depression accounted for 3.7% of all U.S. disability-adjusted life years
and 8.3% of all U.S. years lived with disability.

Causes of Depression
There is no one cause for depression, as it depends on a unique combination of an
individual’s genetic makeup and environmental conditions. There are many factors to
take into account:

 The brain’s physical structure or chemistry

 History of depression in the family

 History of other disorders (anxiety, post-traumatic stress disorder)

 Stressful, traumatic events (abuse, financial issues, death of a loved one)

 Hormone changes (menstrual cycles, pregnancy)

 Certain medications (sleeping aids, blood pressure medication)

Types of Depression
Just as there is no one cause for depression, there isn’t only one type of depression. It can
take many forms. The fifth edition of the Diagnostic and Statistical Manual of Mental
Health Disorders lists nine distinct types:

1. Major depression, as we discussed, is the most common type of depression.

Often, people with major depression experience recurrent episodes throughout
their lives.
2. Dysthymia is a persistent low mood over a long period of time, even a year or
more. It could be described as feeling like you’re living on autopilot.
3. Some people are more sensitive to the lower amount of light in the
wintertime. Seasonal Affective Disorder is a type of depression brought on from a
lack of natural sunlight.
4. Those with Atypical Depression often report feeling a heaviness in their limbs.
They may suffer from irritability and relationship problems, as well as be prone to
overeating and oversleeping.
5. Bipolar Disorder is also called Manic Depressive Disorder because it involves
alternating between mania and depressive episodes.
6. Sometimes depressive episodes can get so severe that hallucinations or
delusions are present, the person becomes catatonic, or they feel stuck in bed. This
is known as Psychotic Depression.
7. Postpartum Depression occurs after giving birth. Mothers may feel
disconnected from their new baby or fear that they will hurt their child.
8. Severe depression that shows up during the second half of the menstrual cycle
is called Premenstrual Dysphoric Disorder. It affects the individual’s ability to
function normally.
9. Situational Depression is triggered by a life-changing event. It could be
anything, from losing your job to the death of an immediate family member.

Signs and Symptoms of Depression

Though there are multiple types of depression, many of them have similar recognizable
symptoms. This list scratches the surface, but it provides a general idea of what
comprises depression:

 Persistent feelings of sadness, hopelessness, worthlessness, or emptiness

 Irritability, frustration, or restlessness

 Loss of interest in activities or hobbies that used to be enjoyable

 Difficulty sleeping, sleep disturbances or sleeping too much

 Fatigue and lack of energy

 Difficulty thinking clearly, remembering, concentrating, or making decisions

 Appetite or weight changes

 Recurrent thoughts of death or suicide

 Physical symptoms such as headaches, stomachaches, or back pain

Experiencing some combination of these symptoms for a period of at least two weeks
likely signifies that you are in the midst of a depressive episode.
Treatment
Any treatment for depression should coincide with a healthy diet and a regular sleep
schedule. It may sound simplistic, but the importance of taking care of your body cannot
be overstated.

There are various methods you could use to sooth the symptoms of depression. All of us
could stand to exercise more often, but exercise is especially helpful for the depressed
mind. It enables you to better handle stress, and the endorphins released during exercise
give you a mental boost. Aside from the mental health benefits, the Centers for Disease
Control and Prevention (CDC) report that physical activity helps you sleep better at night.

Yoga is a more accessible form of exercise, because it doesn’t require equipment and
because many of the moves and poses do not require much effort. Meditation is a highly
effective way of clearing your head and calming your body. It’s also easy to do, with
guided meditations available through phone apps, online in text and videos, and in books.

If you enjoy keeping a journal, you may find that it helps to express your thoughts on
paper instead of bottling them inside. It’s helpful to have close friends and family who
you can confide in, but they’re not always available or may be dealing with stress of their
own. This makes keeping a journal a good idea to have an alternate way to vent.

Therapy with anyone from a guidance counselor to a certified therapist can work
wonders, and many may prefer therapy over the medication route. Situational depression
especially can be relieved by having a way to get everything off your chest and receive
practical advice.

For a more hands-on approach, try experts like psychiatrists or psychologists. They offer
many types of therapy, from light therapy for Seasonal Affective Disorder to cognitive
behavioral therapy that works to change your thought processes.

Other alternatives include drinking special teas or taking supplements. The properties of green
tea and chamomile tea give them a calming effect, and some have found success drinking St.
John’s Wort tea to treat depression. It can also be taken as a supplement. While there is no proof
that St. John’s Wort improves depression symptoms, fish oil, and SAM-e are supplements with a
proven impact.
 There is no shame in taking medication to manage your depression. People routinely take
medication for physical ailments, and having a mental illness isn’t any different. If you’re
worried about the possible side effects, call your doctor to discuss them. Any medication can be
tapered down or ceased, and there are different types available to suit your individual needs and
chemistry.

Remember that recovery is a journey, not a destination. Bad days will still come, but with well-
targeted treatment, you should be able to overcome extreme lows. While science has yet to find a
cure for mental disorders such as depression, it is entirely possible to live a happy and fulfilling
life in spite of it.

If you are experiencing a mental health crisis, or someone you love is in danger, we
strongly suggest that you reach out to to a qualified mental health professional. To aid in
your search please consider our directory of emergency mental health resources.

9 Types of Depression
and How to Recognize
Them
 Major depression

 Persistent depression

 Bipolar disorder

 Depressive psychosis
 Perinatal depression

 PMDD

 Seasonal depression

 Situational depression

 Atypical depression

 Diagnosis

Understanding depression
Everyone goes through periods of deep sadness and grief. These feelings
usually fade away within a few days or weeks, depending on the
circumstances. But profound sadness that lasts more than two weeks and
affects your ability to function may be a sign of depression.

Some of the common symptoms of depression are:

 deep feelings of sadness

 dark moods
 feelings of worthlessness or hopelessness
 appetite changes
 sleep changes
 lack of energy
 inability to concentrate
 difficulty getting through your normal activities
 lack of interest in things you used to enjoy
 withdrawing from friends
 preoccupation with death or thoughts of self-harm
Depression affects everyone differently, and you might only have some of
these symptoms. You may also have other symptoms that aren’t listed here.
Keep in mind that it’s also normal to have some of these symptoms from time
to time without having depression.

But if they start to impact your day-to-day life, they may be the result of
depression.

There are many types of depression. While they share some common
symptoms, they also have some key differences.

Here’s a look at nine types of depression and how they affect people.

1. Major depression
Major depression is also known as major depressive disorder, classic
depression, or unipolar depression. It’s fairly common — about 16.2 million
adults in the U.S. have experienced at least one major depressive episode.

People with major depression experience symptoms most of the day, every
day. Like many mental health conditions, it has little to do with what’s
happening around you. You can have a loving family, tons of friends, and a
dream job. You can have the kind of life that others envy and still have
depression.

Even if there’s no obvious reason for your depression, that doesn’t mean it’s
not real or that you can simply tough it out.

It’s a severe form of depression that causes symptoms such as:

 despondency, gloom, or grief

  difficulty sleeping or sleeping too much
 lack of energy and fatigue
 loss of appetite or overeating
 unexplained aches and pains
 loss of interest in formerly pleasurable activities
 lack of concentration, memory problems, and inability to make decisions
 feelings of worthlessness or hopelessness
 constant worry and anxiety
 thoughts of death, self-harm, or suicide

These symptoms can last weeks or even months. Some people might have a
single episode of major depression, while others experience it throughout their
life. Regardless of how long its symptoms last, major depression can cause
problems in your relationships and daily activities.

2. Persistent depression
Persistent depressive disorder is depression that lasts for two years or more. It’s
also called dysthymia or chronic depression. Persistent depression might not
feel as intense as major depression, but it can still strain relationships and
make daily tasks difficult.

Some symptoms of persistent depression include:

 deep sadness or hopelessness

 low self-esteem or feelings of inadequacy
 lack of interest in things you once enjoyed
 appetite changes
  changes to sleep patterns or low energy
 concentration and memory problems
 difficulty functioning at school or work
 inability to feel joy, even at happy occasions
 social withdrawal

Though it’s a long-term type of depression, the severity of symptoms can

become less intense for months at a time before worsening again. Some
people also have episodes of major depression before or while they have
persistent depressive disorder. This is called double depression.

Persistent depression lasts for years at a time, so people with this type of
depression may start to feel like their symptoms are just part of their normal
outlook on life.

3. Manic depression, or bipolar

disorder
Manic depression consists of periods of mania or hypomania, where you feel
very happy, alternating with episodes of depression. Manic depression is an
outdated name for bipolar disorder.

In order to be diagnosed with bipolar I disorder, you have to experience an

episode of maniathat lasts for seven days, or less if hospitalization is required.
You may experience a depressive episode before or following the manic
episode.

Depressive episodes have the same symptoms as major depression,

including:
  feelings of sadness or emptiness
 lack of energy
 fatigue
 sleep problems
 trouble concentrating
 decreased activity
 loss of interest in formerly enjoyable activities
 suicidal thoughts

Signs of a manic phase include:

 high energy
 reduced sleep
 irritability
 racing thoughts and speech
 grandiose thinking
 increased self-esteem and confidence
 unusual, risky, and self-destructive behavior
 feeling elated, “high,” or euphoric

In severe cases, episodes can include hallucinations and delusions.

Hypomania is a less severe form of mania. You can also have mixed episodes
in which you have symptoms of both mania and depression.

There are several types of bipolar disorder. Read more about them and how
they’re diagnosed.
4. Depressive psychosis
Some people with major depression also go through periods of losing touch
with reality. This is known as psychosis, which can involve hallucinations and
delusions. Experiencing both of these together is known clinically as major
depressive disorder with psychotic features. However, some providers still
refer to this phenomenon as depressive psychosis or psychotic depression.

Hallucinations are when you see, hear, smell, taste, or feel things that aren’t
really there. An example of this would be hearing voices or seeing people who
aren’t present. A delusion is a closely held belief that’s clearly false or doesn’t
make sense. But to someone experiencing psychosis, all of these things are
very real and true.

Depression with psychosis can cause physical symptoms as well, including

problems sitting still or slowed physical movements.

5. Perinatal depression
Perinatal depression, which is clinically known as major depressive disorder with
peripartum onset, occurs during pregnancy or within four weeks of childbirth.
It’s often called postpartum depression. But that term only applies to
depression after giving birth. Perinatal depression can occur while you’re
pregnant.

Hormonal changes that happen during pregnancy and childbirth can trigger
changes in the brain that lead to mood swings. The lack of sleep and physical
discomfort that often accompanies pregnancy and having a newborn doesn’t
help, either.
Symptoms of perinatal depression can be as severe as those of major
depression and include:

 sadness
 anxiety
 anger or rage
 exhaustion
 extreme worry about the baby‘s health and safety
 difficulty caring for yourself or the new baby
 thoughts of self-harm or harming the baby

Women who lack support or have had depression before are at increased risk
of developing perinatal depression, but it can happen to anyone.

6. Premenstrual dysphoric
disorder
Premenstrual dysphoric disorder (PMDD) is a severe form of premenstrual
syndrome (PMS). While PMS symptoms can be both physical and
psychological, PMDD symptoms tend to be mostly psychological.

These psychological symptoms are more severe than those associated with
PMS. For example, some women might feel more emotional in the days
leading up to their period. But someone with PMDD might experience a level
of depression and sadness that gets in the way of day-to-day functions.

Other possible symptoms of PMDD include:

 cramps, bloating, and breast tenderness

  headaches
 joint and muscle pain
 sadness and despair
 irritability and anger
 extreme mood swings
 food cravings or binge eating
 panic attacks or anxiety
 lack of energy
 trouble focusing
 sleep problems

Similarly to perinatal depression, PMDD is believed to be related to hormonal

changes. Its symptoms often begin just after ovulation and start to ease up
once you get your period.

Some women dismiss PMDD as just a bad case of PMS, but PMDD can
become very severe and include thoughts of suicide.

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7. Seasonal depression
Seasonal depression, also called seasonal affective disorder and clinically known
as major depressive disorder with seasonal pattern, is depression that’s
related to certain seasons. For most people, it tends to happen during the
winter months.

Symptoms often begin in the fall, as days start to get shorter, and continue
through the winter. They include:

 social withdrawal
 increased need for sleep
 weight gain
 daily feelings of sadness, hopelessness, or unworthiness

Seasonal depression may get worse as the season progresses and can lead
to suicidal thoughts. Once spring rolls around, symptoms tend to improve.
This might be related to changes in your bodily rhythms in response to the
increase in natural light.

8. Situational depression
Situational depression, clinically known as adjustment disorder with depressed
mood, looks like major depression in many respects.

But it’s brought on by specific events or situations, such as:

 the death of a loved one

 a serious illness or other life-threatening event
 going through divorce or child custody issues
 being in emotionally or physically abusive relationships
  being unemployed or facing serious financial difficulties
 facing extensive legal troubles

Of course, it’s normal to feel sad and anxious during events like these — even
to withdraw from others for a bit. But situational depression happens when
these feelings start to feel out of proportion with the triggering event and
interfere with your daily life.

Situational depression symptoms tend to start within three months of the initial
event and can include:

 frequent crying
 sadness and hopelessness
 anxiety
 appetite changes
 difficulty sleeping
 aches and pains
 lack of energy and fatigue
 inability to concentrate
 social withdrawal

9. Atypical depression
Atypical depression refers to depression that temporarily goes away in response
to positive events. Your doctor might refer to it as major depressive disorder
with atypical features.

Despite its name, atypical depression isn’t unusual or rare. It also doesn’t
mean that it’s more or less serious than other types of depression.
Having atypical depression can be particularly challenging because you may
not always “seem” depressed to others (or yourself). But it can also happen
during an episode of major depression. It can occur with persistent depression
as well.

Other symptoms of atypical depression can include:

 increased appetite and weight gain

 disordered eating
 poor body image
 sleeping much more than usual
 insomnia
 heaviness in your arms or legs that lasts an hour or more a day
 feelings of rejection and sensitivity to criticism
 assorted aches and pains

How do I know which type I have?

If you think you might have any type of depression, it’s important to follow up
with a doctor. All depression types discussed in this article are treatable,
though it might take some time to find the right treatment for you.

If you’ve had a previous bout of depression and think it may be happening

again, see your psychiatrist or other mental health professional right away.

If you’ve never had depression before, start with your primary care physician.
Some symptoms of depression can be related to an underlying physical
condition that should be addressed.
Try to give your doctor as much information about your symptoms as you can.
If possible, mention:

 when you first noticed them

 how they’ve affected your daily life
 any other mental health conditions you have
 any information about a history of mental illness in your family
 all prescription and over-the-counter medications you take, including
supplements and herbs

It might feel uncomfortable, but try to tell your doctor everything. This will help
them give you a more accurate diagnosis and refer you to the right type of
mental health professional.

Worried about the cost of mental health services? Here are five ways to access
therapy for every budget.

Suicide prevention
 If you think someone is at immediate risk of self-harm or hurting another
person:
 •  Call 911 or your local emergency number.
 •  Stay with the person until help arrives.
 •  Remove any guns, knives, medications, or other things that may
cause harm.
 •  Listen, but don’t judge, argue, threaten, or yell.
 If you or someone you know is considering suicide, get help from a
crisis or suicide prevention hotline. Try the National Suicide Prevention
Lifeline at 800-273-8255.
 7 Common Types of
Depression
By Nancy Schimelpfening  | Medically reviewed by a board-certified physician | Updated June 24,
2019

Depression

 Overview
 Types
 Symptoms
 Causes & Risk Factors
 Diagnosis
 Treatment
 Coping
 ADA & Your Rights
 Depression in Kids
When people think about depression, they often divide it into one of two things—either clinical
depression which requires treatment or "regular" depression that pretty much anyone can go
through. As a condition, depression can be a difficult concept to grasp since we refer to it as both
the symptom of a condition and a condition itself.
From a medical standpoint, depression is defined as a mood disorder which causes a persistent
feeling of sadness and the often profound loss of interest in things that usually bring you
pleasure.
It affects how you feel, think, and behave and can interfere with your ability to function and
carry on with daily life. There are many different causes of depression, some of which we don't
fully understand. Seven of the more common types include the following.

Verywell / JR Bee

1
Major Depressive Disorder (MDD)
When people use the term clinical depression, they are generally referring to major depressive
disorder (MDD)1. Major depressive disorder is a mood disorder characterized by a number of
key features:

 Depressed mood
 Lack of interest in activities normally enjoyed
 Changes in weight
 Changes in sleep
 Fatigue
 Feelings of worthlessness and guilt
 Difficulty concentrating
 Thoughts of death and suicide2

If a person experiences the majority of these symptoms for longer than a two-week period, they
will often be diagnosed with MDD.
2

Persistent Depressive Disorder

Dysthymia, now known as persistent depressive disorder, refers to a type of chronic depression
present for more days than not for at least two years. It can be mild, moderate, or severe.3
3

Bipolar Disorder
Bipolar disorder is a mood disorder characterized by periods of abnormally elevated mood
known as mania. These periods can be mild (hypomania) or they can be so extreme as to cause
marked impairment with a person's life, require hospitalization, or affect a person's sense of
reality. The vast majority of those with bipolar illness also have episodes of major depression.4
In addition to depressed mood and markedly diminished interest in activities, people with bipolar
depression often have a range of physical and emotional symptoms which may include:

 Fatigue, insomnia, and lethargy

 Unexplained aches, pains, and psychomotor agitation
 Hopelessness and loss of self-esteem
 Irritability and anxiety
  Indecision and disorganization5

The risk of suicide in bipolar illness is up to 20 to 30 times greater than in the general
population. Psychosis (including hallucinations and delusions) can also occur in more extreme
cases.
4

Postpartum Depression
Pregnancy can bring about significant hormonal shifts that can often affect a woman's moods.
Depression can have its onset during pregnancy or following the birth of a child.6  Postpartum
depression is more than that just the "baby blues."
It can range from a persistent lethargy and sadness that requires medical treatment all the way up
to postpartum psychosis, a condition in which the mood episode is accompanied by
confusion, hallucinations or delusions. 
5

Premenstrual Dysphoric Disorder (PMDD)

Among the most common symptoms of premenstrual syndrome (PMS) are irritability, fatigue,
anxiety, moodiness, bloating, increased appetite, food cravings, aches, and breast tenderness.7
Premenstrual dysphoric disorder (PMDD) produces similar symptoms, but those related to mood
are more pronounced.

They may include:

 Extreme fatigue
 Feeling sad, hopeless, or self-critical
 Severe feelings of stress or anxiety
 Mood swings, often with bouts of crying
 Irritability
 Inability to concentrate 
 Food cravings or binging

Hormonal treatments may A major in addition to antidepressants and lifestyle changes.8

6
Seasonal Affective Disorder (SAD)
If you experience depression, sleepiness, and weight gain during the winter months but feel
perfectly fine in spring, you may have a condition known as seasonal affective disorder (SAD)9,
currently called major depressive disorder, with seasonal pattern.
SAD is believed to be triggered by a disturbance in the normal circadian rhythm of the body.
Light entering through the eyes influences this rhythm, and any seasonal variation in night/day
pattern can cause a disruption leading to depression.9
SAD is more common in far northern or far southern regions of the planet and can often be
treated with light therapy to offset the seasonal loss the daylight.
7

Atypical Depression
Do you experience signs of depression (such as overeating, sleeping too much, or extreme
sensitivity to rejection) but find yourself suddenly perking up in face of a positive event?

Based on these symptoms, you may be diagnosed with atypical depression, a type of depression
which does not follow what was thought to be the "typical" presentation of the disorder. Atypical
depression is characterized by a specific set of symptoms related to:

 Excessive eating or weight gain

 Excessive sleep
 Fatigue, weakness, and feeling "weighed down"
 Intense sensitivity to rejection
 Strongly reactive moods

It is actually more common than the name might imply. Unlike other forms of depression,
people with atypical depression respond better to a type of antidepressant known as
a monoamine oxidase inhibitor (MAO).10

Major depressive disorder

In a given year, more than 16 million Americans (a majority of them women)
experience this very common type of depression, also known as major depression or
clinical depression. Under diagnostic criteria published by the American Psychiatric
Association, people must have at least five symptoms persisting for two weeks or
longer to be diagnosed with major depressive disorder. Those symptoms can include
feelings of sadness, emptiness, worthlessness, hopelessness, and guilt; loss of energy,
appetite, or interest in enjoyable activities; changes in sleep habits; and thoughts of
death and suicide. Most cases are highly treatable.
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Major depressive disorder has two subtypes: “atypical depression” and “melancholic
depression.” People who fall into the former category tend to sleep and eat a lot. They
are emotionally reactive and very anxious, Dr. Noble explains. Those in the latter
category have trouble sleeping and tend to ruminate over guilt-ridden thoughts, she
says. Young adults tend to present with atypical depression, and the melancholic type
is seen more often in seniors.

Treatment-resistant depression

Sometimes people with major depressive disorder don’t readily respond to treatment.
Even after trying one antidepressant and then another–and maybe a third or fourth–
their depression stubbornly hangs on. “Maybe it’s genetic, maybe it’s environmental,”
Dr. Noble says. “Their depression is just tenacious.”

Helping people overcome treatment-resistant depression begins with a thorough

workup to ensure a proper diagnosis and identify other psychiatric and medical causes
of their symptoms. Patients are counseled on proper dosage and duration of treatment.
If a medicine isn’t working, doctors will try switching to a similar drug or one from a
different class. Patients may benefit from adding a second antidepressant from a
different class and perhaps another type of medicine, such as an antipsychotic.

RELATED: 10 Surprising Antidepressant Facts

Subsyndromal depression

A person who has depressive symptoms but doesn't quite check all the boxes for a
diagnosis of major depression may be deemed “subsyndromal.” Maybe she has three
or four symptoms, not five, or maybe she’s been depressed for a week, not two, Dr.
Noble explains.

“Rather than look at symptoms, I usually look at functionality,” she says. Is the
patient able to go to work and take care of day-to-day responsibilities? If the person is
struggling, they may still benefit from treatment, including with medication, she says.

Persistent depressive disorder

People with persistent depressive disorder (PDD) have a low, dark, or sad mood on
most days and at least two additional symptoms of depression lasting two years or
more. In children and teens, PDD (also called dysthymia) may be diagnosed if
symptoms of irritability or depression persist for a year or more. “It may wax and
wane in intensity, but generally it’s a low level of depression,” Dr. Noble explains.

To be diagnosed with this type of depression, people must also have two of the
following: sleep problems (too much or too little); low energy or fatigue; low self-
esteem; poor appetite or overeating; poor concentration or difficulty making
decisions; and feelings of hopelessness.
Usually PDD requires treatment with a combination of medication and psychotherapy.

RELATED: 7 Types of Therapy That Can Treat Depression

Premenstrual dysphoric disorder

Up to 10% of women of childbearing age experience premenstrual dysphoric disorder

(PMDD). This severe form of PMS can trigger depression, sadness, anxiety, or
irritability, as well as other extreme symptoms, in the week before a woman’s period.

“It can be really uncomfortable, disabling, and interfere with a woman’s day-to-day
life,” says Dorothy Sit, MD, associate professor of psychiatry and behavioral sciences
at Northwestern University’s Feinberg School of Medicine in Chicago.

Scientists believe these women may have an abnormal sensitivity to hormonal

changes during their menstrual cycle. Taking antidepressants, specifically selective
serotonin reuptake inhibitors, in the two weeks before their period or throughout the
month can be very effective, Dr. Sit says. Certain types of contraception may help too.
Researchers at the University of California San Diego are exploring the use of light
therapy to improve sleep quality and mood in women with PMDD.

Bipolar depression

Wide swings in mood and energy, from elation to hopelessness, are the signature of
bipolar depression, also called bipolar disorder or manic-depressive illness. To be
diagnosed with this form of depression, a person must have experienced at least one
bout of mania. Bipolar usually shows up in young adulthood. While women and men
are diagnosed in equal numbers, studies point to possible gender differences: Men
appear to have more manic behavior; women tend toward depressive symptoms.
Bipolar usually worsens without treatment but can be managed with mood stabilizers,
antipsychotic medicines, and talk therapy.

While further research is needed, a recent study by Dr. Sit and colleagues
suggests light therapy may be a potential treatment for bipolar depression too.
Compared with dim placebo light, daily exposure to bright light at midday may reduce
symptoms of depression and improve functioning in people with bipolar disorder, the
study found.

RELATED: 10 Subtle Signs of Bipolar Disorder

Disruptive mood dysregulation disorder

Screaming and temper tantrums can be features of disruptive mood dysregulation

disorder (DMDD), a type of depression diagnosed in children who struggle with
regulating their emotions. Other symptoms include an irritable or angry mood most of
the day nearly every day and trouble getting along in school, at home, or with their
peers.

“These are the kids with strong emotional outbursts,” Dr. Noble says. “They’re just
not able to contain their emotions,” so they “act out and act on” their feelings.

Currently, DMDD is treated using medications, psychotherapy, and parent training on

how to effectively deal with a child’s irritable behavior.

Postpartum (or perinatal) depression

The birth of a baby brings enormous joy but can sometimes lead to postpartum
depression (PPD), a type that affects one in four women and one in eight men. In
women, postpartum depression is likely triggered by shifts in hormones, fatigue, and
other factors. In men, it’s environmental, brought on by shifting roles and lifestyle
changes that come with parenting.

Postpartum depression can begin any time in the first year following a child’s birth,
although it usually appears soon after the new arrival. Intense feelings of sadness,
anxiety, and exhaustion become overwhelming and can interfere with daily life. It can
provoke thoughts of hurting yourself or your baby.

Compared to the “baby blues”–which is a mild, short-lived, and extremely common

condition causing anxiety and depressive symptoms in the immediate wake of a
baby’s birth–PPD usually requires treatment with antidepressants and/or talk therapy.

RELATED: 11 Celebrities Who Opened Up About Postpartum Depression

Seasonal affective disorder

Seasonal affective disorder (SAD) is a recurring type of depression (also known as

seasonal depression) that usually strikes in the fall or winter. Along with a change in
mood, SAD sufferers tend to have low energy. They may overeat, oversleep, crave
carbs, gain weight, or withdraw from social interaction.

Women and younger adults are at higher risk of developing SAD. It can also run in
families. SAD is diagnosed after at least two years of recurring, seasonal symptoms.
While the exact cause is unclear, research suggests it may be related to an imbalance
of the brain chemical serotonin. An overabundance of the sleep hormone melatonin
and insufficient levels of vitamin D may also play a role.

SAD is typically treated with a daily dose of light therapy and sometimes medication.
RELATED: 8 Ways to Cope With Seasonal Affective Disorder

Substance-induced mood disorder

Using or abusing sedating drugs can change your mood. Symptoms, such as
depression, anxiety, and loss of interest in pleasurable activities, typically appear
shortly after taking or abusing a substance or during withdrawal.

Substances that can lead to this type of depression include alcohol (if you drink too
much), opioid painkillers, and benzodiazepines (which act on the central nervous
system).

To diagnose someone with a substance-induced mood disorder, doctors must rule out
other potential causes of depression, and the depression must be severe enough to
interfere with daily activities.

Psychotic depression

People with psychotic depression have severe depression accompanied by psychosis,

which is defined as losing touch with reality. Symptoms of psychosis typically include
hallucinations (seeing or hearing things that aren't really there) and delusions (false
beliefs about what's happening)

One of Dr. Noble’s patients, two years after beginning treatment, confessed that she
had a year during which she would not eat anything her father cooked because she
thought he was poisoning her. The woman was otherwise lucid; she simply suffered
from psychotic depression that had not been fully treated.
Doctors usually prescribe antidepressants and antipsychotic medicines together to
treat psychotic depression.

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Depression due to an illness

Coping with a serious chronic disease, like heart disease, cancer, multiple sclerosis,

and HIV/AIDS, can be depressing in and of itself.

Adding insult to injury, there’s now evidence that disease-related inflammation may
also play a role in the onset of depression. Inflammation causes the release of certain
chemicals by the immune system that cross into the brain, leading to brain changes
that can trigger or worsen depression in certain people, Dr. Noble explains.
Antidepressants may help prolong their life and improve their ability to function, she
says, and therapy can help many patients cope with mental and physical illnesses.
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