One in five women and one in 10 men will experience depression during his or her lifetime. But the diagnosis alone does not fully describe the condition; there are several types of depression, distinguished by duration, severity and type of symptoms. The following three kinds of depression are distinct disorders described in the Diagnostic and Statistical Manual of Mental Disorders (DSM), an American Psychiatric Association publication that details criteria for psychiatric disorders.
Major Depressive Disorder (also called Major Depression or Clinical Depression) – This is diagnosed when a major episode of depression occurs with symptoms that last most of the day and nearly every day for at least two weeks. One of the symptoms is always a depressed mood and/or a marked decrease in enjoyment or interest in most activities. In addition, at least four of the following symptoms are present: loss of energy, excessive guilt or feelings of worthlessness, significant changes in weight or appetite, too little or too much sleeping, psychomotor agitation or retardation, reduced ability to concentrate or make decisions, and persistent thoughts of death or suicide.
Bipolar Disorder (also called Manic Depression) – This is diagnosed when a person cycles between states of depression and mania, or when a person experiences only the mania. A manic episode lasts for at least one week and features an extremely elevated or irritable mood. At least three (or four if only mania is experienced) of the following symptoms are also present: inflated self-esteem or self-importance, compulsive talking, racing thoughts or ideas, a decreased need for sleep, an increase in goal-oriented activities or excessive movement, and excessive involvement in pleasurable but potentially risky behavior (for example, over spending, careless sexual activity, or unwise business investments).
Dysthymic Disorder (also called Dysthymia) – This is diagnosed when an individual experiences a depressed mood for at least two years, has not been without the symptoms for more than two months at a time, and has at least two of the following symptoms: loss of energy, feelings of hopelessness, low self-esteem, significant changes in weight or appetite, too little or too much sleeping, and reduced ability to concentrate or make decisions. Generally, this type of depression is described as having persistent but less severe depressive symptoms than Major Depressive Disorder.
Other categories of depression include :
Chronic Depression – This is a major depressive episode that lasts for at least two years.
Post Partum Depression – This is a major depressive episode that occurs after giving birth, usually within four weeks post partum.
Seasonal Affective Disorder (SAD) – This is characterized by episodes of major depression which reoccur at specific times of the year, usually autumn and winter.
Atypical Depression – This is a sub-type of Major Depressive Disorder or Dysthymic Disorder. The criteria for diagnosis is a temporary mood improvement due to positive events and two or more of the following symptoms: significant changes in weight or appetite, over sleeping, a heavy feeling in the arms or legs and a long standing sensitivity to rejection.
Situational Depression (also called Adjustment Disorder with Depressed Mood) – This is depression that is developed in response to a specific stressful situation or event. It occurs within three months of the stressor and lasts no longer than six months after the stressor or the consequences of a stressful event has ended.
Double Depression – This occurs when a person with Dysthymia also experiences a major depressive episode ( more severe depressive symptoms lasting at least two weeks).
Endogenous Depression – This is depression that has no identifiable cause.
Psychotic Depression – This is a major depressive episode accompanied by psychotic symptoms such as hallucinations or delusions.
Agitated Depression – This is a kind of major depressive disorder without the low energy or mental lethargy. Instead, the afflicted person experiences physical and emotional agitation, irritability and insomnia.
Catatonic Depression – This is a sub-type of Major Depressive Disorder that is characterized by at least two of the following: loss of voluntary movement and inability to react to one’s environment, excessive movement that is purposeless and not in response to the environment, inability or unwillingness to speak, odd or inappropriate movements or postures (bizarre mannerisms or facial expressions), and involuntarily repeating someone’s words or movements in a meaningless way.
Treatment for depression varies according to the type of depression and its symptoms, but generally a combination of psychotherapy and medication is effective for the majority of affected individuals. Self-help efforts cannot be underestimated. Wellness expert and author Dr. Andrew Weil says that the best single treatment for depression is vigorous, regular exercise for at least 30 minutes per day and for at least five days a week. Others have found relief in prayer and meditation, dietary changes and peer support groups.