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  • Types of Depression


    Just like all other illnesses, depression too comes in different forms. However there are variations in severity, timing, number of occurrences, features and persistence of symptoms characterizing different types of depression.

    Types of Depression by Polarity

    Unipolar Type

    Unipolar type refers to one polarity, one side of the mood spectrum. This side refers to depression type with negative (down) symptoms only. Major depression also known as major depressive disorder is a major type of unipolar depression & terms are often used to describe the same condition. The condition is characterized by symptoms such as depressed moods, decreased interest in activities that the individual once found enjoyable, difficulty in sleeping, fatigue, difficulty in concentrating, feelings of excessive guilt and other negative symptoms for at least two weeks (see the full list of symptoms here http://depressionsymptomssigns.org/). Unipolar depression can occur any number of times during an individual’s lifetime, symptoms of which often disrupt the normal life of the individual suffering from it, as well as the life of people around him/her. Work performance, social & interpersonal relationships are very often compromised due to this condition. Unipolar type depression can occur any number of times during an individual’s lifetime. Terms like unipolar disorder, clinical depression, recurrent depressive disorder are commonly used to describe the same condition.

    Bipolar Type

    Bipolar type refers to two polarities, two sides of the mood spectrum, which are depression & mania. The condition is commonly known as manic depression or bipolar disorder. For a person to be diagnosed with bipolar type there needs to be occurrence of at least one manic episode. Bipolar disorder often lasts a lifetime, and though is not curable, it can be managed & people who suffer from it can lead a fulfilling life. Bipolar disorder seems to have a direct link with creativity, many well-known & respected artists & scientists are believed to be or have suffered from this illness. People who suffer from this disorder can experience all the symptoms of unipolar depression. The manic stage often affects the judgment as well as the behavior of the individuals which causes them to behave in an, what others would think, irrational manner. Bipolar disorder comes in several subtypes as well.

    • Bipolar I Disorder
    • Bipolar II Disorder
    • Cyclothymic Disorder
    • Bipolar Disorder Not Otherwise Specified
    • Rapid Cycling

    Types of Depression By Severity

    Mild

    Symptoms cause minor impairment in social, interpersonal & occupational functioning.

    Moderate

    Social, interpersonal & occupational functioning impairment caused by symptoms falls between mild & severe.

    Severe Without Psychotic Features

    Symptoms cause marked impairment in social, interpersonal & occupational functioning.

    Severe With Psychotic Features

    Delusions or hallucinations exist in addition to regular symptoms that cause marked impairment in social, interpersonal & occupational functioning. Subtypes of psychotic features include:

    • Mood-Congruent Psychotic Features
      The content of delusions or hallucinations entirely consist of themes of typical depressive features like guilt, deserved punishment, nihilism, death, disease.
    • Mood-Incongruent Psychotic Features
      The content of delusions or hallucinations does not consist of themes of typical depressive features, generally includes thought insertion, delusions of control, thought broadcasting and persecutory delusions directly unrelated to depressive themes.

    Types of Depression by the Pattern of Episodes

    Chronic Type

    Full major depressive disorder criteria have been met uninterruptedly for at least the past two years in a row.

    Dysthymic Type

    Chronically depressed mood for most of the days during the year & for most of the day for no less than 2 years (for children 1 year, likely to have more irritable mood than depressed mood), symptoms are not as severe as for those with major depression. Because of the continuous nature of the condition, symptoms usually become a part of person’s everyday life, and they hardly ever mention them. In addition to regular “feeling down”, “sad” symptoms, at least 2 of the following symptoms are reported:

    • insomnia or hypersomnia
    • low self-esteem
    • overeating  or poor appetite
    • low energy or fatigue
    • excessive self-criticism
    • difficulty making decisions
    • poor concentration
    • hopelessness
    • incapable or uninteresting is what they think of themselves

    Usually people who suffer from dysthymia have a high risk of developing major depression.

    Recurrent Type

    More than one episode of major depressive disorder has been indicated.

    Single Type

    Only one episode of major depressive disorder has been indicated.

    In Partial Remission

    Symptoms are present, however, the individual does not meet the full criteria, or a period of less than 2 months with no significant symptoms follows the end of a major depressive episode.

    In Full Remission

    Significant symptoms or signs were not present during the former two months.

    With Full Interepisode Recovery

    Between the 2 latest mood episodes full remission has been reached.

    Without Full Interepisode Recovery

    Between the 2 latest mood episodes full remission has not been reached.

    Types of Depression by Features & Pattern

    With Psychotic Features

    Refers to symptoms of delusions or hallucinations (most commonly auditory). Most commonly reported types include:

    • delusions or hallucinations of guilt or deserved punishment (e.g. feeling responsible for illness of another person, hearing voices scolding for person’s sins & flaws, conviction that the situation is a punishment for a personal wrongdoing or shortfalling)
    • nihilistic delusions of himself/herself or the world
    • somatic delusions (e.g. convinced of being sick with a deadly illness or believes that his/her body is rotting)
    • poverty delusions (e.g. being financially in trouble, bankrupt)
    • persecutory delusions (e.g. believes that deserves being persecuted without feelings of guilt)
    • delusions of thought (e.g. believes thoughts aren’t his/her own or thinks other people can hear his/her thoughts)
    • delusions of being controlled (e.g., believes his/her actions are controlled by somebody or something external)

    With Catatonic Features

    Clinical condition is characterized by significant psychomotor disturbance, such as

    • motoric immobility
    • excessive motor activity
    • peculiarities of voluntary movement
    • extreme negativism
    • echolalia
    • mutism
    • echopraxia

    With Melancholic Features

    Defined by loss of interest, reaction or getting pleasure from almost all or all activities. Even if anything good happens, the mood doesn’t improve even for a short period of time. Not less than 3 of the symptoms below are present:

    • apparent depressed mood
    • depression is regularly worse early in the morning, particularly at awakening
    • psychomotor agitation or retardation
    • noticeable weight loss  or anorexia
    • inappropriate or excessive guilt

    With Atypical Features

    Defined by mood reactivity to potential or actual events. 2 or more of the symptoms below are present:

    • greater than usual appetite or significant weight gain
    • too much sleep, need for sleep or laying in bed
    • heavy feeling in legs or arms
    • acquired pattern of high sensitivity to interpersonal rejection which causes social, occupational or interpersonal impairment

    With Postpartum Onset

    Post-partum depression may occur in women within four weeks after giving birth to a child. The duration and the intensity of this depression can vary.

    With Manic, Hypomanic Features

    Defined by occurrence of one or more episodes of hypomania or mania. Detailed symptoms of manic depression can be found here http://depressionsymptomssigns.org/manic-depression-symptoms/

    With Seasonal Pattern

    Seasonal affective disorder is defined by a regular temporal onset of depression during a certain time of the year (e.g., regularly feels depressed wintertime), however these onsets must not be caused by physical stressors that may occur due to certain factors associated with that time of the year . Full remissions also must re-occur during a particular time of the year (e.g. depression is lifted summertime).

    Other Types of Depression

    With General Medical Condition Onset

    Defined by dominant mood of depression or mixed episode, symptoms of which cause significant impairment in occupational, social & interpersonal functioning, which has evidence backed by physical examination, history or laboratory findings of the condition being caused by the direct physiological consequence of a general medical condition.

    Substance-Induced Type

    Defined by dominant mood of depression or mixed episode, which has evidence of being caused by substance intoxication or substance withdrawal.

    Depressive Disorder Not Otherwise Specified

    As the name suggests, all the other types of depression that don’t fall into other categories belong here. E.g. premenstrual dysphoric disorder, minor depressive disorder, recurrent brief depressive disorder etc.




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