The Many Faces of Depression

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Although depression is a well-recognized mental health condition, not all cases of depression are the same. In fact, depression can take many forms and manifest itself in very different ways, depending on the individual and the root cause of the depression. 

Understanding the many faces of depression can help you identify which category you might fall in. It can also make it easier to talk to your therapist about your concerns and to explain your experience to your loved ones.

Major depression

This is often referred to as “major depressive disorder” or unipolar depression.” If you feel depressed most of the day for most days of the week, you might have major depression.

Some common symptoms of major depression include:

  • Loss of pleasure or interest in things you used to enjoy
  • Unexplained weight gain or loss
  • Insomnia or oversleeping
  • Feeling restless and agitated (or very sluggish and slowed down mentally or physically)
  • Feeling tired and lethargic
  • Feeling persistent guilt or a sense of worthlessness
  • Trouble focusing or making decisions
  • Suicidal thoughts or urges
  • Thoughts of self-harm
  • Feeling tense and restless most days
  • A deep sense of persistent dread

Persistent depressive disorder

Depression that lasts for 2 years or longer is categorized as persistent depressive disorder. This term is now used to describe 2 conditions previously known as “dysthymia” (moderate, persistent depression) and “chronic major depression.”

Seasonal affective disorder (SAD)

This is a form of major depression that happens most during a specific season, usually the winter months. Seasonal affective disorder (SAD) typically goes away in the spring and summer, when the days lengthen and you get more sunshine.

However, it’s important to note that it’s possible (but less common) to have seasonal depression during the spring and summer instead.

One common treatment for seasonal affective disorder (to complement therapy and antidepressants) is light therapy. This involves sitting in front of a special bright lightbox for about 15-30 minutes each day to replace the sunlight you’d normally get during the sunnier months.

Psychotic depression

Psychotic depression is defined as regular symptoms of depression along with “psychotic” symptoms, like:

  • Delusions (false beliefs)
  • Hallucinations (seeing or hearing things that aren’t there)
  • Paranoia (wrongly believing other people are out to get you)

Psychotic depression is generally treated using a combination of antidepressants and antipsychotics.

Peripartum and postpartum depression

“Peripartum” means “around birth” and “postpartum” means “after birth.” This is a major depression that occurs in the weeks and months before or after childbirth. This is more than just minor sadness, worry, or stress over having a child.

While these types of depression typically affect someone who has recently given birth, it’s possible to experience peripartum or postpartum depression if your partner or spouse is the one who has recently given birth.

Antidepressants and therapy are the most common treatment methods for peripartum and postpartum depression, similar to major depression unrelated to childbirth.

How long does postpartum depression last?

Postpartum depression can last anywhere from a few weeks to several months after giving birth. However, seeking treatment sooner than later can help prevent it from lasting a long time.

Premenstrual dysphoric disorder

Premenstrual dysphoric disorder (PMDD) refers to depression and other symptoms around the start of a person’s menstrual period. It’s usually treated using antidepressants and, sometimes, oral contraceptives.

In addition to feeling generally depressed, common PMDD symptoms include:

  • Irritability
  • Mood swings
  • Trouble focusing
  • Anxiety
  • Fatigue
  • Feeling overwhelmed
  • Change in appetite or sleep habits

Bipolar depression

This is one side of the double-sided coin of bipolar disorder’s alternating periods of extremely high energy (mania) and extremely low mood (depression). During the low period, they may have symptoms like feeling sad, hopeless, or lethargic.

Everyone’s depression is different. But knowing the terms and categories of depression can help you understand your symptoms better. It can also help you describe your situation more accurately and thoroughly to your mental health care provider, which in turn can mean better treatment for you.

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