What is Depression?

Depression: A Primer

Thanks for coming back this morning. Yesterday, in light of the Robin Williams tragedy, we looked at some of the warning signs of suicide and some action steps you can take if you’re concerned that someone you know may be thinking of harming themselves. Over the next few days I would like to focus our attention on depression itself.
Depression is a complicated phenomenon. There are several different types of depression and their causes can be purely psychological, biochemical, or as is most often the case, a combination of the two. The good news is that depression is very successfully treatable with most clients going on to lead healthy, normal lives.
Following is a blog that I originally published on 5/21/13 discussing the different types of depression and how to recognize them:
Depression seems to have become a national epidemic. The media are constantly giving us stories about depression and trying to sell us pills, potions and nostrums to treat it. In fact, if you go turn on your television right now, I’m willing to wager that you won’t be able to go a half hour without at least one advertisement for some form of depression treatment.
So with all this attention on this disorder, you’d think that people were pretty well versed about what depression is, how to recognize it and how to treat it, wouldn’t you? Unfortunately, just the opposite is true. Most people don’t have a clue…but we’re going to change that right now.
First of all, did you know that there are several different types of depression? The first and probably most common is Major Depressive Disorder (MDD). This condition is characterized by a depressed mood most of the day, particularly in the morning, and a loss of interest in normal activities and relationships — symptoms that are present every day for at least 2 weeks. Other common symptoms include:

  • Fatigue or loss of energy almost every day.
  • Feelings of worthlessness or guilt almost every day.
  • Impaired concentration, indecisiveness.
  • Insomnia or hypersomnia (excessive sleeping) almost every day.
  • Markedly diminished interest or pleasure in almost all activities nearly every day
  • Restlessness or feeling slowed down.
  • Recurring thoughts of death or suicide.
  • Significant weight loss or gain (a change of more than 5% of body weight in a month).

Another variety of depression is chronic mild depression or Dysthymia. With this type of depression the symptoms can linger for a prolonged period of time…in some cases for two years or longer. People with Dysthymia can also slip into major depressive episodes. With the exception of the length of time the client experiences symptoms the presenting symptoms are the same as MDD.
Atypical Depression is a condition that can have some symptoms that are similar to those of major depression, but it doesn’t have the number of symptoms needed for a diagnosis of major depression. In general, people with atypical depression tend to experience their first depressive episode at an early age, usually during their teenage years. The major difference with Atypical Depression is mood reactivity; that is a person with Atypical Depression will see his or her mood improve if something positive happens. In major depression, positive events don’t typically translate into positive feelings. In addition, diagnostic criteria call for at least two of the following symptoms to accompany the mood reactivity:

  • sleeping too much (hypersomnia)
  • increased appetite or weight gain
  • having a more intense reaction or increased sensitivity to rejection, resulting in problems with social and work relationships
  • having a feeling of being weighed down, paralyzed, or “leaden”

Bipolar Disorder (formerly called Manic Depression) is characterized by dramatic mood swings ranging from deep, crushing depression to feelings of extreme elation, grandiose thinking and feelings of invincibility. Each episode is different with the feelings ranging from mild to extreme, and they’re unpredictable as they can manifest themselves over several weeks or literally within minutes. The depressive symptoms are similar to MDD, but the symptoms associated with a manic episode can include:

  • Disconnected and racing thoughts
  • Grandiose notions
  • Inappropriate elation
  • Inappropriate irritability
  • Inappropriate social behavior
  • Increased sexual desire
  • Increased talking speed and/or volume
  • Markedly increased energy
  • Poor judgment
  • Severe insomnia

Other forms of depression include Seasonal Affective Disorder (a form of depression that affects people typically in the fall and winter and is associated with decreased exposure to sunlight), Psychotic Depression (similar to MDD, but with hallucinations and feelings of extreme worthlessness and persecution). Another form of depression we hear about frequently is Postpartum Depression which affects women who have recently given birth; in fact one of the diagnostic criteria is that the onset of symptoms occurs within four weeks of delivery.
OK, we’ve covered a lot of ground today, but I hope you are taking away a better understanding of what depression is, how it manifests itself and major warning signs and symptoms. Tomorrow, we’ll look at treatment options for the various types of depression, so I hope to see you back tomorrow.
In the meantime, I hope you have an intentionally great and optimistic day.

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