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Types
of
Depression
Everyone experiences some unhappiness. The
sadness and grief people experience are usually appropriate and
necessary. Sometimes these trial and tribulations can even
present an opportunity for personal growth. However, when depression
becomes long lasting and interferes with daily life, it may indicate a
depressive disorder. A depressive disorder is distinguished
from normal sadness by its severity, duration, and accompanying
symptoms.
Depression is not a character flaw that people can 'just get over'.
Most people who are depressed do not seek psychiatric help. They suffer
needlessly. Depression is a treatable illness. If you suspect that you
suffer from depression please consult your family
physician, a psychologist, or psychiatrist for help.
Major
Depression
The overarching feature of major depression is
abnormality. Its main features are persistant saddness, marked
functional impairment, disabling physical symptoms, and
disabling psychological symptoms that last at least 2 weeks.
Mood Symptoms
- abnormal
depressed mood - hopeless, discouraged, and empty
- abnormal
loss of interest and pleasure mood - crippling lack of
motivation and reduced capacity to experience pleasure
- abnormal
irritable mood - often alienates loved ones
Physical
Symptoms
- abnormal
appetite - either eating too little or too much
- abnormal
sleep - either difficulty falling asleep, frequent awakenings
during the night or very early morning awakening or the opposite,
excessive
sleeping
- fatigue
or loss of energy - profound, prominent and disabling
- agitation
or slowing - either actual physical slowing of speech,
movement and thinking or observable pacing and physical restlessness
Cognitive
Symptoms
- abnormal
self-reproach or inappropriate guilt - marked lowering of
self-esteem and self-confidence with increased thoughts of pessimism,
hopelessness, and
helplessness or feelings of excessive and unreasonable guilt
- abnormal
poor concentration or indecisiveness - becoming quickly
mentally fatigued when asked to read, study, or solve complicated
problems
- abnormal
morbid thoughts of death (not just fear of dying) or
suicide - hopelessness
Atypical
Depression
The symptoms of atypical depression include overeating, oversleeping, a
general feeling of sadness,strong feelings of rejection, and laeden
paralysis (a sensation of heaviness especially in the arms). The
ingestion of carbohydrates cause an increase in serotonin in the brain
so the preference for overeating carbohydrates reflects a type of
self-medication for these sufferers. An atypical depressive may be able
to enjoy pleasurable circumstances despite being unable to seek out
such circumstances. This contrasts with the "typical" depressive, who
generally has reduced appetite and insomnia, and who is often unable to
find pleasure in anything. Patients with atypical depression are more
apt to have shorter but more frequent episodes of depression and are
also more likely to be passive aggressive and have an
obsessive-compulsive personality. Some studies suggest that the MAO
inhibitors like phenelzine are more affective drugs in treating this
disorder than the SSRIs or tricyclics. Despite its name, atypical
depression is the most common subtype of depression.
Chronic
Depression
Chronic, but mild depression is called dysthymia.
Dysthymia shares most of the same symptoms with major depression but
is less intense and last at least two
years. People with chronic depression suffer from low energy, a general
negativity, and a sense of dissatisfaction and hopelessness. They do
not exhibit marked changes in mood or in daily functioning
and suicidal thoughts are not usually present. It can be described as a
general sadness that always seems to be with you.
When people with chronic depression also have episodes of major
depression from time to time, the condition is known as double
depression.
Grief
Grief is a healthy emotional response to loss. It has much in common
with the symptoms of depression but usually only lasts between three
and six months. After this
period of grief, people begin to become reinvolved with life and "move
past" it.
If the grief remains severe, however, it increases the risk for
on-going depression. This severe persistent grieving is sometimes
called complicated grief disorder and the sufferer should seek
treatment.
Situational
Depression
Published the first week of April 2007 in Archives of General
Psychiatry.
http://archpsyc.ama-assn.org/cgi/content/short/64/4/433
The gist of this article is that major
depressive disorder is likely overdiagnosed 25% of the time. The only
'exclusion' to the diagnosis in the DSM IV is 'bereavement' and doesn't
take into account depressive symptoms that people have as a normal
response to losses or traumas such as divorce, financial failure, and
other such situational factors, and the article points out that lots of
doctors just give depression checklists and don't bother to do a good
taking of history to find out the cause of the symptoms. The actual
study doesn't say this but some think their real implication is that
medications won't fix a divorce, financial disaster, and those kinds of
things. This isn't really news, lots of mental health professionals
have known this all along.
Hysteroid Dysphoria
The hysteroid dysphoria is characterized by repeated episodes of
depressed mood in response to feeling rejected, and a craving for
sweets and chocolate.
Seasonal Affective Disorder (SAD)
SAD is described as
depression during the fall or winter. This type of depression lifts in
the spring or summer, and may be replaced by a manic phase. The
majority of
people who suffer from SAD experience fatigue, a tendency to overeat,
and a tendancy to oversleep in winter. Some people, however, experience
loss of appetite and sleeplessness instead.
Premenstrual Dysphoric Disorder
An estimated 3% to 8% of
women have PDD. The symtoms are severe depression, irritability, and
tension for a week or so before menstruation. These symptoms dissipate
after the menstrual period begins.
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