Overview

Most people go through times of grief or sadness, but depression is something more. The World Health Organization (WHO) says depression is a persistent sadness and a lack of interest in previously enjoyed activities. The WHO says that 5% of adults are dealing with this disorder across the world.

The National Institute of Mental Health reports that 21 million American adults had at least one major depressive episode during the past year. This number came from the 2020 National Survey on Drug Use and Health.

Types of Depression

There are several different kinds of depression. Most forms of depression have common symptoms. Some types have specific symptoms or causes. It is important to remember that people can have several of these symptoms from time to time without having depression.

Here are the most common types of depression:

• Major depressive disorder
• Persistent depressive disorder
• Perinatal depression
• Seasonal affective disorder

Major Depressive Disorder

Major depressive disorder (MDD) is also sometimes called clinical depression. This is one of the most common mental health issues people face in the United States. For someone to be diagnosed with MDD they must meet specific criteria.

The first part of the criteria includes the following:

• A person must have a change from their previous functioning
• Symptoms must occur for a minimum of two weeks
• One of the symptoms must be a depressed mood or a loss of interest in pleasure

In addition to the above a patient must have five or more of the following symptoms during the two weeks:

• Having trouble falling asleep or wanting to sleep more than normal
• Feelings of restlessness
• Sudden loss or gain of weight, or a change in appetite
• Loss of interest in activities previously enjoyed
• Feeling sad or irritable most of the day, almost every day
• Feeling unusually tired and lacking energy
• Feeling worthless or guilty
• Problems concentrating, thinking, or making decisions
• Thoughts of self-harm or suicide

Causes

It is not known what exactly causes someone to experience MDD. Several different factors may be involved. People with depression show some physical changes inside their brains. Changes in brain neurotransmitters that affect mood could also influence depression.

A change in hormones might be involved in causing depression. There is also the possibility of a genetic factor causing someone to be more likely to experience depression. The condition is more common in people with relatives that also have depression.

Some factors seem to increase the risk of developing depression:

• Traumatic events such as the death of a loved one, abuse, financial problems
• Low self-esteem, being too self-critical, or pessimistic
• History of other mental health disorders
• Serious or chronic illness
• Substance abuse
• Certain medications

Treatment

There are some different things people can try while dealing with depression. Talking to a therapist can help someone cope with a traumatic situation. Some lifestyle changes may help improve some symptoms.

Dietary changes like avoiding processed foods and alcohol may help some symptoms. Adding foods high in nutrients may also help. Exercising in moderate sunlight can help boost mood.

Many medications can be prescribed to help with depression symptoms. Patients should work with their doctors to find which medication works best for them. The following medications could be prescribed for MDD:

• Celexa
• Lexapro
• Prozac
• Luvox
• Paxil, Paxil CR
• Zoloft
• Viibryd
• Pristiq
• Fetzima
• Khedezla
• Cymbalta
• Effexor, Effexor XR
• Remeron
• Wellbutrin

Persistent Depressive Disorder

Persistent depressive disorder may also be called dysthymia. This is a chronic (long-term) form of depression. The symptoms of this disorder are similar to MDD, but come and go for years. In a typical case, symptoms do not disappear for more than two months at a time.

In addition to the symptoms of MDD, someone with Persistent depressive disorder may have feelings of hopelessness. They might also avoid social activities. The treatment and medication options are the same as MDD.

Perinatal Depression

Perinatal depression can occur in pregnant women. This includes depression that starts during pregnancy and depression that starts after the baby is born (postpartum depression).

Perinatal depression does not seem to have a specific cause. The risk factors and possible causes are the same as MDD. Pregnancy hormones can also be a risk factor. The physical and emotional demands of caring for a newborn can also be involved.

The symptoms are also the same as MDD with the addition of the following:

• Persistent doubts about their ability to take care of their newborn
• Trouble bonding or creating an attachment to their newborn
• Thoughts of harming themselves or the baby, thoughts of suicide

Treatment options are also consistent with those for MDD. Women should work closely with their doctors concerning medication. This is to minimize any possible negative effects on the baby.

Seasonal Affective Disorder

This type of depression is connected to the change of the seasons. For most people it begins in the fall, lasts through winter, and symptoms end in the spring and summer months. People tend to be affected each year.

The specific cause of seasonal affective disorder is not known. Some possible contributing factors are:

• Melatonin levels – the change of season might change the body’s melatonin level, affecting mood.
• Serotonin levels – reduced sunlight can cause a drop in serotonin levels, affecting mood.
• Vitamin D – Vitamin D is produced by the skin in sunlight, reduced sunlight can cause low levels of Vitamin D.

Treatment for SAD is similar to MDD. Psychotherapy and medications can be used. Light therapy may be added to mimic sunlight within the first hour of waking up.