types of depression

Source: National Institute of Mental Health

Just like other illnesses, such as heart disease, depression comes in different forms. This booklet briefly describes three of the most common types of depressive disorders. However, within these types, there are variations in the number of symptoms, their severity, and persistence.

Major depression (or major depressive disorder) is manifested by a combination of symptoms (see symptoms list below) that interferes with the ability to work, study, sleep, eat, and enjoy once pleasurable activities. A major depressive episode may occur only once; but more commonly, several episodes may occur in a lifetime. Chronic major depression may require a person to continue treatment indefinitely.

A less severe type of depression, dysthymia (or dysthymic disorder), involves long lasting, chronic symptoms that do not seriously disable, but keep one from functioning well or feeling good. Many people with dysthymia also experience major depressive episodes at some time in their lives.

Another type of depressive illness is bipolar disorder (or manic depressive illness). Bipolar disorder is characterized by cycling mood changes: severe highs (mania) and lows (depression), often with periods of normal mood in between. Sometimes the mood switches are dramatic and rapid, but usually they are gradual. When in the depressed cycle, an individual can have any or all of the symptoms of depression. When in the manic cycle, the individual may be overactive, over talkative, and have a great deal of energy. Mania often affects thinking, judgment, and social behavior in ways that cause serious problems and embarrassment. For example, the individual in a manic phase may feel elated, full of grand schemes that might range from unwise business decisions to romantic sprees and unsafe sex. Mania, left untreated, may worsen to a psychotic state.

Symptoms of Depression and Mania

Not everyone who is depressed or manic experiences every symptom. Some people experience only a few; some people suffer many. The severity of symptoms varies among individuals and also over time.

Depression

• Persistent sad, anxious, or “empty” mood.
• Feelings of hopelessness or pessimism.
• Feelings of guilt, worthlessness, or helplessness.
• Loss of interest or pleasure in hobbies and activities that were once enjoyable, including sex.
• Decreased energy, fatigue; feeling “slowed down.”
• Difficulty concentrating, remembering, or making decisions.
• Trouble sleeping, early morning awakening, or oversleeping.
• Changes in appetite and/or weight.
• Thoughts of death or suicide, or suicide attempts.
• Restlessness or irritability.
• Persistent physical symptoms, such as headaches, digestive disorders, and chronic pain that do not respond to routine treatment.
  

“You don’t have any interest in thinking about the future, because you don’t feel that there is going to be any future.”

-Shawn Colten, National Diving Champion

“I wouldn’t feel rested at all. I’d always feel tired. I could get from an hour’s sleep to eight hours sleep, and I would always feel tired.”

-Rene Ruballo, Police Officer

Mania

• Abnormal or excessive elation.
• Unusual irritability.
• Decreased need for sleep.
• Grandiose notions.
• Increased talking.
• Racing thoughts.
• Increased sexual desire.
• Markedly increased energy.
• Poor judgment.
• Inappropriate social behavior.
  

NIH Publication No. 05-4972
Revised 2005