According to a recent Gallup article, depression is at an all-time high.
About 18% of adults – more than 1 in 6 – have said they’re depressed or are being treated for depression. Even worse, nearly 3 in 10 adults have been clinically diagnosed with depression at some point in their lifetime, according to the survey, which is also a record high. Depression comes in many forms, some more severe than others.
Symptoms of Depression
- Emotional Symptoms: Persistent sadness, feelings of hopelessness, helplessness, or worthlessness, irritability, and anxiety.
- Physical Symptoms: Changes in sleep patterns (insomnia or oversleeping), changes in appetite or weight, fatigue, and unexplained aches and pains.
- Cognitive Symptoms: Difficulty concentrating, making decisions, or remembering details.
- Behavioral Symptoms: Withdrawal from activities once enjoyed, reduced social interaction, and changes in activity levels.
- Psychomotor Symptoms: Slow movements or speech, or feeling physically agitated.
Contributing Factors
- Biochemical Factors: Imbalances in neurotransmitters such as serotonin, norepinephrine, and dopamine can affect mood and behavior, contributing to depression.
- Genetic Factors: A family history of depression increases the risk. Genetic predisposition plays a crucial role.
- Environmental Factors: Stressful life events such as trauma, loss of a loved one, financial problems, or a difficult relationship can trigger depression.
- Psychological Factors: Personality traits such as low self-esteem, chronic stress, or a pessimistic outlook can make an individual more susceptible to depression.
- Medical Conditions: Chronic illnesses such as diabetes, heart disease, or chronic pain can contribute to depression.
Recognizing Depression
To help others recognize depression, consider watching for these key indicators:
- Mood: Persistent low mood or sadness, irritability, or mood swings.
- Energy: Noticeable fatigue, lack of motivation, or frequent tiredness.
- Sleep: Disturbances in sleep patterns, like waking up too early, insomnia, or excessive sleeping.
- Appetite and Weight: Significant changes in appetite or weight, either increased or decreased.
- Interest: Loss of interest or pleasure in activities once enjoyed.
- Cognition: Difficulty concentrating, making decisions, or forgetfulness.
- Social Interaction: Withdrawal from family, friends, or social activities.
Major Depressive Disorder (MDD)
Characterized by a persistent feeling of sadness or lack of interest in outside stimuli, leading to significant impairment in daily life. It is a common and serious mood disorder that affects how a person feels, thinks, and handles daily activities. It goes beyond typical sadness and can significantly impact one’s quality of life. Typically, MDD is treated with a combination of medication and psychotherapy. Key Symptoms of Major Depressive Disorder:
- Persistent Sadness: Continuous feelings of sadness or emptiness.
- Loss of Interest or Pleasure: Not caring about activities once enjoyed.
- Changes in Appetite: Significant weight loss or gain.
- Sleep Disturbances: Insomnia or excessive sleeping.
- Psychomotor Changes: Being restless or slowed down.
- Fatigue: Loss of energy or increased fatigue.
- Feelings of Worthlessness or Guilt: Excessive or inappropriate guilt.
- Cognitive Issues: Trouble concentrating, thinking, or making decisions.
- Thoughts of Death or Suicide: Recurrent thoughts of dying or suicidal ideation.
Persistent Depressive Disorder (PDD) / Dysthymia
Persistent Depressive Disorder, formerly known as dysthymia, is a chronic form of depression. Treatment often includes a combination of antidepressant medications and psychotherapy, particularly Cognitive Behavioral Therapy (CBT). Key Symptoms of Persistent Depressive Disorder:
- Depressed Mood: Most of the day, more days than not, for at least two years.
- Appetite Changes: Poor appetite or overeating.
- Sleep Disturbances: Insomnia or hypersomnia.
- Low Energy: Persistent fatigue.
- Low Self-Esteem: Feelings of inadequacy or low self-worth.
- Poor Concentration: Difficulty making decisions or focusing.
- Feelings of Hopelessness: Persistent pessimistic outlook.
Seasonal Affective Disorder (SAD)
What it is: Seasonal Affective Disorder (SAD) is a type of depression that occurs at certain times of the year, usually in the winter when daylight hours are shorter. With less sunshine, their biochemical/neurochemical balance gets a bit off-kilter.
Symptoms: Individuals may feel depressed, fatigued, and lose interest in activities usually enjoyed. Other symptoms include changes in sleep patterns, appetite changes, and difficulty concentrating. The following biochemical and neurochemical factors play a significant role in Seasonal Affective Disorder:
- Serotonin Levels: Serotonin is a neurotransmitter that contributes to feelings of well-being and happiness. Reduced sunlight during the winter months can lead to decreases in serotonin levels. This decrease can trigger symptoms of depression, as serotonin is crucial for mood regulation.
- Melatonin Production: Melatonin is a hormone responsible for regulating sleep-wake cycles. Light influences melatonin production; darkness triggers its release, making us feel sleepy. During the winter, longer nights and shorter days can dysregulate melatonin production, leading to sleep disruptions and mood disturbances associated with SAD.
- Circadian Rhythm Disruption: Our circadian rhythm, or internal biological clock, is influenced by light exposure. Reduced sunlight in the winter can disrupt the normal circadian rhythms, leading to feelings of lethargy and depression commonly seen in SAD.
- Vitamin D Deficiency: Sunlight exposure helps our bodies produce Vitamin D, which is essential for various bodily functions, including mood regulation. During the winter months, lower sunlight exposure may lead to Vitamin D deficiencies, which have been linked to depressive symptoms.
- Genetic Predisposition: Genetic factors may also influence the susceptibility to SAD. Some individuals might be more genetically predisposed to neurotransmitter imbalances or circadian rhythm disruptions, increasing their risk of developing SAD.
Postpartum Depression
Postpartum Depression (PPD) is NOT your fault. It is a complex mix of physical, emotional, and behavioral changes that happen in some women after giving birth. It is a form of clinical depression that typically occurs within the first four weeks postpartum, but it can begin later and last for several months. Postpartum Depression is treatable, and seeking support from healthcare professionals is crucial. Therapy, medication, and support groups are common and effective treatments. Key symptoms of Postpartum Depression include:
- Persistent Sadness: Feeling sad or crying excessively without a clear reason.
- Loss of Interest: Losing interest in activities that were once enjoyable.
- Fatigue: Experiencing overwhelming tiredness that doesn’t improve with rest.
- Anxiety: Feeling extremely anxious or having panic attacks.
- Irritability: Being unusually irritable or angry.
- Sleep Issues: Having trouble sleeping even when the baby is asleep, or sleeping too much.
- Appetite Changes: Significant changes in appetite, either eating too little or too much.
- Thoughts of Harm: Having thoughts of harming oneself or the baby.
- Difficulty Bonding: Struggling to connect with the newborn.
Psychotic Depression
A severe form of depression where the person experiences psychosis, such as delusions or hallucinations. Psychotic Depression is a subtype of Major Depressive Disorder (MDD). Treatment can include a combination of antidepressants and antipsychotic medications, along with psychotherapy. Key symptoms include:
- Severe Depressive Symptoms: Including profound feelings of sadness, hopelessness, and worthlessness.
- Psychotic Symptoms: Such as delusions (false beliefs) and hallucinations (seeing or hearing things that are not there) related to depressive themes.
- Agitation or Physical Immobility: Extreme restlessness or being unable to move.
- Paranoia: An irrational fear that others are plotting against or want to harm them.
- Cognitive Impairments: Difficulty concentrating, making decisions, and remembering things.
Atypical Depression (AD)
Atypical Depression is a subtype of Major Depressive Disorder characterized by mood reactivity and other specific symptoms. Treatment often involves a combination of medication (such as SSRIs or MAOIs) and therapy, particularly Cognitive Behavioral Therapy (CBT). Key symptoms include:
- Mood Reactivity: Temporary improvement in mood in response to positive events.
- Weight Gain or Increased Appetite: Eating significantly more than usual.
- Hypersomnia: Sleeping excessively, more than usual.
- Leaden Paralysis: Feeling heavy, leaden feelings in arms or legs.
- Sensitivity to Rejection: Extreme sensitivity to interpersonal rejection, leading to significant social or occupational impairment.
Bipolar I Disorder
What it is: Bipolar I is characterized by the presence of one or more manic episodes that last at least seven days, or by manic symptoms that are severe enough to require immediate hospital care. Episodes of depression are also common, but not necessary for the diagnosis.
Symptoms: Manic episodes involve elevated mood, increased activity, energy levels, and sometimes impulsive or risky behavior. Symptoms can include inflated self-esteem, decreased need for sleep, more talkativeness, racing thoughts, distractibility, and increased goal-directed activity. Depressive episodes in Bipolar I can include feelings of sadness, hopelessness, a loss of interest in most activities, fatigue, and difficulties with concentration.
Bipolar II Disorder
What it is: Bipolar II involves a pattern of depressive episodes and hypomanic episodes, but no full-blown manic episodes as seen in Bipolar I.
Symptoms: Hypomania is a milder form of mania that includes the same symptoms but is less severe and shorter in duration. Unlike manic episodes, hypomania does not cause significant impairment in social or occupational functioning or require hospitalization. However, depressive episodes in Bipolar II are often more frequent and intense than those in Bipolar I, leading to significant distress and impairment.
Other Specified and Unspecified Bipolar and Related Disorders
What it is: These categories are used for symptoms of bipolar disorder that do not meet the criteria for the specific types listed above. This includes individuals who have bipolar symptoms that do not fit neatly into one category.
Symptoms: Symptoms vary widely depending on the individual and may include mood episodes with mixed features or rapid cycling, where an individual experiences four or more mood episodes within a year.
Understanding the distinctions between these forms of bipolar disorder can be crucial for proper diagnosis and treatment. Each type has unique challenges and impacts on daily life, making it essential to seek professional advice for appropriate management.
Cyclothymic Disorder
What it is: This is a milder form of bipolar disorder involving chronic, fluctuating mood swings that include depressive and hypomanic symptoms. However, the symptoms are not severe enough to meet the criteria for a full hypomanic or depressive episode.
Symptoms: Individuals with cyclothymia experience mood instability that may seem like a personality trait rather than a medical condition, characterized by episodes of emotional highs and lows. These mood changes can be unpredictable and disrupt daily life, but they are generally less severe than in Bipolar I or II.
