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Periods of feeling sad or down are normal.
But when you experience intense feelings of sadness or feel unworthy for more than a couple of weeks, you may be dealing with depression.
But did you know there are different types of depression?
Knowing which type of depression you may be struggling with can help find an appropriate treatment plan for your depression symptoms and situation.
Depression affects everyone differently and is caused by different factors. While some types of depression disorders have similar symptoms, there are key differences.
We’ve highlighted the most common types of depression as well as treatments, such as types of therapy for depression.
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Major depressive disorder (MDD) is a mood disorder that affects thoughts, emotions and quality of life. Major depression is also referred to as chronic depression, unipolar depression, clinical depression, severe depression or simply depression.
Depression is a common disorder, with an estimated 21 million U.S. adults experiencing a depressive episode (a period of a low mood or depressive symptoms) in 2020, respectively, including teens.
While the exact cause is unknown, various factors can contribute to depression, such as genetics, biology, environment, life events and brain chemistry.
Major depression symptoms can include:
Persistent feelings of sadness, hopelessness or worry
Irritability
Constant anxiety
Loss of interest in regular activities
Problems with sleep (either sleeping too much or too little)
Change in appetite
Aches and pains from unknown causes
Trouble concentrating or making decisions
Fatigue
Recurring thoughts of death, suicidal thoughts and suicide attempts
A health care professional typically diagnoses a depressive disorder after symptoms have lasted for over two weeks, nearly every day.
Major depression can also be present at the same time as many anxiety disorders.
Everyone experiences major depressive disorder differently. Some people experience a depressive episode once, while others struggle with several episodes throughout their life.
A serious mood or behavior change brought on by the changing of the seasons is known as seasonal depression or seasonal affective disorder (SAD).
While many people may feel sadder as the days get shorter and darker in fall and winter, seasonal depression is a type of depression that affects how you feel, think and behave in your daily life.
Many people also experience a milder form of seasonal depression known as the “winter blues”.
Typically, SAD follows a seasonal pattern beginning in the late fall or early winter months and goes away during the spring or summer seasons.
Seasonal affective disorder can also occur in the spring and summertime when it’s known as summer-pattern SAD or summer depression, although it’s less common.
Symptoms of seasonal depression are similar to those of major depression as well as more season-specific ones.
For example, someone with winter-pattern SAD may experience:
Overeating
Weight gain
Feeling the desire to withdraw from socializing
Hypersomnia (oversleeping)
While around 5 percent of U.S. adults experience SAD, about 10 to 20 percent of people experience the “winter blues”.
Persistent depressive disorder — or persistent depression — is a chronic, more mild type of depression.
Formerly known as dysthymic disorder, persistent depression is characterized by depression symptoms that are not as severe as those of major depression but last longer, for at least two years or more.
These depression symptoms can be similar to those of major depressive disorder, such as:
Fatigue
Feeling sad or hopelessness
Lack of concentration
Low self-esteem
Also, similar to major depression, the exact cause of persistent depression is relatively unknown but may be related to traumatic events in life or brain chemical levels.
People diagnosed with persistent depressive disorder may also experience “double depression”, which is an episode of depression existing at the same time as persistent depression.
If you’re experiencing similar symptoms of depression while pregnant or after giving birth, you may have perinatal depression.
Perinatal depression or perinatal mood disorder differs from postpartum depression due to when depression symptoms happen. Postpartum depression only happens after giving birth.
This type of depression is also different from the “baby blues”, which are feelings of sadness after giving birth that usually goes away after a few weeks.
You can learn more about postpartum depression in our guide on postpartum depression causes, symptoms and treatments.
Perinatal depression is relatively common, affecting 10 to 20 percent of women in the U.S.
Symptoms of perinatal depression — also referred to as major depressive disorder with peripartum onset — can be similar to those of major depression as well as:
Trouble forming a bond or emotional attachment with the baby
Persistent doubts about being able to care for the baby
Thoughts about death, suicide or harming the baby or oneself
The intense sadness or anxiety a new mother may feel can impact several different ways she bonds with the baby, such as through breastfeeding.
Perinatal depression can even impact the birth weight and social, cognitive and emotional development of the baby.
Possible causes for this mental illness can include the demands of caring for a newborn as well as childbearing, hormone changes that occur during pregnancy and after birth, a combination of genetic and environmental factors and stress brought on by life.
You may also be at an increased risk of developing perinatal depression if you have a history of depressive, anxiety or bipolar disorders, as well as a lack of social support, a difficult or traumatic pregnancy or birth or a history of abuse.
Premenstrual dysphoric disorder (PMDD) is a serious health condition that occurs before and during your period.
A more serious form of premenstrual syndrome (PMS), this condition causes extreme irritability, anxiety or depression, along with bloating, headaches and breast tenderness caused by PMS.\
Many women only experience mild discomfort during the week or two before their period (the timeframe when PMS typically occurs), but five to eight percent experience moderate to severe symptoms that affect their daily lives.
If you have PMDD, you may experience physical symptoms in addition to emotional symptoms:
Anxiety and panic attacks
Anger or irritability
Severe mood swings
Low energy
Insomnia or trouble sleeping
Loss of interest in daily activities
Reduced interest in relationships and social activities
Increased sensitivity to rejection
A feeling of being out of control
Cramps, headaches, muscle pain and joint pain
Fluid retention, bloating and breast tenderness
Binge eating
Depressed mood
Suicidal thoughts
Many symptoms of premenstrual dysphoric disorder are similar to the signs of major depressive disorder in women.
To be diagnosed with PMDD by a health care professional, you may need to track your symptoms through a few menstrual cycles.
When you experience a drastic change or disappointment in your life, you may go through situational or reactive depression.
Although not a recognized depressive disorder, situational depression can be referred to as a type of adjustment disorder that takes place after a stressful event when you experience depressive symptoms.
Situational depression can be caused by a variety of factors:
Loss of a job
Divorce
The passing of a loved one
Financial difficulties
An unstable living situation
Natural disasters
Symptoms of situational depression are similar to those of mood disorders, which may make distinguishing between this mental health condition and others types of depression more difficult.
Our guide to situational depression goes more in-depth about this mental condition.
Manic depression (currently known as bipolar disorder) involves both episodes of depression as well as manic episodes of an unusually elevated mood.
Manic episodes can typically involve feeling elated, extremely “up”, energized or even irritable behavior, while depressive episodes are very sad, hopeless or indifferent periods.
This type of depression can cause shifts in mood, energy levels, concentration and the ability to do everyday activities.
There are three types of bipolar disorder, all of which involve unusual changes in mood, activity and energy levels:
Bipolar I Disorder. A period of manic episodes that last a week or are severe enough to need immediate hospital care, along with depressive episodes of around two weeks.
Bipolar II Disorder. A pattern of depressive episodes and hypomanic episodes (less severe manic episodes).
Cyclothymic Disorder (Cyclothymia). Periods of hypomanic symptoms and depressive symptoms that last for two years or one year in children and adolescents.
Symptoms of manic depression include periods of unusually intense emotions, changes in sleep patterns, unusual activity levels and out-of-character behavior.
Some people may have mixed episodes or periods where they experience both manic and depressive symptoms in the same episode. This could mean feelings of sadness or hopelessness while also feeling extremely energized at the same time.
During some severe episodes, people with manic depression may experience psychotic symptoms of hallucinations or delusions.
Many people with bipolar disorder can have other mental conditions at the same time, such as anxiety disorders, eating disorders or substance use disorders.
Another common type of depression is atypical depression, when you experience common depression symptoms but have a more uplifted mood after a positive event or news.
Those with atypical depression have two or more of the following symptoms that differ from clinical depression, such as:
Increased appetite and weight gain
Excessive sleeping
Increased sensitivity to criticism or rejection
Leaden paralysis (heavy feeling in arms or legs)
Despite the name, atypical depression is very common among those with depressive disorders, affecting an estimated 18 to 36 percent of people, as well as women twice as much as men.
Possible causes of this mental condition could be trauma, stress, negative childhood experience, impaired neurotransmitter functioning (brain chemicals that affect mood, behavior and more), genetics or grief.
If you’re experiencing any of the above symptoms, it’s best to consult with a health care provider to determine which type of depression you might have.
To figure out if you have depression and which type, your health care provider may ask questions about your health and family history as well as possibly perform tests.
Giving your health care provider as much information as possible is helpful, including when your symptoms started, if or how you’re day-to-day life has been affected and any other mental health conditions you have, among other information.
All the different types of depression disorders we discussed above are treatable with a variety of options.
Depending on the type of depression you have, the best treatment plan may vary.
But there are a few common treatments for depression of any type.
Depression is often treated with psychotherapy, also known as “talk therapy”.
A couple of evidence-based therapies for depression include cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT).
With a therapist or counselor, you may talk about factors that contribute to your depression as well as learn new patterns of thinking and behaving to change habits that contribute to depression.
If you think therapy would be a beneficial treatment for your depression, you can consult with a licensed mental health professional online.
Medication, specifically antidepressants, is another common treatment for different types of depression.
Most antidepressants work by changing the levels of certain brain chemicals that are associated with causing depression.
Examples of antidepressants typically prescribed are:
Selective serotonin reuptake inhibitors (SSRIs). SSRIs are typically used as first-line medications for treating depression in adults. Common SSRIs include fluoxetine (Prozac®), sertraline (Zoloft®) and escitalopram (Lexapro®).
Serotonin-norepinephrine reuptake inhibitors (SNRIs). SNRIs are used to treat depression and other conditions such as certain anxiety disorders. Common SNRIs include duloxetine (Cymbalta®) and venlafaxine (Effexor®).
Tricyclic antidepressants (TCAs). Tricyclic antidepressants are an older class of antidepressants that may be used for depression if other, newer antidepressants aren’t effective.
Monoamine oxidase inhibitors (MAOIs). MAOIs are another older class of antidepressants less widely used than SSRIs and SNRIs due to side effects and interaction risks.
Atypical antidepressants. Atypical antidepressants are medications that don’t fit into any specific categories. Common atypical antidepressants include bupropion (Wellbutrin XL®) and mirtazapine (Remeron®).
A complete guide on depression medications has more details on the above antidepressants and other medications.
Although therapy and medication are the most effective treatments for depression, certain lifestyle changes can also help you manage symptoms.
There’s evidence that sunlight lamps for seasonal depression can be helpful to some.
Exercise releases endorphins, the body’s “feel-good” chemical, and proteins that improve brain function.
Most importantly, treating depression is an ongoing process. It can take time not only to find the right treatment for you but to adjust to medications or therapy and manage symptoms.
Having patience and accepting where you’re currently at in the treatment process are other beneficial lifestyle changes.
No matter what common type of depression you’re struggling with, finding treatment is possible.
You can use our online mental health resources to find a treatment plan that works for you as well as other helpful tools.
Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.
She received her undergraduate degree in nursing from the University of Delaware and her master's degree from Thomas Jefferson University. You can find Katelyn on Doximity for more information.