We all feel sad or stressed sometimes. “Sometimes we don’t talk about it,” said Charlie Ward Psy.D., program director of comprehensive recovery services at University of Pittsburgh Medical Center Western Psychiatric Hospital. “But the truth is that people experience stress and sadness in the course of ordinary human experiences.”
When those feeling strike, you can do things you enjoy, exercise, or reach out to friends and family and talk about what’s happening. Those things can help you feel better.
Depression is different. Major depressive disorder is a mental health condition marked by loss of interest in activities, sadness, difficulty concentrating, changes in eating and sleeping habits, and, when it’s at its most severe, thoughts of suicide.
“It’s much more complicated than feeling sad and crying, which I think is the image that we have,” said Vaile Wright, Ph.D., senior director of Health Care Innovation for the American Psychological Association. It’s unlikely that you can self-treat your way out of depression. And it’s important to know there are different types of depression.
What are the different types of depression?
Along with major depressive disorder, there are several other different types of depression disorders. Here’s what you need to know about them.
Persistent depressive disorder
Also called dysthymia, persistent depressive disorder is a lower level of depression that lasts for an extended period of time — at least two years, according to the National Institute of Mental Health. “It becomes so embedded it seems almost like a personality trait,” Wright said.
Seasonal affective disorder
Seasonal affective disorder has all the hallmark symptoms of depression and often includes weight gain and increased sleep. “What makes it unique is the onset — the onset is specific to a time of year, generally winter,” Wright said. “It goes away by itself at the end of the season.”
Postpartum depression or perinatal depression
Postpartum depression or perinatal depression strike during or soon after pregnancy. Like seasonal affective disorder, postpartum or perinatal depression develop in response to a trigger. In this case, the trigger is pregnancy and delivery. It’s much more serious than the “baby blues,” where a mom’s mild symptoms of depression subside within the first two weeks after a baby is born.
“The symptoms are all similar to regular depression,” Wright said. “And it includes the added aspects of things like bonding with the infant, or feeling like you’re not a good mom and can’t take care of the infant.” It can also include intrusive thoughts about harming the baby.
Hormonal changes, sleep deprivation, and the stress of taking care of a new baby can exacerbate post-partum and perinatal depression.
Postpartum psychosis is a rare but serious related condition that can include insomnia, agitation, excess energy, hearing voices or paranoid thoughts. “It can be screened for and treated,” Ward said.
In bipolar disorder, you experience a period of depression at least once, and a period of mania at least once. Mania is a state of euphoric risk taking. “During a manic episode somebody might be experiencing rapid speech, flights of ideas, and a little bit of grandiosity,” Ward said. You have to have some combination of the two to be diagnosed with bipolar disorder.
Depression looks different in different people
No matter what type of depression you experience, it can manifest differently. Of course, anyone can experience any of the symptoms. But according to Wright:
- Women tend to be sad or tearful, feel guilt, and lose interest in activities.
- Men are more likely to be irritable and angry, to throw themselves into their work, and to self-medicate.
- Children tend to be irritable and clingy.
When should you seek care for depression?
“Everybody gets the blues, everyone gets sad, we all get stressed. It’s important to normalize those feelings,” Wright said. “It’s when it doesn’t seem to lift.”
Seek care from a mental health professional if your symptoms:
- Interfere with your eating or sleeping.
- Stop you from going to work or school.
- Cause problems in your relationships.
- Prevent you from caring for yourself or your family.
- Are causing concern in friends or family members.
- Last two weeks or more.
Depression is treatable
“No matter the constellation of symptoms or the context in which it occurs, there are treatments available,” Ward said. “If you’re experiencing any or all of these symptoms, it’s a sign that it’s time to maybe chat with your doctor, visit a therapist, or call a helpline. There’s no need to suffer in silence.”
Treatment options that can help include:
- Types of depression therapy such as cognitive behavioral therapy, interpersonal therapy or problem-solving therapy.
- Behavioral activation, or doing activities you would normally enjoy.
- Staying connected socially.
- Different types of depression medications.
“What’s important to know about medication is that it doesn’t make you happy, it just makes you feel a little less crappy, and then you’re better able to actually do some of these things that could be helpful,” Wright said.