Depression comes in all shapes and sizes, and like with all mental illness, it isn’t easy to define the condition owing to its many variations. While it can be easy to say that we are feeling ‘depressed’, if we are a bit down, the medical term actually covers a large variety of conditions, with some being common to others relatively rare.
1. Mild, moderate and severe depression
Depression is diagnosed using a checklist with questions ranging from mood, energy levels, appetite and sleep. This allows GPs to categorise patients as being either mild, moderate or severe. Of all of the forms of depression, this is the most common diagnoses.
If you or a loved one are experiencing changes in any of these areas with symptoms lasting longer than two weeks, it might be worth going and talking to your GP.
- Depressed mood
- Lack of interest in activities normally enjoyed
- Changes in weight
- Changes in sleep
- Feelings of worthlessness and guilt
- Difficulty concentrating
- Thoughts of death and suicide
In a conversation with Mens Health, Consultant Clinical Psychologist Emma Citron said
“Mild to moderate depression is usually treatable via Cognitive Behavioural Therapy (CBT) or talking therapy from a psychologist or counsellor, But if you’re deemed to have a more severe case you may be prescribed antidepressants. If a low mood has lasted longer than two weeks, that’s the point to be going to the GP. It’s completely treatable and usually temporary.”
2. Postnatal depression
Having a baby is a massive step, and for a lot of new mother’s and their partners it can lead to mood changes, anxiety, irritability and often last up to two weeks after giving birth. A statistic from the Royal College of Psychiatrists has said that around 10-15% of mums some dad go through it. It is a pretty common form of depression, and awareness is getting better the whole time.
The symptoms of PND are very similar to regular depression, and it can effect your ability to care for your baby. Make sure that you have a strong support network of family and friends around you if you think you are suffering from it. Emma says;
“Prenatal depression (which occurs during pregnancy, and is also known as antenatal depression) can also occur. If you’re feeling low and tearful, don’t think it’s not real because you haven’t had the baby yet. There are huge hormone and chemical changes during pregnancy, and depression can kick in any time from conception onwards.”
Pregnancy can bring about significant hormonal shifts that can often affect a woman’s moods. Depression can have its onset during pregnancy or following the birth of a child.
Such symptoms can include:
- Low mood, feelings of sadness
- Severe mood swings
- Social withdrawal
- Trouble bonding with your baby
- Appetite changes
- Feeling helpless and hopeless
- Loss of interest in things you used to enjoy
- Feeling inadequate or worthless
- Anxiety and panic attacks
- Thoughts of hurting yourself or your baby
- Thoughts of suicide
3. Bipolar disorder
Bipolar disorder is a mood disorder which is defined by extreme mood swings known as ‘mania’, to a state of depressed lethargy. Sometimes the mania can be so severe that the affected person requires hospitalisation.
A bipolar diagnosis needs to be made by a psychiatrist, who your GP can refer you to, but it can take a few appointments to reach it.
As Emma says; “This is a serious form of depression that’s generally only treatable with medicine as prescribed by a psychiatric,”
“It’s typified by manic episodes – behaviours such as running down the street with no clothes on, or anything that’s out of keeping for the individual concerned. It can also be focusing on one thing or one part of life to an obsessive level. When thoughts take on an obsessive flavour, that’s when I start to worry.”
The risk of suicide is also 15 times higher than in the general population if a person suffers from bipolar. If left untreated, it could lead to psychosis which occurs in more extreme cases.
4. Seasonal Affective Disorder
If you feel that autumn hits and you experience depression, sleepiness, and weight gain but feel perfectly fine around March and April then you may have a condition known as seasonal affective disorder. SAD, or seasonal affective disorder is one categorised by the colder winter months.
It is believed to be caused by a change in the circadian rhythm of the body. This is heavily influenced by light entering the eyes, and the seasonal change in the pattern of day and night can trigger a change in mental state.
Stuart Haydock, MSc Organisational Psychology Resilience Lead, from Bupa says;
“It differs from other forms because it occurs during a specific time of year. Your symptoms will usually begin in early September and may be triggered by low levels of daylight as autumn sets in. Your low mood may then disappear in the spring, usually around April, as the amount of daylight increases.”
Treatment can often be difficult because it has a shorter timeframe, however talking about your feelings, and taking care of yourself is effective. Sometimes antidepressants and CBT can be effective.
Persistent depressive disorder or Dysthymia is characterised by a consistent low mood that lasts for two or more years. It is often quite a mild form of depression, which is why it can go untreated for so long.
Because it lasts for so long, it can often feel like ‘normal’ but much like other types of depression, it is treatable.
As Emma says;
“Dysthymia is a funny one. It’s ‘mood variation’ but everyone’s moods go up and down, right, so how do we know when it’s not normal? It can be hard to diagnose.”
When it comes to recognising dysthymia, it is often first noticed by loved ones, rather than yourself.
“You might not always notice when it’s becoming a problem but others do. You might be more irritable, more withdrawn and people might say they’re worried about you. Be open-minded and take it seriously. Perhaps even take them with you to the GP.”
6. Psychotic depression
Psychotic depression is likely the rarest form of depression on this list, with those suffering from delusions and hallucinations. The NHS defines this as a ‘severe clinical depression with psychosis’.
Psychotic symptoms include:
- delusions – thoughts or beliefs that are unlikely to be true
- hallucinations – hearing and, in some cases, feeling, smelling, seeing or tasting things that are not there; hearing voices is a common hallucination
The hallucinations will often reflect the persons mood, and as they are suffering from depression, this will often be along the lines of committing a crime, or they are to blame for a situation. While it is very rare, it is also very dangerous, and comes with a much higher risk of suicide.
7. Depression and anxiety
This combination appears to go hand in hand, and one can often walk out of a GPs office being diagnosed with both illnesses. While anxiety is not a form of depression, as Emma says;
“Anxiety is really the flip side of the same coin. It can manifest in many of the same symptoms as depression – sleep and appetite problems, an inability to concentrate, or a lack of motivation. They can be difficult to separate.”
Depression and anxiety manifest themselves as shortness of breath, sweaty palms, fear and uneasiness, and sometimes panic attacks. As it is a form of depression, its treatment is very similar, with CBT and some antidepressants covering the combination of mental illness.