Depressed People Don't Always Look Sad: Depression Subtypes

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1. Depressive Episode

  • most common of depression
  • a single episode occurs over weeks to years
  • combination of symptoms 
  • always lasting more than 2 weeks
  • called 'unipolar'
  • one third of affected people experience only one episode, or ‘phase’, in their life
  • if a person doesn’t receive appropriate treatment for their depression, there is a risk of recurrent depressive episodes in the future
  • episodes of depression are always more or less disabling

2. Recurrent Depressive Disorder

  • when the depressive episode recurs
  • also known as major depressive disorder
  • also known as ‘classical’ or ‘clinical’ depression
  • usually begins in adolescence or early adulthood
  • will experience depressive phases that may last months to years including phases with normal mood in between
  • very disabling 
  • unipolar in nature (meaning that there is no mania or hypomania)2. Recurrent depressive disorder
  • when the depressive episode recurs also known as major depressive disorder
  • also known as ‘classical’ or ‘clinical’ depression
  • usually begins in adolescence or early adulthood
  • will experience depressive phases that may last months to years including phases with normal mood in between
  • very disabling 
  • unipolar in nature (meaning that there is no mania or hypomania)

3. Dysthymia

  • milder and less distinct symptoms than a depressive episode or recurrent depression 
  • is persistent, with symptoms lasting much longer, at least 2 years, sometimes decades 
  • is also called ‘chronic depression’
  • unipolar
  • affects functioning but is less incapacitating
  • sometimes get acutely more ill and collapse into major depression
  • having both diagnoses is called dual depression

4. Bipolar I Depression

  • previously named manic-depressive disorder
  • less common than unipolar depression
  • a switch between depressive phases, normal mood phases, and the so-called “manic phases”
  • manic phases are excessive high mood, connected with hyperactivity, restlessness and reduced need for sleep
  • mania affects thinking, judgment, and social behavior causing serious problems and difficulties
  • Indiscriminate or unsafe sexual practices or unwise business or financial decisions may be made when an individual is in a manic phase
  • following a manic episode, affected people often experience depression
  • alternating “turmoil of emotions” like “going from being on top of the world to the depths of despair”
  • difficult to distinguish from unipolar depression

5. Bipolar II Depression

  • more similar to recurrent depressive disorder than to bipolar disorder I
  • type II bipolar depression at first sight look like they have sad mood phases
  • repeated depressive episodes interrupted by hypomania (a moderate euphoric state much milder than mania that the person and the family can confuse with normal mood or joy.)

6. Mixed Depression and Anxiety

  • depressive symptoms are frequent within anxiety disorders
  • generally easy to diagnose if depression is the main problem 
  • a balanced combination of depression and anxiety symptoms coexist

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7. Depressive Psychotic Episode

  • special form of depressive episode is psychotic or delusional depression
  • psychosis involves seeing or hearing things that are not there (hallucinations) and/or having false ideas or beliefs (delusions)
  • can develop false beliefs such as putting heavy guilt on themselves (delusion of guilt), financial ruin (delusion of poverty) or having an incurable severe disease (hypochondriac delusion) despite all evidence to the contrary
  • delusional depression almost always need inpatient psychiatric health care
  • psychotic episodes can be unipolar or bipolar in nature

8. Atypical Depression

  • hypersensitive and changeable mood
  • overeating and oversleeping 
  • panic attacks may occur
  • mild and can be bipolar in nature

9. Seasonal Depressive Disorder

  • similar to atypical depression 
  • occurs seasonally during climate changes such as fall or winter
  • when the depression season phase ends, people get well and regain normal functioning again

10. Brief Recurrent Depressive Disorder

  • mild and minor form of depression that can compromise functioning
  • affects mostly young people 
  • short periods of depressed or mixed mood, typically lasting less than 2 weeks.