Depression

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Medical Author:

Roxanne Dryden-Edwards, MD

Roxanne Dryden-Edwards, MD

Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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• Types of Depression
• Depression Facts/Statistics
• Causes of Depression
• Symptoms and Signs of Depression
• When to Seek Medical Care
• Depression Diagnosis
• Depression Treatment
• Self-Care at Home
• Medical Treatment
• Depression Medications
• Other Therapy for Depression
• Follow-up
• Depression Prevention
• Depression Prognosis
• Getting Help: Support Groups and Counseling
• For More Information
• Synonyms and Keywords
• Authors and Editors
• Read more on Depression from Healthwise
• Viewer Comments: Depression - Effective Treatments
• Viewer Comments: Depression - Symptoms

Types of Depression

Throughout the course of our lives, we all experience episodes of stress, unhappiness, sadness, or grief. Often, when a loved one dies or we suffer a personal tragedy or difficulty such as divorce or loss of a job, we may feel depressed (some people call this "the blues"). Most of us are able to cope with these and other types of stressful events.

Over a period of days or weeks, the majority of us are able to return to our normal activities. But when these feelings of sadness and other symptoms make it hard for us to get through the day, and when the symptoms last for more than a couple of weeks in a row, we may have what is called "clinical depression." The term clinical depression is usually used to distinguish the illness of depression from less difficult feelings of sadness, gloom, or the blues.

Clinical depression is not just grief or feeling sad. It is an illness that can challenge your ability to perform even routine daily activities. At its worst, depression may lead you to contemplate, attempt, or commit suicide. Depression represents a burden for both you and your family. Sometimes that burden can seem overwhelming.

There are several different types of clinical depression (mood disorders that include depressive symptoms):

• Major depression is an episode of change in mood that lasts for weeks or months. It is one of the most severe types of depression. It usually involves a low or irritable mood and/or a loss of interest or pleasure in usual activities. It interferes with one's normal functioning and often includes physical symptoms. A person may experience only one episode of major depressive disorder, but often there are repeated episodes over an individual's lifetime.
• Dysthymia, often commonly called melancholy, is less severe than major depression but usually goes on for a longer period, often several years. There are usually periods of feeling fairly normal between episodes of low mood. The symptoms usually do not completely disrupt one's normal activities.
• Bipolar disorder involves episodes of depression, usually severe, alternating with episodes of extreme elation called mania. This condition is sometimes called by its older name, manic depression. The depression that is associated with bipolar disorder is often referred to as bipolar depression. When depression is not associated with bipolar disorder, it is called unipolar depression.
• Seasonal depression, which medical professionals call seasonal affective disorder, or SAD, is depression that occurs only at a certain time of the year, usually winter, when the number of daylight hours is lower. It is sometimes called "winter blues." Although it is predictable, it can be very severe.
• Psychotic depression refers to the situation when depression and hallucinations or delusions are experienced at the same time (co-occur). This may be the result of depression that becomes so severe that it results in the sufferer losing touch with reality. Individuals who primarily suffer from a loss of touch with reality (for example, schizophrenia) are thought to suffer from an imbalance of dopamine activity in the brain and to be at risk of subsequently becoming depressed.

Adjustment disorder is a state of distress that occurs in relation to a stressful life event. It is usually an isolated reaction that resolves when the stress passes. Although it may be accompanied by a depressed mood, it is not considered a depressive disorder.

Some people believe that depression is "normal" in people who are elderly, have other health problems, have setbacks or other tragedies, or have bad life situations. On the contrary, clinical depression is always abnormal and always requires attention from a medical or mental-health professional. The good news is that depression can be diagnosed and treated effectively in most people. The biggest barriers to overcoming depression are recognition of the condition and seeking appropriate treatment.

Depression Facts/Statistics

Clinical depression affects about 19 million Americans annually. It is estimated to contribute to half of all suicides. About 5%-10% of women, and 2%-5% of men will experience at least one major depressive episode during their adult life. Depression affects people of both genders, as well as all races, incomes, ages, and ethnic and religious backgrounds. However, it is twice as common in women compared to men and three to five times more common in the elderly than in young people.