Depression is marked by low mood, changes in sleep or appetite, feelings of hopelessness, and losing interest in activities previously enjoyed. Depression is divided into several different categories in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the manual that therapists and doctors use to provide mental health diagnoses. These categories are delineated based on the underlying cause of the condition or the manifestation of certain symptoms.
If you think you might have depression, you don’t need to know what type you think you have before seeking support. A skilled therapist can offer you a diagnosis based on the symptoms you discuss with them, then help you find a path forward.
Here are the 10 most common types of depression:
1. Major Depressive Disorder
Major depressive disorder (MDD) is what most people think of when they think about depression. To be diagnosed with major depression, symptoms like low mood and loss of motivation must last for at least two weeks and cause significant issues with daily functioning. Someone with MDD may only have one period of major depression in their lifetime, but it’s typically marked by multiple depressive episodes that reappear every so often.
Here are a few of the markers unique to MDD:
- Must have at least five of the nine symptoms of depression listed in the DSM
- Depressive episodes last at least two weeks, but can come and go throughout someone’s life
- Symptoms are typically more severe than with some other types, like persistent depressive disorder
2. Persistent Depressive Disorder
Persistent depressive disorder (PDD), previously called dysthymia, is similar to MDD in that the list of symptoms is the same, but people with PDD experience them somewhat less severely. However, the main piece separating PDD from MDD is the timing: Someone with PDD must experience symptoms for at least two years to receive a diagnosis, and symptoms are consistent (or persistent) throughout that time.
Someone can receive diagnoses of both MDD and PDD if they have had at least one major depressive episode plus lower-grade, consistent symptoms lasting for years. This is commonly known as “double depression.”
Here are some of the unique factors of PDD:
- Symptoms may be less “debilitating” than with MDD, but don’t let up over time or go through episodes
- Symptoms must last for at least two years
- PDD often develops gradually (even unnoticeably), while MDD is often triggered by an event and can come on suddenly
3. Seasonal Affective Disorder
Seasonal affective disorder (SAD) involves issues with in mood, sleep, motivation, and general functioning set off by the changing of the seasons. Most people with SAD experience low mood in the winter that lightens in the spring and summer, but others have the reverse, with summer depression that subsides in the fall or winter.
Some of the markers of seasonal affective disorder include:
- Symptoms that start out mild but get progressively worse as the season continues
- Having low energy, feeling sluggish, and likely sleeping too much
- Appetite changes, commonly craving foods high in carbs (though summer SAD can involve poor appetite and weight loss)
- Symptoms resolve when the season shifts
4. Situational Depression
Sometimes depression can be triggered by a difficult situation, like job loss, a big move, or the death of a loved one. If symptoms of low mood, sleep issues, appetite changes, and lack of motivation persist a few months after the event, a diagnosis of situational depression could be given.
Situational depression can alleviate after the major life change has settled, but often still requires treatment for symptoms to fully resolve.
5. Peripartum Depression
Pregnancy and childbirth bring drastic hormonal changes, which can significantly impact mood and functioning. Depression can pop up at any point in the childbearing process, including during pregnancy and postpartum, up to a few years after giving birth. Most episodes of perinatal depression begin 4-8 weeks after the baby is born, and can lead to difficulties bonding and taking care of the newborn.1
6. Premenstrual Dysphoric Disorder (PMDD)
Serotonin and other hormones change during the menstrual cycle, which can cause dips in mood the week or two before someone’s period starts. Symptoms like irritability, sadness or despair, low energy, or lack of interest in daily activities typically resolve two or three days after menstruation begins. PMDD impacts about 5% of people who have periods.2
7. Atypical Depression
A version of MDD, atypical depression involves low mood, but levels of reactivity and varied mood are higher. Someone might bounce between sadness and irritability to hope and happiness when a positive event occurs. This is paired with an excessive appetite and sleeping more, and is usually also accompanied by a sense of interpersonal rejection that lingers regardless of other mood fluctuations.
While exact numbers are unknown, atypical depression is believed to account for 18-36% of MDD cases.3
8. Treatment-Resistant Depression
Most common for those with MDD but possible for any type of depression, sometimes people try multiple medications but don’t find that it helps resolve symptoms. If someone is prescribed at least two different medications for their depression without feeling relief, this is referred to as “treatment-resistant depression,” or difficult-to-treat depression.
However, there is still hope. Alternative treatments like transcranial magnetic therapy (TMS) and Spravato® are approved for treating depression when other medications haven’t been successful.
9. Psychotic Depression
Some people with depression can experience “major depression with psychotic features,” such as delusions or hallucinations. These are typically related to their depression, like believing that they are to blame for something that hasn’t happened.
Another symptom is “psychomotor agitation,” involving an inability to relax or sit still, or the opposite, in which someone’s thoughts and movements slow significantly.4
10. Bipolar Depression
People with bipolar disorder experience significant mood swings, going from emotional highs known as mania or hypomania, to extreme dips. The times of low mood are referred to as bipolar depression. These depressive episodes manifest similarly to other forms of depression, in which someone loses interest or pleasure in most activities and feels sad or hopeless.
Getting Help for Depression
Thankfully, no matter what type of depression you may be dealing with, treatments are available. For people with mild to moderate symptoms, depression can often be treated with psychotherapy. However, for many, adding medication on top of therapy can make a big difference in symptoms, helping someone recover through both changes in brain chemistry and learning new coping skills with their therapist.
Treatments for depression can include:
- Therapy: A therapist can help you untangle the underlying thoughts or causes of your depression, then learn new coping skills to help you feel better.
- Medication: A doctor or psychiatric provider can prescribe medication to help boost neurotransmitters in the brain responsible for mood. The most common medications for depression are SSRIs and SNRIs, which increase the production and processing of serotonin and norepinephrine.
- Transcranial magnetic stimulation (TMS): TMS involves placing magnets on the outside of the head to stimulate areas of the brain that may be underactive due to depression. This procedure is very low risk and has few side effects.
- Spravato®: The first FDA approved nasal spray for hard-to-treat depression, Spravato® is an esketamine treatment that can alleviate symptoms of depression quite quickly, often within hours to days.
The exact combination of necessary treatments could depend on what type of depression you’re dealing with. A skilled mental health professional can help you determine what would be most effective for your specific needs.
Connect with NEHS for Supportive Care in Massachusetts
You deserve to find depression treatment that’s comprehensive, compassionate, and convenient. We aim to help our neighbors across Massachusetts find healing, offering therapy and medication at all of our clinics. Many of our offices also offer alternative treatments for depression, such as TMS and Spravato®, providing hope to many who haven’t found relief through traditional medications.
If you’re ready to get started, you can call 508.794.8711 or schedule your first appointment today.
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