2012年9月20日 星期四

Different Types of Depression


Most people think of depression as a single disorder or illness. What many people don't realize is that there are several different types of depression that can be diagnosed by a mental health or medical professional. Depending on the type of depression, the symptoms the patient is experiencing, and the severity of the symptoms, the treatment may vary. It is therefore very important to be sure the diagnosis is correct in order to ensure the best approach to treatment.

The first type of depression is major depressive disorder (MDD) and can vary in severity from mild to severe. The symptoms for MDD need be present for only two weeks in order to meet the criteria for this diagnosis. Symptoms include a depressed or sad mood most of the time and generally every day, changes in appetite and sleep (either an increase or decrease of either), loss of interest in most things, a feeling of being either slowed down or restless, difficulties with concentration and making decisions, feelings of excessive guilt or worthlessness, low energy, notable weight loss or weight gain (not due to dieting), frequent thoughts of death or suicide or a suicide plan or attempt.

The second type of depression is dysthymic disorder and the symptoms have been present for at least two years in adults. This is generally considered a more mild depression than major depressive disorder, although many of the symptoms are similar. Many professionals refer to this as a "low grade depression". The primary symptom is a depressed or "blue" mood more often than not, and is present on most days. Other symptoms may include problems with sleep or appetite, lack of energy, low self-esteem, difficulties with concentration and decision making, and a general feeling of hopelessness.

The third type of depression is referred to as an adjustment disorder with depressed mood. This type of depression is triggered by a distressing situation or event which significantly impacts the individual. Examples of precipitating events may include the breakup of a significant relationship, loss of a job, moving to a new place leaving behind family and friends, or a major life transition. The event often involves either a loss or a situation that negatively affects one's self-esteem, or both. The person's reaction to the event is beyond what is generally considered normal, which is why it is considered a "disorder". Sometimes with an adjustment disorder of this type the person may also be experiencing symptoms of anxiety, and that is called an adjustment disorder with mixed anxiety and depressed mood.

This acute type of depression is often more readily responsive to treatment than other types of depression, unless the person has a prior history of a depressive disorder or has a concurrent psychiatric disorder. The symptoms occur within 3 months of the beginning of the event, and are no longer present more than 6 months after the end of the stressful situation (unless the stressful situation itself is chronic in nature).

The fourth type of depression is in conjunction with bipolar disorder. The symptoms are the same as in major depressive disorder, but the patient has a history of at least one manic or hypomanic episode and is then diagnosed with bipolar disorder rather than MDD. A common criterion in each type of depression is that it is adversely affecting the person's functioning at work or school, at home, and / or in his or her social life.

Depressive symptoms may also be present secondary to substance abuse, a medical condition, and other psychiatric disorders. If you or someone you know appears to be experiencing symptoms of depression, it is best to have an evaluation by a professional, preferably a psychologist, psychiatrist, or a psychiatric nurse practitioner, especially if suicidal thoughts are present.




Dr. Cheryl Lane has a doctorate in clinical psychology and 15 years experience working in the mental health field. Over the course of her career she has evaluated and treated many patients suffering from depression.





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