Exploring the different types of depression

Depression is more than just feeling sad or down. It’s a mental health condition that can affect all aspects of our lives: our relationships, our ability to function on a day-to-day basis, our home and work life, and our overall health and happiness.

A clinical depression diagnosis is becoming increasingly common in adults. In any given year, about 5% of the world’s adult population experiences depression.

Still, not all of us experience depression in the same way, and that’s partly because within the umbrella of clinical depression, there are several different depression types. When you are experiencing feelings of depression, it can be helpful to understand which type of depression you are dealing with, so that you can get treatment geared toward your unique needs.

8 Common types of depression

The type of depression you are experiencing will depend on how your symptoms present, what is causing your symptoms, and your current life circumstances. It’s possible to experience more than one type of depression throughout the course of your lifetime, especially if you are prone to depression in general.

Here are some of the most common types of depression, and what they may look like:

Major depressive disorder 

Major depressive disorder (MMD) is one of the most common psychiatric conditions worldwide, and 5-17% of adults will experience it in their lifetime. MMD is characterized by a depressed mood, low energy, inability to concentrate, disinterest in activities you used to enjoy, and feelings of guilt, worthlessness, and numbness. Intrusive thoughts about death or killing oneself is also possible with MMD. In addition to these symptoms, individuals with MDD may experience extreme fatigue, difficulty getting out of bed, and trouble sleeping, which can manifest as insomnia or oversleeping. Changes in appetite and weight gain or loss are also common. The causes of MDD can include heredity and genetics, brain chemistry differences, and significant life stressors such as the loss of a loved one. Treatment typically involves a combination of cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and medications, along with lifestyle changes like regular exercise, maintaining a consistent sleep routine, and practicing daily meditation.

Persistent depressive disorder 

Also known as dysthymia, persistent depressive disorder (PDD) is a type of depression that may be less severe than MMD, but is usually longer lasting. People who have PPD may feel restless and unhappy, but may also have periods of feeling more like themselves. One of the more difficult aspects of PPD is how long it lasts. To be diagnosed with PDD, you have to have had your symptoms for at least two years. Individuals with PDD often experience feelings of anxiety and irritability, low energy, and a diminished ability to enjoy activities they once found pleasurable. Physical ailments like headaches and stomach issues are also common, as is trouble sleeping, which may include insomnia or early waking. PDD can be caused by heredity and genetics, chronic stress or trauma, and brain chemistry differences. Treatment for PDD often includes cognitive-behavioral therapy (CBT) and problem-solving therapy, along with medications and lifestyle changes such as connecting with others and journaling.

Bipolar disorder

Bipolar disorder is characterized by extreme mood swings that alternate between depression and mania (or a less severe form called hypomania). Manic episodes are characterized by euphoric feelings, racing thoughts, high energy, and risk-taking. ​​Other forms of mania might include aggression or extreme irritability. The depression episodes are similar to major depressive disorder (MDD). During depressive episodes, individuals with bipolar disorder may experience feelings of sadness, hopelessness, and worthlessness, along with low energy and fatigue. They may also have trouble concentrating, experience changes in sleep patterns, and have thoughts of suicide. The causes of bipolar disorder are complex and can include genetic factors, brain chemistry imbalances, and traumatic events. Treatment typically involves medications, therapy, such as CBT or interpersonal therapy, support groups, such as DBSA, and lifestyle adjustments, including maintaining a regular sleep schedule and engaging in regular physical activity.

Postpartum depression

Postpartum depression (PPD) is a mood disorder affecting women, birthing, or adoptive parents in the first year after childbirth. The disorder is characterized by low moods, inability to concentrate or sleep, agitation and anger, feelings of worthlessness and numbness, and feeling disconnected from one’s baby. Many parents deal with depressive feelings in the first few weeks after giving birth (the “baby blues”). In order to be diagnosed with PPD, your symptoms have to have lasted for at least two weeks.

Symptoms of PPD can also include extreme fatigue, anxiety, and irritability, as well as changes in appetite and trouble sleeping. The causes of PPD may involve hormonal changes, physical and emotional stress of childbirth, lack of social support in adjusting to life with a newborn, and a history of depression could also correlate. Treatment for PPD often includes therapy, such as CBT or interpersonal therapy, medications, support from family and friends, and self-care practices like regular exercise and sufficient rest.

Seasonal affective disorder

Seasonal affective disorder (SAD) usually affects people in the fall and winter months as the days get darker and shorter and as the weather cools. The lack of sunlight is thought to be a major contributing factor to SAD.

Symptoms of SAD often include feelings of sadness, low energy, and a decreased interest in activities. People may also experience changes in sleep patterns, appetite, and weight, as well as difficulty concentrating. The causes of SAD are primarily linked to reduced sunlight exposure, which can disrupt the body’s internal clock and lead to feelings of depression. Treatment options for SAD typically include light therapy, therapy such as CBT, medications, and lifestyle changes, like spending more time outdoors and engaging in regular physical activity.

Psychotic depression

Psychotic depression is diagnosed when a person experiences the signs of major depression along with psychosis. Psychotic symptoms include hallucinations (seeing or hearing things that aren’t there) and delusions (false beliefs about reality that one holds on to despite undeniable evidence to the contrary); this is akin to an episode of severe major depressive disorder. Oftentimes, people experiencing psychosis are not aware that the experience is outside of reality. 

In addition to the symptoms of major depression, individuals with psychotic depression may experience severe anxiety, agitation, and irrational fears. The causes of psychotic depression can include genetic factors, brain chemistry imbalances, and severe stress or trauma. Treatment often involves a combination of medications, therapy, such as CBT, and sometimes hospitalization, along with lifestyle changes to manage stress and ensure safety.

Premenstrual dysphoric disorder

Premenstrual dysphoric disorder (PMDD) is when women or people assigned female at birth experience depressive symptoms centered around their menstrual cycles. These symptoms usually occur several days before the menstrual cycle begins, and during the first day or two of one’s period.

Symptoms of PMDD can include mood swings, irritability, depression, and anxiety, as well as physical symptoms like bloating, headaches, and breast tenderness. The causes of PMDD are believed to be related to hormonal changes during the menstrual cycle. Treatment options typically include therapy, such as CBT, medications, and lifestyle changes, such as regular exercise, a healthy diet, and stress management techniques.

Atypical depression

Atypical depression is characterized by mood reactivity, where a person’s mood can improve in response to positive events. Unlike other forms of depression, individuals with atypical depression may experience increased appetite, weight gain, excessive sleep, and a feeling of heaviness in the arms and legs.

Symptoms of atypical depression often include increased sensitivity to rejection, significant weight gain, and excessive sleeping. Individuals may also experience a heaviness in their limbs and a heightened emotional reactivity. The causes of atypical depression can include genetic predisposition, brain chemistry differences, and life stressors. Treatment options for atypical depression usually involve therapy, such as CBT or interpersonal therapy, medications, and lifestyle changes like maintaining a balanced diet, regular physical activity, and building a supportive social network.

Depression symptoms

The symptoms of depression will vary based on what type of depression you are experiencing. In addition, no two people will experience depression in exactly the same way. At the same time, there are some symptoms that are present in most types of depression and that can help you understand that it may be time to get help and support for the challenges you are facing.

Some of the most common symptoms of depression include:

• Feeling sad, low, and emotionally numb

• Feeling anxious or irritable

• Feeling worthless, hopeless, and guilty

• Having a “doom and gloom” attitude

• Low or decreased energy

• Extreme fatigue—finding it difficult to get out of bed or face the day

• Not being able to enjoy activities that once brought you joy

• Having trouble concentrating or paying attention

• Moving or speaking slowly

• Disrupted sleep: insomnia, oversleeping, waking during the night or earlier than what is normal for you

• Changes in appetite and weight gain or loss

• Physical ailments: headaches, stomachs, digestive issues

• Thought of suicide, including suicide attempts

Perhaps the most serious aspect of depression is that it can lead to suicidal ideation, self-harm, and suicide attempts. If you are experiencing thoughts of ending your life, you are not alone, and help is out there for you.

Here’s what you can do:

• Call 911 or visit your nearest emergency room

• Call the National Suicide Prevention Lifeline (1-800-273-8255) a free and confidential service

• Text 988 for the Suicide and Crisis Lifeline

• Contact a loved one for support or visit your healthcare provider

Causes of depression

Most cases of depression aren’t caused by just one factor, but have several different causes—a perfect storm of factors, so to speak.

Some of the most common causes of depression involve:

• Heredity and genetics

• Brain chemistry differences

• Childhood trauma or other traumatic events

• Life circumstances, such as losing a loved one, divorce, or other significant stressors

• Dealing with medical conditions, such as cancer and diabetes

• Medications or other substances like alcohol or recreational drugs that have depressive symptoms as side effects

Diagnosing depression

In most cases, to be diagnosed with one of the different types of depression, you have to have experienced your symptoms for at least two weeks, and these symptoms have to have significant negative effects on your life.

Even if you aren’t sure whether you are experiencing depression or something else, it’s important to take any mental health disturbances seriously. In addition to starting therapy, a common first step in mental health care is visiting a primary care provider to rule out any medical conditions that could be the source of depressive symptoms. 

If your healthcare provider suspects that you are experiencing depression or another mental health disorder, they will likely refer you to a licensed psychotherapist or psychiatrist for further evaluation and to begin treatment.

Potential treatment paths

The good news is that as serious as depression can be, it’s treatable. Most cases of depression can be managed with psychotherapy, possible medication, and lifestyle changes.

Psychotherapy

Connecting with a licensed therapist is the first step in addressing your depression, whatever type you are challenged with. There are many different kinds of therapists out there; it’s helpful to find someone specifically trained to help manage depression. Some of the therapy modalities that treat depression include:

• Cognitive-behavioral therapy (CBT)

• Interpersonal therapy (IPT)

• Problem-solving therapy

The best therapist for you is one who makes you feel safe and comfortable, who takes your concerns seriously, and who offers you supportive techniques for feeling better.

Medication

Certain medications can be helpful when it comes to managing depression. The medication type you use will be prescribed based on a number of factors, including the type of depression you are dealing with. For example, people with major depressive disorder or postpartum depression will need different medication that people who have bipolar disorder or other disorders where depression isn’t the only symptom.

Usually, it’s best to combine medication with psychotherapy. You will need to get medication prescribed by either an MD or a psychiatrist. The most common types of medications used to treat depression are antidepressants, which may include selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs).

Lifestyle changes

Simply changing aspects of your lifestyle usually isn’t enough to fully treat clinical depression, but when coupled with treatments like therapy and medication, they can be quite helpful. Some examples of lifestyle changes that can help with depression are:

• Getting regular exercise and sticking to a consistent sleep routine

• Making an effort to connect others and not self-isolate

• Trying daily meditation, breathing exercises, and journaling

• Have realistic goals for yourself and not the progress you are making toward feeling better

• Educate yourself about depression, including the different types of depression, and what treatments might work best for you

The bottom line

Depression is a serious condition. Understanding what type of depression you are faced with is an important first step in understanding what is going on with you, and seeking the help you need to move forward and feel better. Remember, depression is treatable, and you deserve the help and support it takes to feel more like yourself again.