The word depression is used to describe a range of moods - from low spirits to a severe problem that interferes with everyday life. If you are experiencing severe or ‘clinical’ depression you are not just sad or upset. The experience of depression is an overwhelming feeling which can make you feel quite unable to cope, and hopeless about the future. If you are depressed your appetite may change and you may have difficulty sleeping or getting up. You may feel overwhelmed by guilt, and may even find yourself thinking about death or suicide. There is often an overlap between anxiety and depression, in that if you are depressed you may also become anxious or agitated.
Sometimes it is difficult to decide whether you are responding normally to difficult times, or have become clinically depressed.
A rough guide in this situation is that if your low mood or loss of interest significantly interferes with your life (home, work, family, social activities), lasts for two weeks or more, and brings you to the point of thinking about suicide then you may be experiencing clinical depression and you should seek some kind of help.
What Causes Depression?
Feeling sad, or what we call “depressed”, happens to all of us. The sensation usually passes after a while. However, a person with a depressive disorder - clinical depression - finds that his state interferes with his daily life. His normal functioning is undermined to such an extent that both he and those who care about him are affected by it.
According to MediLexicon’s Medical Dictionary, depression is “a mental state or chronic mental disorder characterized by feelings of sadness, loneliness, despair, low self-esteem, and self-reproach; accompanying signs include psychomotor retardation (or less frequently agitation), withdrawal from social contact, and vegetative states such as loss of appetite and insomnia.”
What are the different forms of depression?
There are several forms of depression (depressive disorders). Major depressive disorder and dysthymic disorder are the most common.
- Major depressive disorder (major depression) Major depressive disorder is also known as major depression. The patient suffers from a combination of symptoms that undermine his ability to sleep, study, work, eat, and enjoy activities he used to find pleasurable. Experts say that major depressive disorder can be very disabling, preventing the patient from functioning normally. Some people experience only one episode, while others have recurrences.
- Dysthymic disorder (dysthymia) Dysthymic disorder is also known as dysthymia, or mild chronic depression. The patient will suffer symptoms for a long time, perhaps as long as a couple of years, and often longer. However, the symptoms are not as severe as in major depression, and the patient is not disabled by it. However, he may find it hard to function normally and feel well. Some people experience only one episode during their lifetime, while others may have recurrences. A person with dysthymia might also experience major depression, once, twice, or more often during his lifetime. Dysthymia can sometimes come with other symptoms. When they do, it is possible that other forms of depression are diagnosed.
- Psychotic depression When severe depressive illness includes hallucinations, delusions, and/or withdrawing from reality, the patient may be diagnosed with psychotic depression.
- Postpartum depression (postnatal depression) Postpartum depression is also known as postnatal depression or PND. This is not to be confused with ‘baby blues’ which a mother may feel for a very short period after giving birth. If a mother develops a major depressive episode within a few weeks of giving birth it is most likely she has developed PND. Experts believe that about 10% to 15% of all women experience PND after giving birth. Sadly, many of them go undiagnosed and suffer for long periods without treatment and support.
- SAD (seasonal affective disorder) SAD is much more common the further from the equator you go. In countries far from the equator the end of summer means the beginning of less sunlight and more dark hours. A person who develops a depressive illness during the winter months might have SAD. The symptoms go away during spring and/or summer. In Scandinavia, where winter can be very dark for many months, patients commonly undergo light therapy - they sit in front of a special light. Light therapy works for about half of all SAD patients. In addition to light therapy, some people may need antidepressants, psychotherapy, or both. Light therapy is becoming more popular in other northern countries, such as Canada and the United Kingdom.
- Bipolar disorder (manic-depressive illness) Bipolar disorder is also known as manic-depressive illness. It used to be known as manic depression. It is not as common as major depression or dysthymia. A patient with bipolar disorder experiences moments of extreme highs and extreme lows. These extremes are known as manias.