There are different types of depression which can be caused by different biological reasons and life experiences. Understanding the different types can help you identify the specific symptoms and seek the right treatment.
- What Is Depression?
- Types Of Depression
- 1. Major Depressive Disorder (MDD)
- 2. Persistent Depressive Disorder (PDD)
- 3. Bipolar disorder
- 4. Seasonal affective disorder (SAD)
- 5. Postpartum depression (PPD)
- 6. Premenstrual dysphoric disorder (PMDD)
- 7. Psychotic depression
- 8. Atypical depression
- 9. Situational depression
- 10. Cyclothymia
- 11. Treatment-resistant depression (TRD)
- 12. Subsyndromal depression
- 13. Recurrent brief depression (RBD)
- 14. Mixed anxiety-depressive disorder (MADD)
- Identifying Depression
What Is Depression?
Although most of us typically tend to confuse feelings of sadness with depression, it is in fact a mood disorder that can significantly impair someone’s ability to function in daily life. It is a mental health condition that is characterized by low moods, a constant feeling of sadness and a lack of interest. Depressed individuals can experience persistent mood fluctuations that can affect their education, career, relationships and social & personal life. A person may experience periods of chronic sadness, known as depressive episodes, with severe symptoms for at least 2 weeks. Research 1 reveals that the mood disorder can develop due to different adverse life experiences such as bereavement & grief, unemployment, divorce or breakup, financial issues etc. However, it “can arise without any triggering events or for no apparent reason,” states a recent research 2 . Depending on the individual, severity, type and causes, the condition can last for weeks, months or even years.
Also known as major depression or major depressive disorder (MDD), it is believed to be one of the most common psychiatric disorders in the world. “It is a common illness that severely limits psychosocial functioning and diminishes quality of life,” explains a 2018 study 3 . With effective treatment, you can successfully alleviate and manage symptoms and learn to live a healthier life. However, a proper diagnosis is required for effective treatment which depends on identifying the particular type of MDD a person is suffering from.
Types Of Depression
The different types of this mental health disorder may have some common symptoms, but are markedly different from each other in various aspects. Understanding the types is crucial for identifying the symptoms correctly. According to a 2008 study 4 , depression is usually used as an umbrella term that includes a number of related conditions, such as major depressive disorder (MDD), dysthymic disorder, episodic depression, bipolar disorder, seasonal affective disorder, psychotic disorder etc. Another research paper 5 explains that as per the American Psychiatric Association’s Diagnostic Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the term involves different depressive disorders which are classified into MDD, dysthymia or persistent depressive disorder, premenstrual dysphoric disorder, disruptive mood dysregulation disorder and other depressive disorder caused by another medical condition. “The common features of all the depressive disorders are sadness, emptiness, or irritable mood, accompanied by somatic and cognitive changes that significantly affect the individual’s capacity to function,” state the researchers.
Here are some of the most common types of depressive disorder that one must be aware about:
1. Major Depressive Disorder (MDD)
Also known simply as depression, major depression, unipolar depression or classic depression, major depressive disorder is what people generally mean when they say they are suffering from depression. Research 6 reveals that MDD is “a highly prevalent psychiatric disorder” with an average lifetime prevalence of around 12%. The core features 7 of this condition include low moods, persistent feeling of sadness 8 , and a loss of interest or pleasure in activities that were previously enjoyable. One 2015 study 9 explains that MDD is “a serious condition that can affect patients’ ability to sleep, work, eat, and go about their lives.”
MDD is mood disorder which is marked by the following main features:
- Depressed or low mood
- Loss of pleasure or interest in activities
- Weight loss or gain
- Fatigue & lack of energy
- Trouble sleeping or too much sleep
- Difficulty concentrating
- Changes in appetite
- Feelings of worthlessness & guilt
- Feeling lethargic or restless
- Memory problems & difficulty making decisions
- Severe anxiety
- Thoughts of suicide
If someone experiences the above mentioned symptoms for over two weeks, then they can be diagnosed with major depressive disorder. Treatment can include both psychotherapy and medications. A doctor may recommend talk therapy or cognitive behavioral therapy (CBT) 10 and may prescribe antidepressants like selective serotonin reuptake inhibitors (SSRIs) 11 . In case therapy and medication don’t work, a mental health professional may suggest Transcranial magnetic stimulation (TMS), Electroconvulsive therapy (ECT) or Vagus Nerve Stimulation (VNS) for the treatment of this classic form of depression.
2. Persistent Depressive Disorder (PDD)
Also known as dysthymia, PDD is a depressive disorder that lasts for 2 years or more. Persistent depressive disorder incorporates two different disorders 12 , previously identified as chronic major depressive disorder (MDD) and dysthymic disorder, a milder form of persistent depressive disorder. PDD may not be as serious or severe as MDD, but it can still affect the sufferers daily life and relationships. According to a 2009 study 13, 6(5), 46–51. )) , this disorder is “a smoldering mood disturbance characterized by a long duration (at least two years in adults) as well as transient periods of normal mood.” The condition can be severe, moderate or mild. The person can experience depressive episodes and brief periods of relief with minimal or no symptoms. However, the symptoms tend to be pervasive and lasting. This condition is often identified as high-functioning depression as the person may appear active on the outside, especially when symptoms are mild.
Some of the common symptoms of persistent depressive disorder include:
- Low self-esteem
- Feeling inadequate
- Hopelessness, sadness & guilt
- Changes in appetite
- Insomnia or hypersomnia
- Fatigue or loss of energy
- Trouble making decisions or concentrating
- Difficulty functioning in daily life
- Unable to feel happiness
- social withdrawal or isolation
One 2019 study 14 found that “MDD patients with PDD had greater severities of depression, anxiety, and somatic symptoms.” The person may have a depressed mood for most part of the day and may suffer “more days than not.” As the condition can last for several years, the sufferer may feel that the symptoms are a normal part of life. Once diagnosed properly, it can be treated with medication, psychotherapy or a combination of both.
3. Bipolar disorder
Also called manic depressive disorder, it is a chronic episodic illness 15 that is characterized by episodes of severe mood swings involving manic highs and depressive lows. Bipolar disorder is marked by episodes of abnormally elevated mood known as mania or a milder hypomania followed by periods of depressive mood. These episodes can be mild, moderate or so severe that it can impair the ability of the sufferer to perform normal daily functions. Researchers 16 describe the condition as “a chronic and complex disorder of mood that is characterized by a combination of manic (bipolar mania), hypomanic and depressive (bipolar depression) episodes, with substantial subsyndromal symptoms that commonly present between major mood episodes.” For a proper diagnosis, a person needs to experience both manic and depressive states for at least 7 days.
Bipolar disorder typically involves the following features in the manic phase:
- High levels of energy
- Elevated mood or feeling euphoric
- Grandiose thinking
- Irritability or restlessness
- Insomnia or reduced sleep
- Unexplained aches and pains
- Unrealistically high self-confidence and self-esteem
- Risky, abnormal behavior
This can be followed by the depressive phase which may include these signs:
- Lethargy or loss of energy
- Feelings of emptiness or sadness
- Too much or too little sleep
- Loss of interest
- Difficulty concentrating
- Psychomotor agitation
- Disorganization and indecision
- Suicidal thoughts
In extreme cases, a person with bipolar disorder may also experience psychosis, hallucinations and delusions. One can also experience mixed episodes with both manic and depressive symptoms. Certain medications like mood stabilizers (lithium) 17 can help to manage the mood fluctuations. However, antidepressants may not always be effective for this disorder. A doctor or mental health expert may also recommend psychotherapy to treat the patient and help the family members. However, “bipolar disorder is a complex psychiatric disorder to manage, even for psychiatrists, because of its many episodes and comorbid disorders and nonadherence to treatment,” states a 2006 study 18, 3(9), 43–55. )) .
4. Seasonal affective disorder (SAD)
It is also known as seasonal depression or major depressive disorder with seasonal pattern. SAD is a recurrent form of depressive disorder which particularly develops in specific seasons. A 2005 study 19, 2(1), 20–26. )) explains “Seasonal affective disorder (SAD), characterized by fall/winter major depression with spring/summer remission, is a prevalent mental health problem.” It has been observed that SAD mostly occurs during the winter months in regions that are geographically far from the equator, such as extreme northern or southern areas. It happens because there is less sunlight and shorter daytime hours. However, the condition tends to resolve naturally during the spring & summer.
Symptoms typically begin to develop during autumn as daytime begins to reduce and persists till spring. Most SAD symptoms are similar with typical symptoms of other depressive disorder, such as –
- Mood disturbances
- Sadness, hopelessness, emptiness & unworthiness
- Fatigue & loss of energy
- Changes in sleeping and eating patterns
- Weight gain
- Craving carbohydrates
- Heaviness in limbs
- Relationship issues
- Social withdrawal
A person with seasonal affective disorder may even experience suicidal thoughts as the winter season gets harsher. However, due to changes in circadian rhythms to the increasing daytime and natural light, the symptoms get better. However, experts are yet to understand why only a few individuals are affected by it and not others. Another variation of the condition is summer-onset seasonal affective disorder 20 which is observed during the spring & summer season. Light therapy is considered to be the most effective form of treatment for this disorder. A 2014 study 21 states “Bright light therapy (BLT) is considered among the first-line treatments for seasonal affective disorder (SAD).” The therapy exposes the patient to an intense source of light for around 15-30 minutes on a daily basis to balance the lack of daylight due to the winter season. However, a doctor may also recommend psychotherapy, medication or a combination of both as well.
5. Postpartum depression (PPD)
PPD, also identified as perinatal depression and major depressive disorder with peripartum onset, refers to the mood disorder that develops during pregnancy or after childbirth. “PPD is defined strictly in the psychiatric nomenclature as a major depressive disorder (MDD) with a specifier of postpartum onset within 1 month after childbirth,” explains a 2009 study 22 . According to research 23 , around one in seven women can develop PPD. Substantial hormonal changes in a woman’s body during pregnancy can alter the brain which can trigger mood swings. Their mood can be further affected by the physical discomfort and sleep deprivation that follows childbirth. Symptoms are usually observable within 4 weeks of after delivery. The term ‘postpartum’ or ‘postnatal’ 24 is usually used when the onset occurs after giving birth, while the term ‘perinatal’ is used when the condition develops while the woman is pregnant. However, it should be noted that PPD is separate from ‘baby blues’ 25 which tends to resolve naturally over time.
Some of the common symptoms of PPD, which is unique to women, include:
- Intense mood swings
- Anxiety & irritability
- Depressed mood or sadness
- Panic attacks or anger
- Exhaustion and fatigue
- Feeling hopeless, worthless, empty and inadequate
- Loss of interest
- Difficulty bonding with or caring for the child
- Thoughts of hurting the child or self
- Changes in sleep and appetite
- Social isolation and withdrawal
- Suicidal thoughts
When left untreated, PPD can lead to postpartum psychosis, where the person experiences delusions and hallucinations along with the above mentioned symptoms. The condition can last for several months or even a year when not treated. It has been observed when maternal depressive disorders are left untreated it can adversely affect the maternal-infant attachment and negatively influence child development. But with effective treatment approaches, such as hormone therapy, psychotherapy and antidepressants, and family support the symptoms can be relieved. “However, there are multiple barriers to appropriate treatment, including concerns about medication effects in breastfeeding infants,” suggests a 2010 study 26 .
6. Premenstrual dysphoric disorder (PMDD)
An intense type of premenstrual syndrome, PMDD is a hormonal and cyclic depressive disorder. Symptoms tend to develop at the beginning of the period or immediately after ovulation and may resolve naturally when menstruation begins. Women can experience a wide range of somatic, affective and behavioral symptoms on a monthly basis during their menstrual cycle. A recent 2020 study 27 states “Premenstrual symptoms include a constellation of mood, behavioral, and physical indications that occur in a cyclic pattern prior to menstruation and then wane off after the menstrual period in women of reproductive age.” Research 28 shows that these “mood, behavioral, and physical” symptoms tend to recur in a cyclic pattern in women who are of reproductive age. Although the symptoms are mostly mild and generally don’t affect a woman’s professional, social or personal life, about 5-8% of women experience severe symptoms “that can cause significant distress and functional impairment.”
Common symptoms of Premenstrual Dysphoric Disorder (PMDD) generally include:
- Anxiety and tension
- Mood swings
- Depressed mood
- Feelings of hopelessness
- Self-deprecating thoughts
- Persistent anger or irritability
- Hypersomnia or insomnia
- Sleep difficulties
- Loss of interest in normal activities
- Difficulty concentrating
- Lack of energy, fatigue and lethargy
- Changes in appetite or food cravings
- Weight gain
- Headaches or muscle pain
- Breast tenderness or swelling
- Feeling overwhelmed or out of control
Diagnosis requires that the woman has experienced PMDD symptoms during most menstrual cycles over a period of one year and such symptoms are impairing their ability to function in daily life. Once a diagnosis has been made, a doctor may prescribe antidepressants such as SSRIs 29 (fluoxetine and sertraline) for the treatment as they are currently considered as the gold-standard for PMDD. According to one 2008 study 30 , selective serotonin reuptake inhibitors (SSRIs) were found to be effective in treating severe premenstrual syndrome (PMS) & premenstrual dysphoric disorder. However, a doctor may also recommend hormonal treatment, like oral contraceptives 31 , and psychotherapy for effective treatment.
7. Psychotic depression
Also known as depressive psychosis and major depressive disorder with psychotic features, it refers to a severe mood disorder involving a major depressive episode with psychotic symptoms. A 2013 study 32 describes the disorder as “a serious illness during which a person suffers from the combination of depressed mood and psychosis, with the psychosis commonly manifesting itself as nihilistic type delusions, with the belief that bad things are about to happen.” Psychosis 33 is a mental condition marked by disorganized thoughts and behavior. As the brain processes information.differently, the sufferer may have trouble determining what is reality and what is imagination.
Sufferers may experience psychotic symptoms, like hallucinations, delusions and paranoia along with typical depression symptoms. They may hear or see things that are not real, have unrealistic beliefs and falsely believe that others are trying to hurt them. They may also lose touch with reality due to psychosis. However to the sufferers, their hallucinations, delusions and paranoid beliefs may appear as very true and real. Some common symptoms are:
- Hallucinations and delusions
- Paranoid beliefs
- suspicion of others
- Inappropriate & strong emotions
- Difficulty thinking clearly or making decisions
- Reduced performance in school or work
- Lack of personal hygiene
- Social withdrawal and isolation
Diagnosis of depressive psychosis requires the patient to experience symptoms for at least 2 week. They must also experience hallucinations and delusions. Mental health professionals may treat the condition with a combination of both antipsychotic drugs and antidepressants 34 . One 2016 study 35 revealed that the combinations of sertraline with olanzapine, fluoxetine with olanzapine and venlafaxine with quetiapine were more effective than monotherapy or placebo. In severe cases electroconvulsive therapy (ECT) may also be recommended. This therapy includes using controlled electric current to stimulate and ‘reset’ the brain to reduce symptoms. According to research 36 , “Electroconvulsive therapy is particularly effective for psychotic depression.” Moreover, the process is generally safe.
8. Atypical depression
It is a form of depressive disorder that does not involve the ‘typical’ pattern or presentation as observed in other variations. The symptoms for this condition tend to reduce or go away when the individual experiences any positive events, situations or emotions. It is regarded as a biologically distinct subtype or ‘specifier’ of clinical depression. Also known as major depressive disorder with atypical features, it can often be hard to identify this condition as the sufferer may not appear depressed in the typical sense to others or even themselves. But it can be as devastating as persistent or major depressive disorder. However, it is different from other forms of depression as one’s mood can improve temporarily. According to a 2006 study 37, 3(4), 33–39. )) , “Atypical depression is a unique variant of depression that has the personality trait, rejection sensitivity, as part of its diagnostic criteria.” This condition is primarily characterized by the following characteristics 38 :
- Increased appetite or overeating
- Weight gain
- Poor body image
- Oversleeping or insomnia
- Interpersonal rejection sensitivity or high sensitivity to criticism or rejection
- Leaden paralysis or heaviness in limbs
- Unexplained aches & pains
- Intensely reactive moods
The disorder is also related with anxiety disorders and a higher risk of suicide. Depending on the presence and severity of the symptoms, a person may be diagnosed with depressive disorder with atypical features. A doctor may prescribe antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants for the treatment. However, monoamine oxidase inhibitors (MAOIs) 39 , a type of antidepressant, may also be recommended for effective recovery. According to a 2002 study 40 , “MAOIs are clearly an effective treatment for atypical depressives,6 but, as a result of associated dietary restrictions and potential side effects, are generally not considered first-line drugs.” Psychotherapy, such as cognitive behavioral therapy (CBT) 41 , can also help in the treatment process.
9. Situational depression
Also known as adjustment disorder with depressed mood and reactive depression, this distinct subtype 42 refers to a stress-related 43 , short-term depressive disorder. The condition is described as “depression precipitated by events in a person’s life,” by researchers. It is similar to MDD and usually tends to develop when a person experiences severe chronic stress, a traumatic event or any adverse life events. Various situations can trigger this disorder, such as –
- Moving to a new city
- Divorce or breakup
- Abusive relationships
- Loss of a loved one
- Financial difficulties
- Legal troubles
- Terminal illness
It is considered as a form of adjustment disorder as it generates from the sufferer’s inability to cope with changing situations in life. It is observed more in children and adolescents 44 triggered by events like divorce of parents, birth of siblings or moving to a new place. Symptoms typically manifest within a period of 3 months after the triggering event. Diagnosis can be made when the symptoms start to affect and impair the daily life of the individual. The following symptoms can show up within 90 days from the initial event:
- Intense anxiety & stress
- Hopelessness & sadness
- Repeated crying
- Changes in appetite and sleeping patterns
- Muscle pains and aches
- Social withdrawal
- Loss of energy or lethargy
- Difficulty concentrating
As situational depression is a short-term condition, the symptoms tend to get better with time, especially when the person becomes adjusted to the stressor or when the situation improves. In severe cases, a doctor may recommend a combination of medications and psychotherapy for effective recovery.
It is an affective disorder marked by affective dysregulation and emotional reactivity. Alternatively identified as cyclothymic personality disorder or simply cyclothymic disorder, cyclothymia is a milder variation of bipolar disorder where a person experiences periods of both depression and elevated mood for short periods of time. However, these symptoms are not intense or severe enough to be considered as bipolar disorder or a MDD or hypomanic episode. A 2017 study 45 explains “Cyclothymia is characterized by early onset, persistent, spontaneous and reactive mood fluctuations, associated with a variety of anxious and impulsive behaviors, resulting in a very rich and complex clinical presentation.” The person may experience chronic and fluctuating unstable moods which can vary between periods of elation and periods of depressive mood. The symptoms need to last for a period of two years or more in order to be diagnosed as cyclothymia. The sufferer may also experience stable moods for certain periods of time which don’t tend to last more than 2 months.
According to a 2012 study 46 , “cyclothymic disorder is a prevalent and highly impairing disorder on the bipolar spectrum.” Common depressive and manic symptoms of cyclothymia may include:
- Severe anxiety
- Aggressiveness and irritability
- Changes in appetite
- hypersomnia or insomnia
- Loss of energy
- Worthlessness or hopelessness
- Memory problems & lack of attention
- Trouble concentrating
- Unexplained aches and pains
- Unrealistically high self-esteem
- Racing thoughts & speech
- Hyperactivity and restlessness
- Impulsive or reckless behavior
Typically mood stabilizers like lamotrigine and lithium are prescribed for cyclothymia and antidepressants are usually not recommended unless the person develops signs of MDD. According to recent research 47 , mood stabilizers are regarded as first-line psychotropic treatment of cyclothymic disorder, such as –
- Valproate if anxiety is dominant
- Lamotrigine if the anxious-depressive polarity is more prominent
- Lithium for significant affective intensity
The researchers add that psychological interventions such as psychoeducation and counseling can also help to manage symptoms.
11. Treatment-resistant depression (TRD)
TRD is primarily a subset 48 of MDD that does not typically respond to traditional treatment and first-line therapeutic options. The person may still experience the symptoms of major depressive disorder (MDD) even after taking two or more distinct types of antidepressants belonging to different classes within a specific time. However, some experts claim that to be regarded as treatment-resistant, the patient needs to use four different forms of treatment approaches without any success or acceptable outcome. Still it is difficult to describe 49 this condition accurately as it lacks a universal definition and meaning. According to a 2012 study 50 , this mood disorder “defies true definition, but mental health experts agree that it should only be diagnosed in patients who have not been helped by two or more antidepressant treatment trials of adequate dose and duration.” However, as this is a complex condition, multiple definitions 51 and schemas depending on the severity of resistance have been suggested by experts. It is believed that this may be caused by either genetic or environmental factors.
Although the person may follow the treatment plan properly, they may still experience certain signs like low moods, changes in appetite, sleep disturbances etc. Conversely, the symptoms may alleviate for a short period of time and recur eventually. However, one must understand that simply because their condition is not responding to certain medications or treatment approaches, it does not necessarily mean that it is untreatable. In such cases, doctors work closely with the patient and try different treatments to find out which approach works best. It also depends on proper identification of the disorder, causes, diagnosis along with dosage & duration of medications & therapy. The doctor may prescribe antidepressants or antidepressants from different classes to see which is most effective. According to a 2015 study 52 , “Current approaches to managing TRD include medication augmentation (with lithium, thyroid hormone, buspirone, atypical antipsychotics, or various antidepressant medications), psychotherapy, and ECT (electroconvulsive therapy).”
12. Subsyndromal depression
Also known as subsyndromal symptomatic depression (SSD), it refers to a mood disorder where the sufferer with the depressive disorder doesn’t experience all the symptoms of MDD. as they have only a few of the symptoms and don’t typically qualify for a diagnosis of clinical depression, they are considered “subsyndromal”. They also may not meet the other criteria for MDD but are at high risk of developing severe depressive disorders. According to a 2000 study, “SSD is defined as a depressive state having two or more symptoms of depression of the same quality as in major depression (MD), excluding depressed mood and anhedonia.” It is crucial that the sufferer experiences the symptoms for over two week and experiences significant psychosocial dysfunction. The condition shares certain characteristics with MDD and dysthymia. Moreover, people with SSD are also prone to developing suicidal thoughts as well.
A 2012 study 53 found that SSD is a “relatively common condition.” It observed that in the United States prevalence was around 8.4% in the general population in a 12-month period. Moreover, the disorder was observed more in unemployed and unmarried women than in men. Common symptoms associated with SSD that can manifest on daily basis are:
- Depressed mood and sadness
- Lack of interest in activities
- Changes in appetite
- Weight loss or gain
- Insomnia or trouble sleeping
- Anxiety, irritability and restlessness
- Feeling inadequate, hopeless and guilty
- Suicidal thoughts
These symptoms are usually not as severe as other forms of depression and so it may not require a clinical diagnosis. SSD implies that this disorder is unable to meet the criteria for a proper diagnosis of existing mood or depressive disorder like MDD. However, the individual can experience recurring short episodes of such symptoms. Presently, it is categorized by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) as “other specified depressive disorder” with a “depressive episode with insufficient symptoms.” However, consulting a mental health professional and seeking treatment can help the person to function better in their daily life. As per research, treatment and prevention of SSD, MDD and dysthymia “are non-distinguishable.”
13. Recurrent brief depression (RBD)
This prevalent subtype is marked by depressive episodes that are intermittent in nature with severe clinical impairment and a high risk of suicidality. RBD “is a common affective disorder that compromises working capacity and activities of daily living as much as major depression,” explains a study 54 . It shares various features with MDD such as family history, age of onset, intensity of symptoms, longitudinal course of episodes and relation to somatic and psychiatric disorders. Typically, the symptomatic episodes last for around 2-7 days. However, episodes may occur about 6 to 12 times in a year which can then meet the diagnostic criteria for MDD. Due to insufficient symptoms, this mood disorder is categorized as “other specified depressive disorder”.
“The syndrome is defined by depressive episodes that occur at least monthly and last only a few days,” explains a 2014 study 55 . Regardless of the short duration of the episodes, symptoms can be severe and intense, which can impair the sufferer’s ability to function in daily life and cause suicidal thoughts. Common symptoms tend to include stress, hypersomnia, anxiety, restlessness and irritability. Approximately, 50% of patients with recurrent brief depression may also experience short bouts of hypomania. It can also be associated with bipolar disorder and personality disorders. Studies 56 have reported that RBD can be successfully treated with a combination of medication and therapy. Research 57 shows that the atypical antidepressant mirtazapine can help to reduce severity, duration and frequency of brief depressive episodes in RBD. Hence, mirtazapine can be an effective treatment option for RBD patients, suggest the researchers. Another study 58 found that sodium valproate treatment can also help to treat the disorder.
14. Mixed anxiety-depressive disorder (MADD)
“Mixed anxiety-depressive disorder (MADD) is a new diagnostic category defining patients who suffer from both anxiety and depressive symptoms of limited and equal intensity accompanied by at least some autonomic features,” explains a 2000 study 59 . Autonomic features refer to involuntary and uncontrollable physical symptoms as a result of a hyperactive nervous system. However, the symptoms experienced by the sufferers fail to meet the necessary criteria for the diagnosis of particular depressive or anxiety disorders. It has been observed that the symptoms tend to be unassociated with adverse and stressful life experiences.
Although the person may experience both depression and anxiety, neither of them is more dominant or severe to require a specific diagnosis. Even though the anxiety and depressive symptoms tend to be mild, it can impair a person’s ability to function in daily life. A diagnosis can be made when the sufferer experiences symptoms of both anxiety and depression and affects their quality of life, without hinting at an underlying anxiety disorder or major depressive disorder. The symptoms 60 of mixed anxiety-depressive disorder can cause significant distress as both conditions are experienced together. Hence, it is categorized as a separate psychological disorder. According to studies 61 , the symptoms tend to resolve within a year in about 50% of patients. But the “non-remitting patients are at a high risk of transition to a fully syndromal psychiatric disorder.”
Although the symptoms for mixed anxiety-depressive disorder tend to vary from one patient to another, following are the most common ones according to research 62 :
- Worrying excessively about different things
- Chronic sadness or low mood
- Fatigue or chronic tiredness
- Isolation or loneliness
- Difficulty concentrating
- Uncontrollable crying or tearfulness
- Changes in appetite, weight and sleep patterns
- Muscle pain or aches
- Loss of motivation and energy
- Low self-esteem or poor self-image
- Hopelessness and worthlessness
- Mental tension & distress
- Dry mouth
- Shortening of breath
- Hot flushes or cold chills
- Feeling light headed, faint or dizzy
- Suicidal thoughts or behavior
Studies show that MADD is one of the most common psychiatric diseases. But when left untreated, patients tend to have “an increased risk of significant distress at 3 months and a lower quality of life,” found a 2011 study 63 . However, effective treatment involving psychotherapeutic approaches and medications or a combination of both can help in recovery. Therapies such as cognitive behavioral therapy (CBT), exposure and response prevention therapy (ERP) and acceptance and commitment therapy (ACT) may be recommended by doctors. A professional may also prescribe medications, like antidepressants, anti-anxiety drugs or anxiolytic drugs (alprazolam).
Apart from the above mentioned types of depression, there are some other variations of depressive disorders, including –
- Minor depression (MinD)
- Catatonic depression
- Depressive disorder due to other medical conditions
- Melancholic depression
- Substance/medication-induced mood disorders
- Antenatal and postnatal depression
- Combined depression
- Other specified and unspecified depressive disorder
Recognizing what type of depression a person is suffering from is crucial as it can help in proper diagnosis and effective treatment. It is important that you consult a doctor if you can identify some or all of the symptoms of any of the types mentioned above. Regardless of the type and severity, depressive disorders are treatable. Hence, make sure to talk to a doctor, mental health professional or a therapist immediately, especially if you or someone you know is having suicidal thoughts. Recovery is possible with help and treatment.References:
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