As with all mental illnesses, depression isn’t an easy-to-define condition, and there are lots of variations. We might describe ourselves conversationally as feeling ‘depressed’ if we’re a bit down, but medical depression is a formal term that covers a variety of depressive conditions – some very common and some relatively rare.
Labels aren’t always necessary, and they vary from country to country. But it can be helpful to know what to look out for.
Here are the main types of depression recognised by professionals.
1. Mild, moderate and severe depression
Depression is first diagnosed using a checklist of questions about things like energy levels, mood, appetite and sleep. The answers are scored numerically to help GPs categorise patients as mild, moderate or severe cases. These are by far the most common diagnoses.
‘Mild to moderate depression is usually treatable via Cognitive Behavioural Therapy (CBT) or talking therapy from a psychologist or counsellor,’ explains Emma Citron, Consultant Clinical Psychologist. ‘But if you’re deemed to have a more severe case you may be prescribed antidepressants.
‘If a low mood has lasted longer than two weeks, that’s the point to be going to the GP. It’s completely treatable and usually temporary.’
2. Postnatal depression (PND)
PND is a term given to depression that occurs after you have a baby. According to the Royal College of Psychiatrists, around 10 to 15 per cent of mums go through it, so it’s pretty common, and awareness is getting better all the time.
But it’s not just after the baby’s born that women are at risk.
‘Prenatal depression (during pregnancy) can also occur,’ warns Emma. ‘If you’re feeling low and tearful, don’t think it’s not real because you haven’t had the baby yet. There are huge hormone and chemical changes during pregnancy, and depression can kick in any time from conception onwards.’
Symptoms of PND are the same as regular depression, but if it’s severe you might find it difficult to look after yourself and your new baby. Family and friends are vital here so listen to them and seek help if you feel down.
3. Bipolar disorder
Sometimes referred to as ‘manic depression’, this causes extreme mood swings, from energetic mania to depression lethargy. ‘This is a serious form of depression that’s generally only treatable with medicine as prescribed by a psychiatric,’ explains Emma. ‘It’s often lifelong – one you really don’t mess about with.’
She continues: ‘It’s typified by manic episodes – behaviours such as running down the street with no clothes on, or anything that’s out of keeping for the individual concerned.
‘It can also be focusing on one thing or one part of life to an obsessive level. When thoughts take on an obsessive flavour, that’s when I start to worry.’
A bipolar diagnosis needs to be made by a psychiatrist, who your GP can refer you to, but it can take a few appointments to reach it.
4. Seasonal Affective Disorder (SAD)
SAD is commonly experienced in the winter months. ‘The symptoms are the same as regular depression,’ says Stuart Haydock, MSc Organisational Psychology Resilience Lead, from Bupa UK.
‘It differs from other forms because it occurs during a specific time of year. Your symptoms will usually begin in early September and may be triggered by low levels of daylight as autumn sets in. Your low mood may then disappear in the spring, usually around April, as the amount of daylight increases.’
Treatment can be tricky because of the timeframe, but talking about how you feel and self care can be very effective. In more extreme cases, CBT and antidepressants are used.
Also known as persistent depressive disorder (PDD) or chronic depression, dysthymia is a fairly consistent low mood that lasts for two years or more.
‘Dysthymia is a funny one. It’s “mood variation” but everyone’s moods go up and down, right, so how do we know when it’s not normal?’ says Emma. ‘It can be hard to diagnose.’
She explains that it’s often more likely to be recognised by those close to you. ‘You might not always notice when it’s becoming a problem but others do,’ says Emma. ‘You might be more irritable, more withdrawn and people might say they’re worried about you. Be open minded and take it seriously. Perhaps even take them with you to the GP.’
As it’s long-term, dysthymia can feel like your ‘normal’ but like other types of depression, it’s entirely treatable and very worth seeking help.
6. Psychotic depression
NHS Choices defines psychotic depression a ‘severe clinical depression with psychosis’. Psychosis symptoms include hallucinations and delusional thinking.
This is relatively rare but very dangerous, as it comes with an increased risk of suicide.
7. Atypical depression
Despite its name, atypical depression is actually quite common.
According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, patients suffering from ‘atypical’ depression will have general depression or dysthymia symptoms, but unlike those with ‘typical’ depression, they’ll experience ‘an improved mood when positive events happen’.
8. Mixed depression with anxiety disorder
Anxiety often goes hand-in-hand with depression, and a mixed diagnosis is not uncommon, even though anxiety is not strictly a type of depression.
‘Anxiety is really the flip side of the same coin,’ says Emma. ‘It can manifest in many of the same symptoms as depression – sleep and appetite problems, an inability to concentrate, or a lack of motivation. They can be difficult to separate.’
Symptoms of anxiety include shortness of breath, a racing heart, sweaty palms, fear and uneasiness, and sometimes panic attacks. Treatment is actually very similar to depression, so this diagnosis isn’t as complicated as you might think. CBT and some antidepressants have been found to be very effective for anxiety sufferers too. Again, speak to a doctor about the best course of action for you.
‘Mental health is something that affects us all every day,’ Emma reminds us. ‘It’s not just something that happens to other people.
‘It’s so important to remember that depression is absolutely treatable. And just like a physical illness, the earlier you catch it the better.’
If you are experiencing feelings of depression, always speak to your GP for help and advice. You can also visit the Mind website.