Depression

The terms depression and depress(ed) may refer to:

Psychology

• Major depressive disorder (also known as clinical depression or major depression), a specific diagnosis from the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association
  • Major depressive episode
  • Atypical depression, a cyclical sub-type of major depression where sleep, feeding and perception of pleasure are normal but there is a feeling of lethargy
  • Melancholic depression a sub-type of major depression characterized by an inability to feel pleasure combined with physical agitation, insomnia, or decreased appetite
  • Psychotic depression, a sub-type of major depression combined with psychotic or delusional perceptions
  • Depressive Disorder Not Otherwise Specified
• Depression (mood)
• Postpartum depression, a depressive episode occurring within a year of childbirth
• Dysthymia, a long-term low-grade depressive condition
• Adjustment disorder with depressed mood, previously known as "reactive depression"
• Seasonal affective disorder (SAD), a depressed mood related to the seasons
• Depression is the fourth stage of the Kübler-Ross model (commonly known as the "stages of dying")

Physiology

• Depression (physiology), a reduction in a biological variable or the function of an organ
• Depression (kinesiology), an anatomical term of motion

Other

• Depression (geology), a sunken landform
• Depression (economics), an economic downturn more severe than a recession
  • The Great Depression was a severe economic depression in the 1930s
  • The Long Depression was an economic depression lasting between 1873–1896, known at the time as the Great Depression.
• Depression (meteorology), an area of low atmospheric pressure
• Tropical depression (meteorology), a class of tropical cyclone
• "Depress", a song by Eyehategod from the album In the Name of Suffering
• "Depression", a song by Black Flag from the album Damaged

Types of Depression

Mild Depression While symptoms are usually less severe and less numerous in mild depression than moderate and major depression, they still have the ability to cause disruption and distress. Mild depression often goes undiagnosed because many people do not consider the symptoms to be 'bad enough' to discuss them with their doctor or family member/friend. According to The World Health Organisation, mild depression includes two of the first three symptoms and at least two others. - Two weeks of an abnormal depressed mood - Loss of interest or pleasure in activities that used to be enjoyable - Reduced energy, or feeling tired - Loss of confidence and self-esteem - Feeling guilty and unworthy - Recurrent thoughts of death or suicide, or any suicidal/self-harming behaviour - Reduced ability to think or concentrate - Agitated or slow movements - Disturbed sleep (not enough/too much/poor quality) - Change in appetite (increase or decrease) with weight change - Decreased libido - Unexplained physical symptoms

Mild depression may be felt as an ongoing constant state, called Dysthymic Disorder, or it may be a brief period of a few weeks. It may also be episodic and reoccur at varying intervals.

Accurately diagnosing depression when it is mild, and treating it effectively at this stage can prevent the condition from worsening. There are also a wider range of options to manage mild depression and prevent its reoccurrence.

Moderate Depression Moderate depression fits somewhere between mild and major depression. The characteristics of moderate depression tend to be more prominent and more enduring than those described for mild depression and are less severe and/or numerous than those experienced in major depression. People who experience moderate depression may find they have a reduced interest in normally pleasurable activities and simple things require real effort or just get neglected. Moderate depression can cause serious difficulties with social, work and domestic activities, and if left untreated, may lead to major depression. The World Health Organisation classifies moderate depression as including two of the first three symptoms and at least four others. - Two weeks of an abnormal depressed mood - Loss of interest or pleasure in activities that used to be enjoyable - Reduced energy, or feeling tired - Loss of confidence and self-esteem - Feeling guilty and unworthy - Recurrent thoughts of death or suicide, or any suicidal/self-harming behaviour - Reduced ability to think or concentrate - Agitated or slow movements - Disturbed sleep (not enough/too much/poor quality) - Change in appetite (increase or decrease) with weight change - Decreased libido - Unexplained physical symptoms

Moderate depression usually results in: - A detectable reduction in self confidence and/or self-esteem which can have a follow-on effect as we become less motivated and less productive as a result - People often start to worry about things unnecessarily, such as performance at work, even if they are managing to maintain their previous standards - People may be more sensitive and susceptible to feeling hurt or offended within personal relationships

Major (Severe) Depression Major or severe depression may include extreme feelings of depression, distress, agitation, uselessness and guilt. It is unlikely the person will be able to continue with work, social or domestic activities. The World Health Organisation classifies major/severe depression as including all of the first three symptoms and at least five others. - Two weeks of an abnormal depressed mood - Loss of interest or pleasure in activities that used to be enjoyable - Reduced energy, or feeling tired - Loss of confidence and self-esteem - Feeling guilty and unworthy - Recurrent thoughts of death or suicide, or any suicidal/self-harming behaviour - Reduced ability to think or concentrate - Agitated or slow movements - Disturbed sleep (not enough/too much/poor quality) - Change in appetite (increase or decrease) with weight change - Decreased libido - Unexplained physical symptoms Major depression usually causes severe enough symptoms for a change to be noticed by other people even if feelings are actively masked. A person with major depression will usually experience most of the symptoms above. Suicide is a distinct danger. While a person with major depression may be managing one moment, they can plummet very quickly into feelings of hopelessness and despair. It is common for people to feel that they are somehow responsible and 'to blame' for the way they are feeling. It is easy to believe that others are better off without them. It is vital that professional help and treatment is sought as soon as possible and that treatment is followed. As with all major illnesses, during major depression we need additional support on a daily basis in managing the symptoms and help with treatment. People with severe depressive episodes may also suffer from the following, although they are not very common: - Delusions - Hallucinations - Depressive stupor

Bipolar Disorder Bipolar Disorder involves switching between periods of both depression and mania. It is called Bipolar Disorder as people experience both poles: 'highs' and 'lows'. For this reason, in the past it has been called manic-depression. It is generally agreed that there are two different types of Bipolar Disorder: Bipolar I and Bipolar II. Bipolar I Disorder People with Bipolar I Disorder have periods where they meet the classification for major depression, then eventually their mood alters and they begin to experience the extreme opposite - increased energy and feelings of wellbeing. The major depression phase of Bipolar I can consist of the following: - Loss of interest and enjoyment - Reduced energy - Fatigue - Lethargy - Apathy - Depressed mood - Lowered concentration and attention - Reduced self-esteem and self-confidence - Guilt - Unworthiness - Becoming pessimistic - Diminished sleep and appetite - Ideas or acts of self-harm or suicide

The Manic phase of Bipolar Disorder consists of quite opposing symptoms: - A distinct increase in energy and activity - Impaired judgement - Lack of insight - Distractability - Hostile behaviour - Disjointed thinking - Feelings of wellbeing - Physical efficiency - Mental efficiency

While a person experiencing mania may appear more sociable and talkative, they may feel like they are losing control with all these extreme feelings. With Bipolar I, the person may also experience paranoia and hallucinations which modify their perceptions of the world around them. Bipolar II Disorder A person with Bipolar II Disorder will experience both ups and downs such as those with Bipolar I, and feel the same sense of depression. However, the important difference between Bipolar I and II is that the person experiences hypomania, not mania. Hypomanic symptoms include:

- Becoming more sociable - Feeling the constant need to talk - Being overfriendly - Experiencing a decrease in the amount of sleep needed

A person with Bipolar II Disorder will not have hallucinations or paranoid ideas. The manic feelings are less extreme in this type of Bipolar Disorder, however the impact on the person can be similar. The depression phase of both conditions is what causes the most impairment to life. This phase lasts longer than the manic or hypomanic phases and is considered to be the most distressing feature of Bipolar Disorder. Cyclothymia is a related condition, however Bipolar Disorder can improve within a number of years, while Cyclothymia is a chronic condition that can last for a longer time. The Bipolar II symptoms do not necessarily lead to a disruption in social or occupational environments, however they have the potential to negatively impact the life of those affected.

Seasonal Affective Disorder Seasonal Affective Disorder (SAD) is said to occur where depressed feelings change in response to the season. The amount of sunlight the person experiences during different periods has a great effect on their mood. The most common time of year for a person to experience this depression is in the winter time. According to the Diagnostic and Statistical Manual of Mental Disorders, the criteria for Seasonal Affective Disorder includes: - The person experiences a regular pattern of depressive episodes, which begin at a certain time of the year - The depressed mood also stops or changes at a regular time each year - It has lasted longer than 2 years - The person has experienced more seasonal types of depression than other types (major depression for example)

Sometimes people experience the reverse of this effect, having a depressive episode during summer and starting to feel better towards winter. This is known as summer SAD, and is quite rare. In some extreme cases of SAD the individual may also experience significant social withdrawal. Eventually, with the onset of spring the individual comes out of 'hibernation' and depending on circumstances improvement is almost immediate. The emotional difficulties that occur with depression also occur with SAD, however, instead of insomnia and lack of eating, people with SAD tend to sleep more and eat greater amounts of sweets and carbohydrates than normal during their depression period. In some people, the effect of SAD can be quite severe and bring about symptoms of depression that interfere with normal daily functioning. The good news is that it is usually treated with 'Bright Light Therapy' which has minimal side-effects. Sunlight entering through the retina stimulates the production of chemicals in the brain and appears to have an antidepressant effect. People who live at higher latitudes tend to have less sunlight and therefore experience higher rates of SAD. Australia receives a good amount of sunlight due to its position on the globe, and as such, SAD is rare in this country. SAD is also more prevalent in people who are younger and typically affects more women than men.

Postnatal Depression Postnatal Depression (or Postpartum Depression) is a condition that occurs soon after a woman has given birth. It can present the same as other types of depression, however, it comes about in response to the physical and social changes of giving birth and raising a baby. The severity of the depression can range from very mild and almost non-existent, to very severe and long-term. It is quite common for women to experience the 'baby blues', a short term feeling of tiredness and sadness in the first few weeks after giving birth. However, Postnatal Depression is different, and tends to last for longer than a few weeks, causing significant hardship for the mother at a significantly stressful time. The most common symptoms that women are likely to experience with Postnatal Depression include: - Lowered self-esteem - Lack of confidence - Guilt - Inadequacy - Negative thoughts - Pessimism, feelings that life is meaningless - Irritability - Tearfulness - Feelings of inability to cope - Sleeping problems - Lowered libido - Anxiety - Panic attacks - Heart palpitations - Loss of appetite - Difficulties in remembering or concentrating on things

Many factors contribute to the onset of Postnatal Depression. These include: Physical Changes Giving birth, easy or not, is a major experience for the female body and the sudden change in hormones affects the brain's chemical balance. The fact that there is a newborn child that needs attention also means that women are less likely to be able to get the sleep that they need. Broken sleeping patterns and exhaustion puts further strain on a new mother who may be dealing with the beginnings of Postnatal Depression. Emotional Changes The adaptation process that new mothers have to take is made increasingly harder by the fact that there is a newborn that requires care and attention. Recovery is made harder by underlying factors such as: broken sleep, changed relationship with a partner, loss of independence and the constant demands of the child that can sometimes become overwhelming for some women after childbirth. Social Changes The social stigma surrounding childbirth makes adjusting to this new addition extremely hard. A new mother may find herself losing contact with her friends while adjusting to a different lifestyle on one wage which can make the situation even harder. Previous Experiences Earlier life events may contribute to the susceptibility for Postnatal Depression. Women who have experienced poor parenting when they were young may be more at risk. Also, a history of abuse is often a factor that can predispose a woman to Postnatal Depression. Genetics and Environment It is unknown whether the environment (eg social changes and previous experiences) or genetics (eg the nature of the person) are more involved with the predisposition for Postnatal Depression. Both appear to be involved, so it is unlikely that there is a single cause for each case of Postnatal Depression.

External links

• Depression
• SSDI Guidelines For Depression