TYPES OF DEPRESSION, SYMPTOMS, AND TREATMENTS - ARTE - 2025

There are different types of depression based on different factors such as its duration, severity, or symptoms. It is a disease that can affect anyone, from children or young people to older adults.

So much so that the WHO estimates that 350 million people throughout the world suffer from some of the types of depression that exist, with women being the most likely to suffer from it.

In the 4th century BC, Hippocrates already referred to states of mind characterized by dejection and sadness and called it melancholy. It was started from the idea that mood disorders were due to an imbalance in the body's humors (black bile, yellow bile, blood and phlegm).

This concept was maintained until the nineteenth century and is considered the antecedent of current theories that explain mood disorders, including depression.

Depression is one of the disorders that produces the greatest psychological discomfort at present, being probably the one that generates the most patients in clinical practice.

The word depression is used frequently to define a state of mind but, contrary to popular belief, the feeling of sadness is not enough to diagnose depression.

Main types of depression

- Major depressive disorder

This disorder is the one suffered by people who have suffered or are suffering from a major depressive episode. Two subtypes are distinguished:

• Major depressive disorder, single episode: if a single episode occurs.
• Major depressive disorder, recurrent episode: if there has been at least one other major depressive episode in life.

In order to make a diagnosis of a major depressive episode, five or more of the following symptoms have to appear over a period of two weeks. And at least one of these symptoms has to be depressed mood or loss of interest or ability to pleasure:

1. Depressed mood most of the day and almost every day.
2. Marked decrease in interest or in the capacity for pleasure in all or almost all activities, most of the day.
3. Significant weight loss without dieting, or weight gain, or loss or increase in appetite almost every day.
4. Insomnia or hypersomnia every day.
5. Psychomotor agitation or slowing almost every day.
6. Fatigue or loss of energy almost every day.
7. Excessive or inappropriate feelings of worthlessness or guilt.
8. Decreased ability to think or concentrate.
9. Recurring thoughts of death.

In addition, these symptoms cause clinically significant discomfort or deterioration in social, work or other important areas of the individual's activity.

In turn, within the major depressive episode we can find different subtypes. This division has been made with the aim of proposing a more specific intervention and treatments based on each case.

Catatonic type

This form of depression is very rare, but when it appears its main characteristics are the motor alterations that accompany it.

These alterations may consist of immobility for a period of time or strange and sudden movements. When this subtype appears, it is usually accompanied by episodes of mania, that is, in bipolar disorder.

Melancholic type

The main symptom in this case is a general loss of pleasure and a lack of response to stimuli that have usually been considered pleasant. This symptom is known as anhedonia.

In addition, patients who suffer from it usually notice a worsening of their mood in the morning, they wake up early and due to motor alterations such as slowing down or agitation of the body or part of it.

Atypical type

Unlike the previous one, it is characterized by a high number of responses to stimuli. It is accompanied by a very high level of anxiety.

Some of the most characteristic symptoms are an increase in appetite, weight and the need to sleep for many hours.

Postpartum type

This episode can appear in women after giving birth. Symptoms appear in the days after delivery or even a year later.

In addition to the usual characteristics of the depressive state, other peculiarities appear, such as the feeling of fear of being alone with the baby and / or the inability to take care of herself or the newborn. Hormonal alterations play a fundamental role in the appearance of this subtype

Seasonal type

The main characteristic is that both the beginning and the end of the episode coincide with a certain time of the year. They generally begin in autumn or winter and remit in spring, although they can occur at other times.

- Dysthymic disorder

The main difference between this disorder and the previous one is that the symptoms are less severe but more sustained over time, at least two years.

The main symptom that appears is a sad state of mind practically daily and that is maintained for at least the two mentioned years. In addition there are two or more of the following symptoms:

1. Weight loss or gain.
2. Insomnia or hypersomnia.
3. Lack of energy or fatigue.
4. Low self-esteem.
5. Difficulty concentrating or making decisions.
6. Feeling of hopelessness

In the two years that this state of mind is maintained, there cannot be a period of more than two months in which the symptoms have not appeared. If so, dysthymic disorder could not be diagnosed.

In addition, these symptoms cause significant discomfort in the person who suffers them or social, work or other important areas of the individual's activity deterioration.

- Unspecified Major Depressive Disorder

This category includes depressive disorders that do not meet the criteria for inclusion in the other categories. Within this type of disorder the most frequent are:

Premenstrual dysphoric disorder

It refers to depressive symptoms such as markedly depressed mood, significant anxiety, marked affective lability, loss of interest in activities, etc. that usually appear the last week of the menstrual cycle and disappear in the first days of menstruation.

To be diagnosed, these symptoms must have appeared in the majority of menstrual cycles in the last year.

They also have to be serious enough to significantly interfere with work, studies or any area important to the person.

Postpsychotic depressive disorder in schizophrenia

It refers to the appearance of a major depressive episode exclusively in the person suffering from schizophrenia. More specifically, this episode usually appears in the residual phase of schizophrenia.

Minor depressive disorder

It refers to cases that meet the criteria for duration (that is, symptoms appear for two weeks) but do not add up to the five symptoms to diagnose a major depressive disorder.

Recurrent brief depressive disorder

These are depressive episodes of very short duration (between two days and two weeks) that appear during a year with a frequency of at least once a month.

It is important to distinguish if these episodes are associated with menstrual cycles, in which case premenstrual dysphoric disorder would be diagnosed.

- Depression from a duel

After the loss of a loved one, symptoms very similar to those of a major depressive episode appear: anxiety, emotional daze, and denial.

Some people, after the loss, need immediate psychological treatment, as their symptoms cause them such serious discomfort that they cannot continue with their life.

However, the natural process of grief usually resolves in the first few months. Even if some people continue to be afflicted for a year or more.

After the first year, the chances of recovering from a grief without specialized treatment are considerably reduced. In these cases, a normal grieving process turns into disorder.

The most frequent symptoms in this pathological grief are intrusive memories and painfully strong longings for the loved one, as well as the avoidance of people or places that remember the loved one.

Depressive symptoms

People with depression present a series of symptoms that can be grouped into five main categories:

Mood symptoms

Often the basic symptom of depression is deep sadness. But in some cases sadness can be replaced by irritability.

In the most severe depressions, the mood is characterized by an inability to feel, an affective anesthesia is experienced. Other symptoms that appear frequently are dejection, sadness, unhappiness, nervousness, anguish or anxiety.

Motivational and behavioral symptoms

People with depression often experience the so-called "triple A depressive": apathy, apathy, and anhedonia.

These symptoms are related to a general state of behavioral inhibition that in the most severe cases can manifest itself with the generalized slowing of speech, motor responses, gesture, etc. In extreme cases, there may even be a state of motor paralysis.

Cognitive symptoms

In this category, two main groups can be distinguished: There is a decrease in the person's cognitive abilities, such as memory, attention, concentration, mental speed, etc.

On the other hand, cognitive distortions appear, that is, errors in the interpretation of reality, about their environment, the past, the future and their own person.

Symptoms such as delusions of doom or catastrophe, as well as auditory, defamatory, or accusatory hallucinations may come to light.

Physical symptoms

The most common physical symptoms are: sleep disturbances (usually insomnia but hypersomnia may also occur), changes in appetite and weight (by default or by excess), fatigue, decreased activity, aches and pains bodily (headaches, abdominal pain, nausea, vomiting, diarrhea, dizziness, cardiorespiratory problems, etc.) and decreased sexual desire.

Interpersonal symptoms

Social relationships are often completely neglected. According to some research, 70% of people who suffer from depression report having lost interest in the people around them.

They are usually isolated because in addition to the loss of interest on their part, the discomfort they suffer and transmit often causes rejection by others.

Treatment for depressive disorders

Depression, along with anxiety, are the disorders that are most frequently treated in the psychologist's office.

For this reason, there are numerous studies and advances in its treatment. Today we know multiple and varied techniques to deal with it and in most cases a satisfactory result is achieved.

At present, within psychological treatment, three types of therapy stand out that have proven to be more effective: behavioral treatment, cognitive treatment and interpersonal therapy.

The duration of treatment will be longer or shorter depending on the type of therapy, the severity of the symptoms and the progress that the patient makes outside the consultation.

In any case, it is important to bear in mind that depression is a disorder that generates deep discomfort in the person who suffers from it.

In addition, they are not always understood by the people around them, since they tend to downplay the causes that have led to depression. In these cases it is very important to consult with a mental health professional.

References

1. American Psychiatric Association (2002). DSM-IV-TR. Diagnostic and Statistical Manual of Mental Disorders.