Depression symptoms and types
Depression symptoms and types
Everyone has experienced feelings of unhappiness that could be associated with a life event. Is it illness or mood disorder?
About depression
Depression can be seen as a state of mood, as a special symptom manifesting itself in many different mental disorders, and as a clinical diagnosis. Occasional depressive mood experienced as low spirits, dejection, and sadness can be a normal reaction to disappointments, adversities, and losses and should be differentiated from depressive disorders.
Depression can begin at any age. The peak age of depression attack falls between age 15 and 24 years. If the onset of depression symptoms occurs after age 60 years, the condition is probably secondary to other medical causes – neurological (trauma, multiple sclerosis), endocrine, infectious, inflammatory disorders. A pervasive feeling of sadness that lasts for more than two weeks, and effects our general functioning is a sign of depression. Over a lifetime, one out of five Americans will experience a major depression.
Depression is a biological illness that affects behavior, thoughts and feelings. What causes depression? In the brain there are naturally occurring substances called “neurotransmitters.” The neurotransmitters that play a significant role in maintaining our mood are primarily “serotonin and norepinephrine”. When these neurotransmitters are in low levels, the symptoms of depression become clinically evident.
The types of depression
There are several kinds of clinical depression: adjustment disorders with depressed mood, bipolar disorder, cyclothymia, dysthymia, major depression, mood disorders due to a medical condition, postpartum depression, premenstrual dysphoric disorder, seasonal affective disorder, substance induced mood disorder. The main types are major depression, dysthymia, bipolar disorder.
Major depression is a combination of symptoms that interfere with the ability to work, study, sleep, eat, and enjoy pleasurable activities. Such symptoms of depression may occur only once but more commonly to happen several times in a lifetime. It is defined as a depressive episode that lasts for at least two weeks and includes at least five of the following symptoms: depressed mood, loss of interest or pleasure in all or almost all activities, significant weight loss or weight gain, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue or loss of energy, feelings of worthlessness, diminished ability to think or concentrate and suicide thoughts.
Dysthymia involves long-term, chronic symptoms that do not disable, but keeps one from functioning well or from feeling good. Many people with dysthymia some time also experience major depression symptoms during their lifetime. Dysthymic disorder is defined as a chronic disturbance of mood involving depressed mood for at least two years, during which the condition does not met the criteria for major depression. At least two of the following symptoms must be present: poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concentration or difficulty in making decisions, and feelings of hopelessness.
Bipolar disorder is characterized by cycling mood changes: severe highs (mania) and lows (depression). Bipolar disorder is often a chronic, recurring condition.
Two thirds of patients with depression in primary care present with somatic symptoms. These patients are difficult to diagnose, feel an increased burden of disease, rely heavily on health care services, and are harder to treat. Seasonal affective disorder is currently included as a specified of either bipolar or recurrent major depressive disorder. The cognitive and emotional symptoms are as in other types of depression but the vegetative symptoms are the reverse of classic depressive vegetative symptoms, namely increased sleep and increased appetite.
Depression symptoms and measurement of depression
Depression symptoms are characterized not only by negative thoughts, moods, and behaviors, but also by specific changes in bodily functions (e.g., eating, sleeping, and sexual activity). The functional changes are often called neurovegetative signs. Main symptoms are sleep disorder, interest deficit (anhedonia), guilt (worthlessness, hopelessness, regret), energy deficit, concentration deficit, appetite disorder, psychomotor retardation, suicidality. To meet the diagnosis of major depression, a patient must have four of the symptoms plus depressed mood or anhedonia, for at least two weeks. To meet the diagnosis of dysthymic disorder, a patient must have two of the six symptoms marked with an asterisk, plus depression, for at least two years.
In addition to the traditional interview, various methods have been developed for assessing and measuring depression and depressive symptoms, such as structured interviews, checklists, interview-based rating scales, and self-assessed rating scales. Some of these are specific for depression and depressive symptoms, while others are multidimensional. The Hamilton Rating Scale for Depression, the Zung Self-Rating Depression Scale and the Beck Depression Inventory are among the most frequently used self-rating scales measuring depressive symptoms.
