Depression Types, Ways to Cope with Depression & Treatment Options
There are many different types of Depression. Depression is not just the typical emotion of sadness (an emotion that we all experience), depression is more complex. Depression is also one of the most common mental health diagnoses in adults in the U.S. In 2021, an estimated 14.5 million U.S. adults ages 18 and older had at least one major depressive episode with severe impairment just during that past year (5.7% of all U.S. adults) per the National Institute of Mental Health.
Also, According to the National Institute of Mental Health:
- The prevalence of adults with a major depressive episode is highest among individuals between the ages 18 and 25.
- 8.7% of women have depression.
- 5.3% of men have depression.
Therefore, if Depression is so common, why is there still such a stigma? Why do most people still not know a lot about Depression, including the best treatments? If you want to learn more about Depression, you are in the right place.
First, what is Depression? What constitutes a “Major Depressive Episode”? Depression is a cluster of symptoms, occurring most of each day, for at least two weeks. You must have at least five of the symptoms at once. Another requirement for the diagnosis is that these symptoms have to be negatively interfering with your life and cause you distress. Depression symptoms include and affect your emotions, thoughts, physical sensations and functions, and behaviors.
Cognitively with our thoughts, we typically see a diminished ability to think or concentrate, indecisiveness, more negative self-talk, and recurrent thoughts of wanting to die or kill yourself. In rare severe cases of Depression there can be Psychosis (hallucinations, delusions, reality not intact).
Emotionally we often see a depressed mood or numb/empty, loss of interest or loss of pleasure in all or almost all activities (e.g. in hobbies and loved ones just don’t bring you the same joy they once did), feelings of worthlessness and/or inappropriate guilt, helplessness, hopelessness. Physically, people often appear agitated/restless or appear slowed down, have weight gain or loss (not intentional), energy loss/fatigue, or effects on libido. Behaviorally we often notice changes in eating – eating less (not trying to diet) or eating more, changes in sleep – sleeping less/insomnia and/or interrupted sleep, or sleeping more, difficulty doing self-care, difficulty working and/or going to school, difficulty doing tasks, and difficulty socializing.
If you are currently experiencing a major depressive episode, and if your symptoms are not better described by a different type of Depression or diagnosis, you can be diagnosed with Major Depressive Disorder (MDD), Single Episode. However, if you have had more than one Depressive Episode in your life it is then classified as Recurrent Episode.
This type of Depression is usually assumed to be due to chemical imbalances in Serotonin, Norepinephrine, and/or Dopamine. This is why this type of Depression is usually treated with SSRIs (Selective Serotonin Reuptake Inhibitors), SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors), Atypical Antidepressants, and/or Mood Stabilizers.
There are also other types of Depression that have to be negatively affecting your life and causing you distress in order to be an actual diagnosis. Some of these types of depression, their believed causes and treatments include:
– Dysthymia/Persistent Depressive Disorder – a more mild but chronic Depression. It is a Depressed mood, most of the day, for more days than not, for at least 2 years. However, we don’t usually see the worthlessness, excessive guilt, suicidal ideation, loss of interest, and restlessness or slowed down movements that we would see in Major Depression.
– Bipolar Type 1: To be diagnosed with Bipolar Type 1: you have to have had at least one Depressive Episode in your life and at least one Manic Episode in your life – also a cluster of symptoms lasting for at least one week. Examples of Depressive Episodes include: inflated self-esteem, not sleeping for days, not tired, more talkative, thoughts racing/flight of ideas, distracted, agitation, very goal-focused and an increase in goal-related activities, and an excessive involvement in risky behaviors. Bipolar Type 1 can also include delusions and/or hallucinations and folks usually need to be hospitalized for safety and stabilization.
– Bipolar Type 2: To be diagnosed with Bipolar Type 2: you must have had at least one Depressive Episode in your life and at least one Hypomanic Episode in your life (also a cluster of symptoms lasting for at least four days. Same symptoms as Mania but decreased need for sleep isn’t as severe and no delusions and hallucinations. These symptoms are usually milder than when in a Manic Episode. Bipolar is also believed to be neurobiological and imbalances in chemicals. Bipolar is usually treated with some type of Depression medication mentioned above plus a mood stabilizer and/or anti-psychotic medication.
– Grief: The loss of someone or something involves the feeling of grief. Mourning can look like Depression and can lead to Depression. Complicated Grief diagnosis is persistent, intense, and debilitating grief past 12 months of a loved one passing away.
– Perimenopause/Menopause: Often feelings and symptoms of Depression may occur. This is believed to be due to hormonal changes.
– Premenstrual Dysphoric Disorder (PMDD): Feelings and symptoms of Depression may occur. You would have at least five of the following systems before and the first few days of your menses during most of your menstrual cycles. Examples include: mood swings, increased sensitivity to rejection, irritability/anger/more conflicts, depressed mood/hopelessness, anxiety/tension/keyed up, feeling overwhelmed/out of control, difficulty concentrating, fatigued/lethargic, loss of interest in activities, change in appetite, change in sleep, and physical symptoms that you usually see with PMS. This is believed to be due to hormonal imbalances and/or sensitivity to hormonal shifts. PMDD is typically treated with some type of hormonal treatment i.e. birth control and/or an anti-depressant medication (like the ones listed above).
– Post-Partum Depression: This is believed to be due to hormones, stress, and lack of sleep/exhaustion. This is different than the normal first two weeks post-birth “Baby Blues.” This is not feeling like yourself longer than the first two weeks through six months post-partum. There is a lot of negative self talk/shame/worthlessness, feeling empty/numb or overly sad, having difficulty bonding with the baby, loss of interest in things, exhausted despite if you were able to get sleep or not able to go to sleep even when you get the chance to, appetite changes, excessive inappropriate guilt, and/or suicidal thoughts. This specific Depression diagnosis is typically treated with some type of hormonal treatment i.e. birth control and/or one of the anti-depressants listed above. Building support for the post-partum parent is also very important.
– Seasonal Affective Disorder: (SAD) is essentially Depression in the winter due to the lack of Vitamin-D. Seasonal Affective Disorder is common in the state of Ohio. Doctors will typically prescribe a Vitamin-D supplement and/or recommend Light Therapy, in addition to an anti-depressant medication.
– Thyroid Issues: Hypothyroidism (underactive thyroid/low thyroid hormone levels) can cause or include Depressive type symptoms. This is treated with Thyroid specific medications, usually by an Endocrinologist.
– Substance Use Disorder induced Depression – This disorder is due to the use of a substance/substances and/or the withdrawal from substance/substances. It is difficult to accurately diagnose and treat the specific type of Depression when substances are being used. 30 days of abstinence are highly recommended, done in a safe and supported way.
– Depression caused by or a symptom of a Major Medical Condition: For instance, Depression after a stroke, Depression with Parkinson’s Disease, or Depression with Huntington’s Disease.
–Untreated/Unmanaged ADHD: Often, Depression symptoms occur and vulnerabilities in those with untreated/unmanaged ADHD (attention Deficit Hyperactivity Disorder).
– PTSD: Depression symptoms may also occur and vulnerabilities in those with untreated/unmanaged trauma disorders i.e. PTSD (Post-Traumatic Stress Disorder).
– Situational Depression: Symptoms may be based on the stress of the situation and how the situation is interpreted. A type of Situational Depression is Burnout. Burnout can look like Depression and may lead to Depression. This happens to about 70% of people who experience Burnout. Burnout is from chronic stress with something you are doing a lot of e.g. work stress due to long hours, heavy workload, lack of support, and/or unclear expectations. Burnout can cause emotional exhaustion, reduced productivity and performance, feeling detached, physical symptoms e.g. headaches, insomnia, fatigue.
– Genetic Predisposition: There is research stating some of these Depression Diagnoses have a genetic predisposition and/or causes.
Ways to Cope with Depression:
- Self-care (especially hygiene i.e. bathing/showering and putting on clean clothes/getting out of your PJs)
- Any movement i.e. stretching, walking, just getting out of bed every hour or off the couch once an hour
- Getting around 8 hours of sleep a night – no more, no less (working on sleep hygiene)
- Avoiding all substances
- Mindfulness
- Aromatherapy
- Hobbies/engaging in things you enjoy even if it isn’t bringing you joy in that moment due to the Depression
- Utilizing your supports/any connecting with others/socializing even if the Depression doesn’t want you to
- Acceptance skill
- Taking things moment by moment
- Embracing your emotions
- Externalizing and challenging your thoughts
- Journaling
- Setting and working towards small attainable goal
- Routine
- Rewarding yourself
- Problem solving skill – changing what you can/controlling what you can
- Reminding yourself of the causes of feeling this way and reminding yourself it is temporary
- Go to your nearest hospital if feeling unsafe
- Numbers to call or text when feeling unsafe
- Call and Text 988 For Ohio
- National suicide prevention line: CALL 1-800-273- TALK (8255)
- Call Franklin County Prevention HOTLINE 614-222- 5445
Ways to Treat Depression:
Other ways to treat Depression include utilizing types of psychotherapy that have been found by research to effectively improve Depression symptoms. Some of these psychotherapies include: Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT) skills, Radically Open Dialectical Behavioral Therapy (RO-DBT), Acceptance and Commitment Therapy(ACT), and Interpersonal Therapy (IPT).
Other medical treatments for Depression Include: Nutrition Counseling, supplements for any vitamin and mineral deficiencies that are causing a lower mood and lower energy, Ketamine Treatment, Trans-Magnetic Stimulation (TMS), or Electroconvulsive therapy (ECT).
If you or a loved one are suffering from any type of depression, we have numerous therapists that have experience with therapy for treating depression and other mental illnesses as well as psychiatric medication management prescribers on staff to help treat your depression with medication. We invite you to reach out for help so we may partner with you on your mental health journey.
*Article written by Asia Place, LPCC-S, CDCA (Columbus Behavioral Health therapist in Dublin, Ohio)
