This blog will be looking at the basics of depressive disorders to help build general understanding and awareness of the different forms of depression. Depression affects over 21 million adults in the US and 17% of adolescents ages 12-17. Rates are actually expected to be higher in adults and adolescents as it often goes unreported. Raising awareness of what Depression is and what it may look like can help those get the support they need.

Depression is not just feelings of sadness- it affects one’s ability to function in their daily life and negatively impacts their overall well being. Depression is physical as much as it is psychological. It also impacts our emotional, cognitive, and physiological functioning.

Depression is often thought of through the lens of sadness, but it can actually present as numbness or irritability, especially in adolescents. It can also have atypical features. The person that “lights up the room” with their personality can also be struggling with severe depression.

Many individuals with depression describe a “fog”, like their brain is working differently. Depression takes over our brain and can alter our thinking into noticing only the negative aspects of things, leaving us feeling hopeless and worthless, despite our current life circumstances. Also individuals with Depression often feel physical pains like headaches, muscle aches, digestive issues, as well as increases in pre-existing pains. There can also be some form of anxiety present. Unfortunately, the combination of elevated anxiety and depression can lead to an increased risk of self medicating habits like drinking and substance use as well as an increase in suicidal thoughts and behaviors. This is one of the reasons working with a professional to help with Depression can be so important.

Types of Depression

The most commonly thought of types of Depression are forms of Unipolar Depression, meaning that the depressive episodes DO NOT occur with any forms of manic or hypomanic episodes.

Manic episode- at least 1 week of symptoms that significantly affect one’s functioning (socially, occupationally, etc). These symptoms must differ from the individual’s normal behavior and can include impulsivity, irritability, grandiose behavior, decreased need for sleep, racing thoughts, increasingly talkative, rapid speech, distractibility, motor agitation, and an abnormally elevated or irritable mood.

Hypomanic episode is a milder form of mania that does not significantly impact one’s functioning (socially or occupationally) and only needs to occur for 4 days.

If symptoms of depression did occur with manic or hypomanic episodes, then that would be a form of Bipolar Depression, which is a separate category of disorders.

To receive a diagnosis for depression, one’s symptoms must cause significant impairment in the functioning and quality of their life. Symptoms also have to meet certain durations and criteria for each type of diagnosis. Your mental health provider would be able to evaluate you for these criteria.

You can learn more about Seasonal Affective Disorder in my blog here:

Chronic Depression

Chronic Depression is an inflammatory illness. It can cause changes in the brain’s functioning as well as its structure.

In the brain, cortisol is an anti-inflammatory hormone that is meant to calm our stress response as quickly as possible. When a brain is chronically stressed, meaning the stress response is constantly activated as it is with chronic depression, it begins to ignore the natural functioning of cortisol. This can lead future cortisol releases to begin to cause inflammation instead of relieving it.

Risks of Depression

All mental illnesses can have biopsychosocial origins, meaning there are biological and environmental influences in their expression. So the body we are born into and the experiences that we have create a foundation for the expression of mental illness. The most common risk factors are family mental health history, childhood abuse or maltreatment, chronic social prejudice, and substance use.

Genetically, we know that there is a threefold increase in risk of developing Depression if a biological parent or biological sibling also have Depression. Physiologically, we know that having chronic health conditions and chronic pain also increases one’s risk of developing Depression. Environmentally, a higher ACES (Adverse Childhood Experiences Scale) score signifies a higher risk of Depression. ACES criteria include childhood traumatic experiences, abuses, and neglect. Chronic trauma and stress, at any age, can also increase risks for Depression. Finally, substance abuse can also increase risks of Depression.

Getting Help

Treatment can include a combination of interventions like medication through a psychiatrist and therapy, such as Cognitive Behavioral talk therapy with a therapist. Other forms of services from mental health professionals can be beneficial as well, such as neurostimulation therapies for treatment-resistant depression.

It’s important to also prioritize what individuals can seek help with on a daily level, such as building selfcare. This would look like working towards healthier routines for sleeping, eating, being active, socializing, and reducing substance use. All of these areas can be incredibly hard to maintain during episodes of Depression, which is why all goals should start small and be sustainable. Working with a mental health professional can help you approach any of these areas compassionately and realistically.

Suicide hotline- call or text 988 (lines are open 24 hours a day/7 days a week)

Veterans hotline- text 988 and then press 1 or you can text 838 255

Call 9-1-1 for emergencies related to a suicide attempt

For therapists or psychiatrists check your local areas for providers in your network or call your insurance provider for a list of providers in your network.

psychologytoday.com can also help you narrow down providers in your area based on specialty and insurance

Depression and Bipolar Support Network- http://www.dbsalliance.org/