November 21, 2014

Types of Depression

There are many types of depression; however, due to the trying circumstances that many find themselves in today; I thought it might be appropriate to discuss Situational Depression vs Clinical Depression. There are other types of depression, however; these two classifications encompass most of them.

Let’s face it we are in the toughest economy that most of us have ever experienced. Every news channel that we turn to shows the world on fire, riots, revolutions, real estate is at an all time low, unemployment at record highs; who doesn’t have some anxiety or depression? During these stressful times it seems that we are seeing all types of depression manifest. Getting enough sleep, exercise, and a good diet are critical. These tense circumstances can trigger all of the types of depression.

There are Many Types of Depression Brought on by Differing Circumstances Situational Depression versus Clinical Depression

How do we determine the types of depression and the difference between situational depression (SD) and clinical depression (CD)? This is a very important question because the cause of our depressive state will determine the therapy. Both situational depression and clinical depression share a common bundle of symptoms. Feeling the blues, loss of appetite or increased appetite, change in sex drive, trouble sleeping, lack of energy, apathy, problems concentrating, feelings of guilt, physical pain, agitation, feelings of hopelessness. These are all symptoms that both situational and clinical depressive disorders share. Distinguishing symptoms that are more closely associated with CD are suicidal thoughts, symptoms occurring for no apparent cause, symptoms that are not a commensurate or appropriate response to the stress; and a family history of depression. These are indicators that the depressive disorder may be clinical depression.

Diagnosing the Types of Depression viz. Situational vs Clinical is Critical to a Depression Treatment Plan and Good Prognosis

Generally we will consider the severity and number of symptoms of depressive episode in determining the cause. This can be a bit tricky because both disorders can entail a bundle of severe symptoms which will vary from person to person depending on the trauma or stress in their lives. As a general rule clinical depression is much more severe and prolonged, clinical depression causes more impairment in functioning and doesn’t tend to go away once the stressor is removed. Also the more stress that one has with difficult situations, the more likely the person is of developing or manifesting a clinical depressive disorder. Depression accompanied with psychotic features is also a sign of major depression, or possibly schizoaffective disorder. A thorough psychiatric evaluation will often reveal the causes of the psychosis.

Situational Depression Triggers: Typically major stressors in life will bring on situational depression such as a divorce, death of a loved one, loss of a job, the economy, or any factors that will negatively affect your life. These can be very debilitating and usually trigger this type of depression. When these triggers are present a practitioner must look at the length of time of the symptoms, the number and type of symptoms; and the family history of the individual. The length of time for situational depression symptoms will usually coincide with the duration of the stressful events. Again this is not an exact science in making the distinction between situational depression and clinical depression. Situational depression is quite normal and these stressors should bring on feelings of angst, the blues, and other symptoms. Emotionally healthy people grieve over these situations. Situational depression will typically remit once the stressors are no longer present or it will decrease as one learns to cope with the situation.

Clinical Depression Triggers: Sometimes the major stressors in life will trigger clinical depression; when this occurs, making the distinction between situational depression and clinical depression can be a challenge. We may look at the symptoms to see if they exist long after the stressful events have ceased. Again suicidal thoughts are a telltale sign of clinical depression. Sometimes a patient responding positively to an antidepressant will confirm that the disorder is one of clinical depression because the medication is treating an imbalance of chemicals which are the underlying cause of clinical depression. Chemical imbalances are typically not associated with situational depression; however, some genetic studies are showing that exposure to long periods of trauma or stress might turn certain genes on or off, or cause them to mutate and affect the chemistry of the brain. We have discovered that the more stressors or traumas that one has had, the more vulnerable one is to developing CD; especially in those who are genetically predisposed to clinical depression.

Clinical depression is most evident when a combination of 4 or 5 of the aforementioned symptoms occur without any apparent traumatic or stressful events present. Additionally suicidal thoughts go hand in hand with CD; however, this doesn’t entail that every individual with clinical depression has suicidal thoughts. The inability to enjoy almost any aspect of life is another sign of CD. A family history of depression is an indicator of CD since we are quite sure that depression is a genetic illness. Genetic illnesses don’t entail that they will always be passed along but do increase the risks. Genetic illnesses can also develop in early life while the brain is still developing. Most often CD will last for long periods of time but can subside within 6 months to 1 year left untreated. If someone has CD and they respond favorably to antidepressant medication, this might also be a good indication that their depressive disorder is caused by an underlying chemical imbalance instead of a stressful situation. Medication is very important in treating depression because when left untreated, CD can cause brain cell death and a reduction in the size hippocampus region of the brain. Studies have shown that the SSRI antidepressants have a catalyst effect on stem cells in the brain transforming into mature brain cells in the hippocampus. Depression left untreated can also cause memory issues or early unset Alzheimer’s.

Situational depression is always accompanied by traumatic events or stressful situations and will typically be short lived or continue with the presence of the causative events. Situational depression can be very debilitating and should be treated, especially when it interferes with everyday tasks, relationships, and ordinary functioning. Often the best treatment for SD is exercise, removing the stressors in your life, changing your worldview, and diet; just to mention a few. When SD persists for a period of time which may be as few as 2 weeks, and the symptoms don’t appear to be subsiding, seek help. These symptoms may be the unset of CD, the sooner you begin therapy the greater the chances are of precluding a severe CD episode. So as you can see it is sometimes difficult to tease apart the type of depression one has. Therefore, it is necessary to be evaluated by a trained professional that can determine whether or not a medication is indicated for your type of depression. Different types of depressive disorders will each require different treatment plans. Each of the types of depression will also have different mechanisms that bring about the depressive episodes.

If think you have one of these types of depression and you are experiencing 4 or 5 of the symptoms mentioned, don’t panic! Life is very difficult. Paying close attention to the economy, job market, political events, and international crises is going to give all of us some distress. Keep watch over your emotional well being, eat well, exercise, and take a break from the news. If these symptoms persist beyond the alleviation of the stressors or don’t get better, if you have a family history of depression, or you are having suicidal thoughts; please seek help immediately. The antidepressant medications today have efficacy rates over 70% even with the first one tried and most of the time they are well tolerated. The goal is to find the appropriate medication for each individual patient, such that, the person doesn’t even know that they are taking the medication except that it is taking away all of the person’s symptoms of depression. The goal is to eradicate all of the patients symptoms, thus putting them in complete remission. I know that it can be achieved because I have seen it many times. There is much hope for you too. If you are seeking a qualified psychiatrist in Scottsdale or Phoenix psychiatrist, please call my office. Depression treatment is a large part of my practice and is very successful.  Read more on other types of depression

this article on the types of depression is for informational purposes only and not for diagnosing or treating any medical condition
If you found this helpful, please share it online!